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NHS 'should learn' from trailblazing charities on nursing

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The expertise of charities that are blazing a trail in community nursing transformation should be harnessed around the decision-making table, health experts have urged.

They found that organisations, such as the Queen’s Nursing Institute and Marie Curie, were already making strides in redesigning services to overcome modern-day challenges facing the care system.

“There is universal agreement that substantial change is required”

George Plumptre

In a new report, the King’s Fund said it was “striking” that third sector organisations in the nursing world were already delivering change in areas earmarked as priorities in the NHS Long Term Plan.

The think tank was commissioned by the National Garden Scheme – which raises money by opening up private gardens to the public – to explore the contribution of six large charities in the nursing sector that benefit from its funds.

They are the QNI, Macmillan Cancer Support, Marie Curie, Hospice UK, Parkinson’s UK and the MS Society, which provide nursing support in the fields of community care, end-of-life care and specialist care of long-term conditions.

The report laid out how the charities had embarked on pioneering initiatives including to grow new nurse leaders, develop new roles in the cancer workforce, provide support to patients earlier in the end-of-life pathway, and utilise technology to deliver staff training to nurses in the community.

For example, the report – called Investing in Quality: The contribution of large charities to shaping the future of community nursing and healthcare – noted how Hospice UK had adopted a virtual education system called Project ECHO.

“The report’s content provides some powerful examples of what is possible”

George Plumptre

The charity first trialled the technology with its Northern Ireland Hospice after finding it difficult to regularly convene the 33 specialist palliative care nurses in employment, before rolling it out more widely across its hospices. 

The system uses a ”hub-and-spoke” knowledge-sharing model, in which clinical specialist teams (the hubs) run live virtual classes with staff across multiple health care providers in the community (the spokes).

The sessions are recorded to allow those on night shifts who often miss out on training opportunities to benefit and to produce an online library for further use.

Project ECHO reduced the amount of time staff were required to spend attending external training sessions in person, and lessened the pressure to backfill time, the report said.

Looking ahead, Hospice UK is looking to offer the training sessions to health professionals outside of the charity to improve end-of-life care in other settings.

To support this, it has invested in developing three “super-hubs” able to deliver Project ECHO training.

The report concluded that, through sharing ideas such as these, the charities could help the wider health system overcome some of the key challenges it was facing and meet the ambitions of the NHS Long Term Plan. 

“At a time when delivering operational change is high on the agenda, these are tangible contributions to improvement in areas of national priority and potentially hold learning for the wider system,” it said. 

The overall direction of travel for the wider health system towards integrated, community-oriented provision – which was laid out in the NHS plan – was ”ripe with opportunity for these beneficiary organisations”, said the document.

It added that questions should be raised about how the voluntary and statutory sectors could work together most effectively to drive improvements under the new integrated care systems, which would result in decisions being made more locally. 

“A one-size-fits-all approach to these local conversations, which focuses on charities as potential providers of services or as sources of volunteers, will miss opportunities to leverage their capabilities and expertise to the fullest extent,” warned the report.

“These are tangible contributions to improvement in areas of national priority”

King’s Fund report

George Plumptre, chief executive of the National Garden Scheme, said: “We are confident this report will make a substantial and timely contribution to the current debate about community nursing, health and care.

“There is universal agreement that substantial change is required; there is far less agreement, however, as to how that change should be achieved,” Mr Plumptre added.

“The report’s content provides some powerful examples of what is possible by highlighting what our beneficiary charities are actually doing now,” he said.

The report will be launched today by care minister Caroline Dinenage at an event at the King’s Fund offices in London. 

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