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Best practice must happen for every patient every time


One complaint I hear too often from frontline staff is that they don’t get enough time to do what they trained to do - provide a high standard of care for patients.

And the complaints I hear too often from patients are that, while the standard of treatment they receive is good and speedy, the food was poor, the staff were too busy to make them feel like they were really listened to or the ward wasn’t clean enough.

It’s for these reasons that the Quality Strategy for NHS Scotland was launched. It recognises that getting the highest quality treatment is as important as being treated quickly. It recognises that a good standard of care is not just about waiting times or targets - it’s about putting the quality of care the patients receive at the heart of the health service.

‘One of the important messages from staff was this new approach needs to be shared, owned and delivered by nurses working directly with patients’

Nurses know already that care and compassion are important parts of their job and build on the tradition of nursing. The strategy supports this emphasis on traditional values. It builds upon high quality services already provided to ensure that these are reliably and consistently delivered all of the time.

Staff and the public have told us that the things they want from a high quality health service are:

  • A clean and safe care environment;
  • A service where staff and services are caring and compassionate;
  • Consistent clinical excellence;
  • Clear and understandable explanations and communications about conditions and treatments;
  • Good collaborative working between clinicians, patients and other services;
  • Providing continuity of care and good access to care.

The strategy is based on these principles.

So, how does the strategy work? It prioritises all of our activity with a focus on the six dimensions of healthcare quality - safe, effective, person centred, efficient, timely and equitable - so that we all share an understanding and ambition of quality in healthcare in a way that allows us to measure improvement.

The strategy gives you the opportunity to work in the way you know will be best for patients and for you. It gives you the opportunity to do the things that matter to you - provide care that is empathetic, compassionate and clinically excellent.

I know from speaking to staff on the frontline that not being able to do this is one of their biggest frustrations. Over the last few months, everyone who works in the NHS has been asked to come up with ideas to improve the quality of services. Everyone working with and for NHS Scotland is being asked to identify one thing they can change as well as one thing in the system that needs to be changed. What is important is that it is not just chief executives and managers being asked, but those at the forefront who are leading this quality improvement.
For patients, it aims to make them partners in their own care. Staff will be expected to work with patients to ensure their views are heard and are taken account of to shape and improve services.

The health service already provides some truly excellent care. The strategy is about making the standard of care even better and ensuring that best practice happens for every patient every time. Through delivering care more reliably and reducing variation, we will improve NHS efficiency.

The work of the Patient Safety programme and the Healthcare Associated Infection Taskforce are exemplars of the strategy and are aligned to it in their aims and approach. The strategy builds on the superb results the Patient Safety programme is having and the great work being done to drive down healthcare associated infections.

One of the important messages from staff was this new approach needs to be shared, owned and delivered by staff working directly with patients and other service users. I want to stress the strategy is for all staff, including support workers, administrative staff, cleaners, technical and non-technical staff. It is for everyone working in Scotland’s NHS.

Through encouraging innovation and supporting staff to change the way things are done, whether small changes or significant ones, we will be able to actively improve the way we deliver healthcare.

Staff will have a greater sense of being valued by the NHS, and by patients and families. This will lead to greater job satisfaction. They will experience a role where they have a significant and meaningful contribution to make in identifying changes they know will make a difference for themselves and for their patients. In turn, this means that patients and the public will encounter staff and services where they truly feel at the centre of all that is happening or being planned.

As it is the staff at the forefront of services who will be leading the way on the improvements in the quality of all aspects of NHS services, it is essential for them to be actively involved and supported to create and innovate.

The health service in Scotland is already good. With your help in achieving the quality strategy, we can make it even better.

Nicola Sturgeon is health secretary for Scotland


Readers' comments (5)

  • Marjorie Lloyd

    lack of time is no excuse all nurses must manage their time

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  • Nicola, are you going to apply this thinking across the whole of the UNITED Kingdom? Just a thought!

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  • I work in Scotland, and have been pleased to see this strategy adopted as an ethos. Accountable for my own practice I always try to deliver compassionate care, & agree that, although sometimes more time is needed, often it is the attitude you approach your patient with that can convey it even without extra time.

    However, as a patient I've seen the worst of care, only for it to be covered up/denied by organisation as what happened not documented so my word against theirs - that worries me less for me (what happened can't be undone) but what it says about the organisation's attitude to ensuring quality/it doesn't happen to anyone else.

    As a nurse, I'm well aware staff will be pulled up for a gap in paperwork (visible) whereas the fact the patient was under constant observation whilst nurse providing compassion and a listening ear is lost. Is it surprising that skews staff's priorities? How would Ms Sturgeon address that?

    Also, as budget constraints hit, wards are already being made to run under their 'minimum' staffing, with bank shifts not even being put out. This affects ability to provide quality care, impacting on both patients and risking staff burnout (at which point they're harangued for attendance). The organisation has announced nursing cuts. How are you planning to reconcile the 2 agendas Ms Sturgeon?

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  • I think Nicola must come down to earth! Idealism is different from reality that people face day after day in NHS! Here is real world, shortage of staff, no breaks, more jobs, paperwork, pressure from managers,... and threats of cutting workforce! Nice words do not solve the problem!

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  • dream on nicola, that will only happen when the service is returned to a service and funded accordingly. continually pressuring people to perform what you know to be the impossible is cruel

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