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High impact action scores may not be collected

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Hospitals may not be able to compare how well they are implementing the high impact nursing actions because the Department of Health is worried about collecting too much information.

Many trusts have been recording their own scores linked to the eight actions - which include eliminating pressure ulcers and cutting the number of patient falls. They were launched last year by the chief nursing officer for England Dame Christine Beasley and are designed to reduce costs while also improving care.

Clearly, if you don’t measure, you don’t really know what improvement you are making

The DH left it unclear whether trusts would be told to send in their scores for national comparison and benchmarking.

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Dame Christine told Nursing Times she could see the benefits of mandating collection, but she said she may not be able to implement that because the department wants to limit how much extra information it collects as part of its quality, innovation, productivity and prevention programme (QIPP).

She said: “The high impact actions are part of QIPP, which is really important, and they are part of discussions about what should be measured at a national level.”

Dame Christine said discussions were ongoing about “whether [collection] is mandatory or bottom-up… in a world where clearly the [government’s] white paper points to transparency, but also to reducing bureaucracy”.

She said the decision had not yet been made.

“Clearly, if you don’t measure, you don’t really know what improvement you are making. I want to work out the benefit of what we are trying to collect and how easy it is to get it,” she said.

Sheffield Teaching Hospitals Foundation Trust nurse director and chief operating officer Hilary Chapman, who is also the nurse representative on the NHS national quality board, said mandating collection would help trusts improve. If it was not carried out, they should find another way to collect and compare, she added.

Professor Chapman told Nursing Times: “If collection is mandated we will get greater consistency [of practice]. We would be able to look for areas which have done good work and learn from them, which is important.

“Patients need to see information they can compare about things that are important to them. We should be able to say to a patient, for example, ‘We are the fourth best large university hospital on MRSA rates’, and they can ask, ‘Who is number one?’”

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