Continence nurse blog: Time for specialist nurses and health management to work together

If you managed to read the October continence blog you will have read my little tirade about value for money/waste of money and how robbing Peter to pay Paul if useless at best and financially risky at worst.

There can be absolutely no doubt in the mind of any right-minded person that nurses are no different than any other individual; we too must survive on the money we have, either in the bank or in your purse/wallet.

What often shocks us as nurses is how the burden of reducing costs and improving what we do ‘for less’ seems to fall into our laps.

I don’t think we mind, but cut, cut and cut again does not give any incentive to increase productivity. As individuals and teams we are used to having things ‘taken away’ and never getting anything in response.

Can any manager (at any level) really believe that you can keep beating us with the stick and expect us to keep responding positively?

If this practice prevails, then I see the end of the NHS.

At a time when the whole global economy is in trouble, it is a fair assumption that our national economy will also be in trouble, and it is.

And if our nation is in trouble it follows that, financially, our NHS could be at risk. It is incumbent on all of us to play our part and reduce waste to a minimum.

As a continence nurse specialist, we constantly strive to increase value and reduce costs, but it becomes a little worrying when we read in the nursing press about the Audit Commission has found that 20 trusts (7%) did not even meet minimum financial standards for balancing the books, and 12 of these failed to do this for three consecutive years.

I wonder what stick was used to beat those finance directors and their teams?

Performance varied across England. The NHS bodies in North West Strategic Health Authority (SHA) area achieved the highest average score overall. The average overall score of NHS bodies in Yorkshire and the Humber SHA area was the lowest. NHS London has the highest proportion of NHS bodies performing strongly but also has the highest proportion failing to achieve minimum standards.

Why can’t we get it right? It is possible to get things right, after all the Audit Commission report shows how good we can be. It is possible to get things right if managers can have the faith to trust the skills and knowledge of their specialists (after all they did employ you to do the job), and the specialist is competent, then we can make ends meet.

Let me give just one example. While I was still in the employ of a primary care trust, my manager, finance director and chief executive gave permission for me, as service head, to take forward a new multi-million pound contract.

Of course I had to feed back periodically, but the day to day management was mine and I was happy with this simply as ‘it was my job’.

I used available resources, calling upon other experts in contract management whose expertise lay within the areas of contract law, European Union law and all of the legalese that goes with that.

Together we took the requirement, an excellent new five-year contract that saved not less than £20,000 per year. (This is the sum my managers felt was needed to achieve financial stability).

In the end, by working with contractors, our experts ‘in-house’, and supported at all levels by trust managers, we signed up to a contract to both meet and exceed expectations in both financial probity and product quality.

This is just one example, and I’m confident there are other such co-operations and collaborations.

Perhaps it’s timely that all managers, finance directors and chief executives should consider how, by working together, we can achieve theirs and our own objectives.

This blog also appears on blogspot.com

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