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Allan Jolly examines the essence of care

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VOL: 98, ISSUE: 18, PAGE NO: 33

Allan Jolly is a lecturer at the School of Nursing and Midwifery, University of Southampton

For over half a century we have been attempting to realise the founding principles of the NHS - a national, comprehensive and equitable service free to all at the point of need. The NHS Plan (Department of Health, 2000) reinforces these core principles, which include 'a universal service for all based ... around the needs and preferences of individual patients while working to improve the quality of service'.

For over half a century we have been attempting to realise the founding principles of the NHS - a national, comprehensive and equitable service free to all at the point of need. The NHS Plan (Department of Health, 2000) reinforces these core principles, which include 'a universal service for all based ... around the needs and preferences of individual patients while working to improve the quality of service'.

Laudable intentions, yet for more than 50 years the service and service users' experiences across the UK have been of variable quality. The NHS has had no shortage of initiatives attempting, by one means or another, to improve the patient's lot. Yet it remains patchy. Service users want an end to the postcode lottery, to be treated with dignity and respect, and to be cared for in a compassionate and competent manner when they are at their most vulnerable.

The Essence of Care (Department of Health, 2001) attempts to deliver the goods by improving the quality of service. It focuses on eight fundamental aspects of patient care: nutrition; principles of self-care; privacy and dignity; record-keeping; personal and oral hygiene; continence and bladder and bowel control; pressure ulcers and the safety of patients with mental health needs.

The strength of The Essence of Care is that it is founded on the participation of more than 2,000 users, carers and health professionals. It is firmly focused on putting users first and advocates a structured approach to comparing and sharing good practice on what is really important to them.

Few health care professionals and allied support workers would not like to do better, but staff are overworked, tired of change and often feel unsupported by a government that is seen as being out of touch with local opinion.

Despite this, The Essence of Care has received overwhelming support and enthusiasm from both health care staff and service users (see p36). Many nurses are involved in the initial implementation of The Essence of Care because they know it is worthwhile, and they are doing so in addition to their day-to-day workloads. What is unacceptable, however, is to be told that the Department of Health has run out of facilitation packs and that there is no plan to print more.

Goodwill goes only so far. NHS staff need to be supported and their efforts rewarded. The department would do well to recognise their enthusiasm for The Essence of Care and should show its support by giving them the toolkit to do the job, instead of allowing the many requests for facilitation packs to fall on deaf ears.

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