The “6Cs” nursing values will remain at the heart of a new nursing strategy for England and there will be a strong community focus to forthcoming guidance on staffing, the chief nursing officer has said.
Speaking last week at the Queen’s Nursing Institute’s annual conference, CNO for England Jane Cummings set out the latest developments on work that nurse leaders are involved with.
She highlighted that her team at NHS England was currently working on a follow-up to the three-year national nursing strategy Compassion in Practice, which is due to expire at the end of the year.
As part of drawing up the new vision, which is set to be published in March, Ms Cummings said she had been reviewing the original strategy, which introduced the 6Cs nursing values.
“One of the most important things is around evaluating,” she said. What’s been the benefit of Compassion in Practice.”
She acknowledged that there had “always been some different views about the 6Cs”.
“Our plan at the moment is to keep the 6Cs at the heart of what we do going forward, but to develop a vision… that really does reflect what patients, public, profession want”
But she said: “Most people that speak to me –and I don’t think it’s just because they think it’s what they think I want to hear – say that they want to keep the 6Cs.
“There’s a few that say: ‘they’ve had their day, do we want to continue them’. [But] the vast majority have said please keep it going,” she said.
“They have had significant impact, we know there’s lots of people have made real strives in terms of care and compassion as a result,” added Ms Cummings.
“Our plan at the moment is to keep the 6Cs at the heart of what we do going forward, but to develop a vision… that really does reflect what patients, public, profession want – that does address some of the key issues that commissioners and providers have, but also sets a long-term direction for travel.
She outlined some of the themes that had come up so far for inclusion, for example on public health and prevention, innovation and workforce issues.
“These are the sorts of things that have come forward so far – something around population health – personalisation is really important – but being aware of the productivity, safety, staffing dynamics,” she said.
“How can we really transform and innovate…and how do we sustain and develop the workforce to be able to do that,” she added.
“For each of the workstreams that we’ve identified we will build into that the role of community nursing, because actually it’s critical in each of those areas”
Ms Cummings told delegates that she wanted the new strategy to be “very much a bottom-up vision” that was based on the views of frontline staff.
“It’s not about a group of us, the nurse leaders, sitting in a room and coming up with a plan. It’s about really engaging with people and asking them what they think.
She called on nurses to get involved in the debate about the new strategy, either by email, social media or attending a stakeholder event.
“Please do engage and get your views,” she said. “It’s your strategy as much as mine and it’s important that we reflect that.”
Ms Cummings also discussed progress on the new workforce guidance that NHS England will be producing, following its controversial decision to end the National Institute for Health and Care Excellence’s programme of safe staffing guidelines.
Ms Cummings, who is leading the work, said a number of workstreams would be set up for different parts of nursing and care.
She said there would be a specific workstream looking at community nursing but all of the others would also have a strong community input.
“For each of the workstreams that we’ve identified – whether that be children’s nursing, community, mental health, learning disability, or urgent and emergency care – we will build into that the role of community nursing, because actually it’s critical in each of those areas,” she said.
“That will be up and coming and we’ll get some of the details around that out fairly soon,” she told delegates.
She reiterated a point made earlier in the year that the guidance, unlike that of NICE, would not only focus on nursing but would “look at multi-professional working”.
“Nurses and midwives are absolutely critical but we also need to think about the impact of allied health professionals, [and] doctors,” she said.
“It’s your strategy as much as mine and it’s important that we reflect that”
The CNO added that she would delay a decision on whether to develop guidance on midwifery until after findings were published from the independent maternity review being chaired by Baroness Julia Cumberlege.
She also noted that NICE had already published guidelines on safe staffing in midwifery as part of its now halted programme.
“NICE published guidance on midwifery, so I think we want to see what the independent review recommends and then we’ll have a look and see whether we need to support that with any other midwifery workforce guidance,” she said.
The decision to take the safe staffing guidance programme away from NICE was met with much criticism and scepticism earlier this year.
Ms Cummings noted that the work on safe staffing would need to focus on three factors
“That is around improving health outcomes, it’s about improving experience – staff and patient experience – but it’s also making the best use of the resources we’ve got. We can’t do one of those without the others,” she said.
“We need to look at all three but make sure that at the end of the day our focus is on delivering the best possible care with the best outcomes and the best experience and using the money we’ve got to the very best of our ability, which is critical,” she added.
“We need to make sure… our focus is on delivering the best possible care with the best outcomes and best experience and using the money we’ve got to the very best of our ability”
In addition, the CNO said a new framework for commissioning community nursing had been completed and was currently in the “sign off” process before it was published by NHS England.
She said the framework was intended to provide “insight” for service providers and commissioners so they “the right level of community nursing”.
This was also important she noted with regards to the “vanguard” sites being set up around the country to pilot more integrated ways of providing healthcare, and to which nurses “were absolutely critical”.
“It’s about trying to encourage better commissioning of community nursing and better understanding about what benefits that can bring – that’s a really important focus and we know we have to think very carefully about commissioning the right workforce,” she said.
She added: “The demands are increasing. It’s likely to go further when we look at the vanguards, so let’s make sure we think ahead and we think and plan for what we need.”