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No opt-out: nurses told of 'moral duty' to save money


Nurses have been told how to fulfil their “professional and moral responsibility” to help the NHS cut waste and save money, in comprehensive guidance shared exclusively with Nursing Times.

The 260-page document has been published to show nurses how they can implement and measure the eight “high impact actions” aimed at saving more than £9bn.

Produced by the NHS Institute for Innovation and Improvement, High Impact Action for Nursing and Midwifery – The Essential Collection draws on lessons learnt from trial sites.

It states: “A few nurses and midwives may still think that money is someone else’s business, but those that think this are, quite frankly, out of touch with reality - opting out isn’t an option.

“Addressing financial inefficiencies is a key personal, professional and moral responsibility.”

The “high impact actions” were announced last November and include areas such as improving patient nutrition, reducing pressure sores and falls and cutting staff absence.

A major theme in the document is the importance of good communication methods. At one trust, infection control teams carried out trolley dashes through the wards, handing out themed “goodies” to get people talking about catheter care.

Another trust designed a giant floor game to disseminate important information.

The guide also sets out how cost benefits can be calculated. For example, by using the Department of Health’s estimate that the daily cost of care for a patient awaiting hospital discharge is £100, nurses can identify savings from reducing delays.

Chief nursing officer Dame Christine Beasley urged nurses to read the document, saying  senior nurses such as matrons and ward sisters would be “absolutely pivotal” in achieving the drive.

She said: “We have seen that’s the case from productive ward work, where ward sisters and ward leaders at that level have really taken it on and made it their own.”

She told Nursing Times that successful pilots had often addressed two or three areas together such as pressure ulcers, falls and nutrition.

But work to date had also shown that nursing leaders also needed the backing from their organisations to ensure change actually happened, she stressed.

NHS South Central chief nurse and director of clinical standards and workforce Katherine Fenton said it was vital nurses took action now to avoid “slash and burn policies.”

She said: “Nurses have got to get involved otherwise we will suffer.” Unless senior nurses were engaged, “others haven’t got a chance.”

Some might be worried about schemes appearing to pit ward against ward, but Ms Fenton said the work had shown nurses could be “energised” by an element of competition.

However some improvements, such as nurse led discharge and nutrition, had proved particularly tough to crack, she said.

NHS County Durham and Darlington took action on nutrition, involving enforcing protected meal times, gathering patient feedback on menus and ensuring hot, fresh meals were available 24 hours a day.

Modern matron Karen Dyson said patients were happier and catering costs had fallen.

Another case study in the guide is East Kent Hospitals University NHS Foundation Trust, which used routine falls risk assessments, sensor alarms and falls “champions”. One ward reduced its falls rate by 85 per cent in a year.


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Readers' comments (72)

  • Hear hear Phil Dup!

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  • Okay.........How about " EVERYBODY OUT???!!! " I agree with all of the above. After 30 years of unstinting service, in a job that I have loved, I am sick and tired of the likes of Beasley pontificating to those of us who have already saved the NHS an ABSOLUTE FORTUNE in unpaid hours. Wake up and smell the coffee. Get out of your Institute and wise up. The natives are restless. How very dare you, Christine Beasley...How very dare you!!!

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  • Exactly Margaret, heres another idea too, why don't we calculate exactly how much Nurses have saved the NHS on average over the last 20 years or so, then we can order our useless union to send a bill to these pathetic managers, to be paid with immediate effect.

    God I can't wait to get out to Melbourne. This country is taking the piss out of us!

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  • I'm bored of should, moral and duty used as as an imperative for nurse or nursing. Please stop it NT.

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  • I whole-heartedly agree with the above comments. Camero, Cleg and Osbourne are multi millionaires.. They are obviously very patriotic and caring. I am sure a pay freeze for them won't hurt

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  • How much money and time was squandered by a subcommittee of non medically skilled untrained business people in coming to the conclusion that once again Nurses hold the key to saving the NHS from failing in its duty of care. Not a duty of care to our patients but a duty to save money.

    The answer is tragically simple.... reduce administration posts. There are far too many amateurs in positions beyond their capabilities their knowledge and expertise using inappropriate skills to set ludicrous and meaningless targets for too few real professional care givers to meet.

    Let us return the NHS to a service which supplies a safe efficient system of care to our patients not a top heavy service which is financially geared to jobs for administration and IT systems, a service which would rather use agency Nurses than provide appropriate numbers of NHS staff on each ward.

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  • Anonymous | 29-Jun-2010 8:39 pm, I agree with you, but I have seen petitions like this put forward in the past only to be ignored. The RCN actually has a no strike policy. What is needed is a NATIONAL movement straight from the off.

    Roger Hodson I totally agree pal, but we are not going to get that because to few people are willing to fight for it.

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  • Martin Gray

    Don't you feel that those in power think that a nice pat on the back and a supprting word or two is all they have to do to get frontline staff to back down? It's like giving a puppy a treat for doing as it's told! 'Patronising' is a word that springs to mind because that's the atitude that management and politicians have to workers.

    Having a 'no strike' policy is a cop-out for the unions; they take millions in membership fees, pay their staff higher than a clinician, squander money on bureaucracy, and don't do anything positive to support their membership. I can't help but feel they are all secretly in cahoots with the NHS management and Government.

    Perhaps we should all just STOP filling in the paperwork and concentrate solely on giving practical patient care, refuse to do clinical tasks that ought to be done by house officers and registrars, make doctors get their own tea, do their own bloods, own cannulatuions and own observations on their patients. Yes that is working to rule rather than an all-out strike but boy would it be effective!!!!

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  • Martin, you make Doctors a cup of tea?

    Seriously though you are right, a simple work to rule, if everyone did it would be unbelievably effective!

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  • Peter Goble

    Nursing Times will not issue a rallying cry and no leader will emerge to start a ball rolling. But there is a tide in human affairs and it will eventually turn. The effects can't be foreseen but they will be momentous, you will be caught up in them, you will know that a certain destiny calls you to action, and that you are called upon to choose whether to act or whether to remain aloof: a mere bystander.

    The important thing is to be aware that there is always a tipping point, and to be ready to act in solidarity with others when the time comes. You will know what needs to be done, and you will find the courage - with others - to do it.

    We are talking about the NHS here, aren't we? We are talking about how it has been ruined to line the pockets of the unscrupulous, and to feed the egos of careerist ideologues, aren't we? We are talking about exploitation and contempt of human values, aren't we?

    But the writing is on the wall, here on this forum, and has been for several years. Somewhere in history, a clock is ticking........

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