A framework for nursing, midwifery and care staff

Susan AitkenheadHead of Nursing, NHS England 22 June 2016

Development: built on previous learning

Engaging our stakeholders

July – September 2015Extensive engagement

Wide consultation, events, engaging with stakeholders across the sectors and populations

Gathering input and academic debates

October To 6 November

Collating and assessing feedback

Reviewing feedback

NovemberCo-drafting Think Tank Twitter chat pre-CNO Summit

Review of draft at

December CNO

Summit

Further re-engagement

and testing development

Dec - Jan

Post-Summit re-shaping

Post-Summit Twitter chat

Virtual feedback group

Editorial Board

External editorial ‘eye’

18 May 2016

Launch of completed working version

18 May 2016 Launch Total number of tweets using the hashtag: #Lead2Add Estimated total reach: 3,849,080 Live stream had 1170 live views and watched live at several

events throughout the country

Co-production approach: cross-sectoral

Prevention

Empowering PatientsEngaging

Communities

New Models of

Care

Local Leadershi

pAligned National Leadershi

pModern

Workforce

Exploit Info.

Revolution

Use of Innovation

Drive Efficiency

Aligned to FYFV

Positioning all nursing, midwifery and care staff as leaders…

Meeting the challenges of today;

And influencing the health and care landscape of the future

• Nursing, midwifery and care staff form the largest proportion of the health and care workforce and work with individuals and communities of all ages and across all sectors;

• Evidence shows that new models of care lead to cost-effective, people-centred services with better outcomes, according to Health 2020 (World Health Organisation 2014);

• However, Health 2020 also warned that the work of nursing, midwifery and caring staff is still undervalued.;

• Leading Change, Adding Value gives England’s nursing, midwifery and care staff a new opportunity to demonstrate the beneficial outcomes and impact of our work.

Leading Change, Adding Value

• Focus on activity that creates ‘high value’ and having the courage to stop activity that results in ‘low value’ for those whom we care.

Leading small organisational change up to whole system transformation…

• Variations that cannot be justified by reasons of geography, demography, or infrastructure;

• Can be a sign of poor quality care, missed opportunities and waste and can result in poorer outcomes, poorer experience and increased expense

What does success look like?

Triple Aim Outcomes ***BETTER***

Outcomes

Experiences

Use of Resources I

ndivi

duals

Populations

Professions

Underpinned by 10 Commitments

Developed by staff and people who use and care about health and care services.

These commitments help align efforts to areas where unwarranted variation is recognised and support the transition needed to build sustainable services of the future.

1. We will promote a culture where improving the population’s health is a core component of the practice of all nursing, midwifery and care staff

2. We will increase the visibility of nursing and midwifery leadership and input in prevention

3. We will work with individuals, families and communities to equip them to make informed choices and manage their own health

4. We will be centred on individuals experiencing high value care

5. We will work in partnership with individuals, their families, carers and others important to them

6. We will actively respond to what matters most to our staff and colleagues

7. We will lead and drive research to evidence the impact of what we do

8. We will have the right education, training and development to enhance our skills, knowledge and understanding

9. We will have the right staff in the right places and at the right time

10. We will champion the use of technology and informatics to improve practice, address unwarranted variations and enhance outcomes

Commitment 10:We will champion the use of technology and informatics to improve practice, address unwarranted variations and enhance outcomes.Impact Statement:Technology impacts on every aspect of our lives and we must strive to recognise the potential that advances in technology can make on how we provide effective and consistently high standards of care.

Informatics and Technology

• Key themes running through all of the framework;

• Case studies: The role of the Enhanced Practice Nurse in Harrow (virtual ward) and Releasing nursing time while providing safer care (implementation of the electronic patient record, supported by a handover page showing the patient’s latest National Early Warning Scores (NEWS) score);

Painting a Picture of Towards the Future

• Technology will assist by measuring vital signs, indicating when to exercise more, eat less, take medication or seek help - often from home, reducing the need to physically attend the GP surgery or hospital department;

• Secure digital health records will be accessible to quicken response times and improve emergency care - with the data shaping future practice;

• Children and adults will have their genomes sequenced predicting inherited disease and enabling preventive treatments to prolong life;

• An emphasis on working together across traditional boundaries in integrated teams;

Reiterating that technology has helped transform care and our roles in providing it. Stating that we need to…

Continue to be at the forefront of innovation, enabling individuals to access information, use diagnostic tests, record their own health data and live more independently and safely in their own homes.

Use it to help enhance our clinical decision making by providing access to the relevant information at the point of care and enable us to reach out to communities in sparsely populated areas.

Be prepared for routine tasks we currently undertake to be replaced by technological developments and to use the advances to improve outcomes, promote self-management and increase efficiency and productivity.

How?• Developing the skills needed

in a technology-literate workforce.

• Advocating technologies that may assist in reducing unwarranted variations in care.

• Leading as early adopters of technology to improve health and enhance efficiency.

• Empowering and supporting individuals to improve health and self-manage care.

• Using technology to manage workflow more effectively such as mobile working.

Next Steps

Multiple events are continuing across the country and the next phase will see the development of an implementation plan largely driven through the regional structures and major partners;

Each will be developing local plans and we will be co-ordinating these accordingly into a national framework that can be shared;

Continue to build on our partnerships, particularly with Higher Education Institutions, social care, and international colleagues to ensure mutual support and learning as we move forward with the framework;

Build up capacity & capability in identifying & addressing unwarranted variation.

• Going forwards - opportunities for nursing, midwifery and care staff to clearly evidence our impact and lead with confidence.

• Building on the best of our past while helping shape the NHS and social care system for the future…. #Lead2Add

Thank you

susanaitkenhead@nhs.net

www.england.nhs.uk/leadingchange