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Chief Nursing Officer’s Bulletin June 2010

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All the latest new from the current CNO’s bulletin.

The Spending Challenge - have your say

A major public engagement exercise was announced today to help shape the forthcoming Spending Review. NHS staff are hugely involved in this process and the Prime Minister, David Cameron, has written to them today asking for them to share their ideas on how we can rethink public services to deliver more for less.

An engagement programme is being run from 24 June to 9 July to collect ideas on how the Government can deliver services more efficiently while maintaining and improving quality. A website has been specifically set up to gather up these ideas, with every serious idea being considered by government departments, the Treasury and by teams at No 10 and the Cabinet Office.

Nurses to play key role in delivering new health priorities

New Secretary of State for Health Andrew Lansley has set out his five priorities for the DH. They sit alongside the overarching drives to reduce running and management costs right across the NHS, and to improve quality of care while also making the NHS more efficient and productive. Nurses will play a key role in delivering reforms in these areas.

  1. A patient-led NHS - ensuring it responds to people’s needs and their wishes when it comes to managing their own care.
  2. Shifting focus and resources towards better health outcomes - targets that have no clinical justification will be removed and doctors and nurses will be given control over the running of day-to-day services, with a focus on outcomes for patients.
  3. Empowering professionals throughout the NHS - healthcare professionals and patients will be given more power and responsibilities, replacing the top-down approach from central government.
  4. Improving our public health services - the NHS will have to work with a range of partners focusing strongly on improving people’s health through preventive measures.
  5. Reforming long-term care - improving accessibility of, and options for, long-term social care by focusing on prevention, personalisation and partnership delivery.

Former nurse appointed health minister

Former nurse Anne Milton has been appointed Parliamentary Under-secretary of State for Health.

Health Secretary of State Andrew Lansley announced the new ministerial team for health on 13 May.

After training at Bart’s Hospital in London, Anne worked in the NHS for 25 years, including roles as a hospital and district nurse, in research and supporting GPs and nurses working in palliative care. She pioneered a scheme to look after people who were sent home early from hospital and was also once a Royal College of Nursing union steward.

Before being elected as an MP in 2005, Anne was a borough councillor for five years in Surrey. In July 2007, she was appointed as a Shadow Minister for Health.

Anne’s portfolio includes:

  • Public health, including sexual health, tobacco, drugs and alcohol
  • Vaccination and immunisation
  • Blood and transplants
  • Fertility and embryology
  • Fluoridation
  • Food, diet and nutrition
  • Children’s health
  • Maternity services
  • Nursing and midwifery
  • Health visiting
  • Professional regulation
  • Medical education and training

In profile: Ward Manager

Colin Reynolds is Ward Manager at Wyvern Court mental health rehabilitation ward in Bridgwater, Somerset. In 2004, he was employed as a deputy manager to lead on a project to develop a flexible approach to meeting need on a mental health rehabilitation and recovery unit.

Can you give an overview of your career so far? After qualifying as a registered mental nurse in 1999, I worked on an acute inpatient ward then joined a Psychiatric Intensive Care Unit to broaden my experience. In 2004, I started at the Rehabilitation and Recovery Service, taking the lead for the repatriation of patients with
challenging behaviours. I’m now in a band 8a position, which includes working on future projects and providing senior management support to inpatient wards on a weekend rota. I also have an honours degree in Health Studies.

What does your current role involve? I have management responsibility for about 60 staff members within the Rehabilitation and Recovery service. I am also part of a project group that is working towards developing existing and new rehabilitation services within Somerset Partnership NHS Foundation Trust.

How has the Rehabilitation and Recovery Service repatriated patients? Wyvern Court traditionally provides inpatient rehabilitation to people with complex and often challenging behaviours. In 2004, the trust decided to repatriate many patients who had been nursed out of county by other service providers. One of the reasons behind this was the National Service Framework, which included standards to reduce social exclusion associated with mental health problems, and provide a range of mental health services with timely access, including a secure bed as close to home as possible. Feedback from family and carers also highlighted difficulties maintaining contact with patients that may have been many miles from their homes.

How did you manage the project? The Rehabilitation and Recovery team worked with the Out of Area Treatment team to identify patients who would be suitable for repatriating. A multi-disciplinary team - including professionals from medical, psychology, social work, occupational therapy, and nursing - then assessed their individual needs and planned how they would be met locally. All staff received training that focussed on behaviour principles, activity and structure, operational procedures and creating individual care plans for the planned patients.
How did you improve the physical environment? Between 2004 and 2006, we created a single-sex ward with five single bedrooms and shared facilities. The patients selected for repatriation during this period were all female and four of them presented with challenging behaviour that included violence and aggression. When a fifth patient who could not mix with the other patients joined the unit, the final bedroom was created as a separate annex. The ward has limited beds to create a low-stimuli environment where patients can receive intensive input. We paid attention to areas for therapeutic activity - for example, there’s an open plan kitchen to encourage everyday activities and interaction.

What results have you seen? Fifteen patients have been repatriated or prevented from being placed out of county, and feedback from them, and from carers, has been positive. Most have progressed into community settings, some with supported housing and some on an independent basis. By providing a flexible approach to care - that includes the physical environment as well as multi-disciplinary clinical care - patients’ outcomes can be improved and the service can be more responsive to the their needs. This approach also meant that the trust was well placed to deliver single sex accommodation, and the same flexible environment is now being carried over to new buildings. Culturally, there’s a more positive attitude to providing complex care packages and greater optimism for favourable outcomes.

Why is nurse leadership important? Nurses work in a very dynamic way and have to be able to lead and inspire staff to provide a high quality service. I would advise nurses interested in pursuing a leadership role to embrace change, help others turn threats into opportunities and to lead by example by being a positive role model.
Can you name a career highlight? Qualifying in 1999 and being able to remain on a similar learning curve since, grasping opportunities as they have arisen.

QNI awards

Community nurses from all over the country received the title of Queen’s Nurse at the QNI’s Spring Award Ceremony in May. Two new Fellows of the Institute were also named.

Viv Bennett, Deputy Chief Nursing Officer at the DH, and Rosemary Kennedy CBE, Chief Nursing Officer for Wales, join the 36 other Fellows of the Institute who are leaders in diverse fields relating to community nursing.

Having joined the Department in 2008, Viv’s portfolio has steadily expanded to include community nursing and health visiting, commissioning, transforming community services, mental health and learning disability and services for children and families. She is national co-chair of the transforming community services board, and leads the Action on Health Visiting programme.

‘I felt very honoured to be given a QNI Fellowship,’ Viv says. ‘I have been passionate about care outside hospitals for many years and to be awarded a Fellowship from an organisation with such a long history and high reputation for improving care for people in their homes is fantastic.

‘Recently, I have worked with QNI and Queens Nurses on transforming community services and continue to be impressed with their professionalism and commitment, and I look forward to supporting them as a Fellow.’
Outstanding achievers

Also at the ceremony, five nurses received the Queen Elizabeth the Queen Mother’s Award for Outstanding Service.

Stella Abiona, Doreen Diamond, Eve Gibb, Susan Gowland and Wendy Weller were handed their certificates by guest of honour, Dame Donna Kinnair, Director of Commissioning and Nursing at Southwark PCT, and a member of the Prime Minister’s Commission on the future of nursing and midwifery.

‘I have worked in community nursing for 40 years and I still enjoy the sheer diversity of the job. Every day is different and you never know who you’re going to meet - especially in the area I cover now,’ says Susan Gowland, Nursing Sister in the community falls team, Central Manchester.

‘I was stunned to receive the Award for Outstanding Service - I didn’t know anything about it until the letter arrived on my birthday!’

‘The nurses here all care for vulnerable people - they have delivered a voice to people in the community who have none. They are advocates for the older generation. Nursing is a great profession and we should be “good ancestors” for the nurses of the future.’ Dame Donna Kinnair at the ceremony

News in brief

Professionals’ newsletter
NHS Choices has launched a quarterly e-newsletter for health professionals and health intermediaries. Be the first to hear about new developments and content on NHS Choices, that you can use and share with your colleagues and patients.

Influenza season 2010/11
A letter from the Interim Chief Medical Officer, the Chief Nursing Officer and the Chief Pharmaceutical Officer contains details of the annual influenza immunisation programme, influenza immunisation for health and social care staff, and the poultry worker immunisation programme. Nurses will wish to ensure they - and their practice staff - take all the relevant action required to prepare for the influenza season.

Skills Passport update
For the last year, Skills for Health has been piloting a Skills Passport for healthcare professionals, aimed at building skilled, flexible and productive health workforces that can demonstrate their suitability for roles within the health sector and beyond. The idea is that the Skills Passport will be an online repository for an individual’s employment record, skills, competencies, achievements, qualifications, training and positions held. Through the external evaluation - involving eight employer organisations and about 300 nurses - employees and employers highlighted benefits such as transferability of skills, reduction in employment checks and the duplication of training, and overcoming fraudulent professionals entering the profession via verification.

Further development work is now being done to broaden the passport beyond nursing - stay tuned for future updates.

Men’s Health Week 14-20 June 2010
The Men’s Health Forum is encouraging government, NHS and sports organisations to work together to help one million more men in England achieve the Chief Medical Officer’s minimum recommended levels of physical activity by 2012. Men’s Health Week is supported by the DH, NHS Choices and Sport England. Nurses are encouraged to review the online resources, including the A Question of Health mini manual.

  • Order A Question of Health
  • Access other resources on the site

National Eye Health Week
Eye care health professionals and UK charities came together to launch the first ever National Eye Health Week (NEHW) from 14-21 June. Under the banner ‘Vision matters’, the week encouraged people to take better care of their eyes and go for regular sight tests, both of which can improve lives by detecting early signs of conditions such as glaucoma, diabetes and high blood pressure. The Vision Matters patient information leaflet is available to order from the Vision Matters website, which will continue to be updated with guidance on maintaining good eye health. Nurses are asked to make their patients and colleagues aware of the week and spread the word about the importance of regular eye tests for general health.

  • Visit the dedicated campaign website
  • Download the patient leaflet

Military and Civilian Health Partnership Awards for 2010
The third annual Military and Civilian Health Partnership Awards have been launched, celebrating exceptional care for the Forces across all professional disciplines and settings. The awards are open to civilian health and social care staff and military medics working within the Defence Medical Services, the health service and the private or voluntary sectors. Entrants can be self-nominated or entered by patients, colleagues or members of the public.

The awards ceremony will take place on 25 November 2010 at Belfast City Hall. The closing date for nominations is 9 July.

  • Visit the Health Partnership Awards website for more information or call 028 9076 5602.

The Centre for Workforce Intelligence (CfWI)
CfWI is a new body that will provide a single, authoritative resource on workforce development planning for all parts of the NHS and social care system. It will provide accessible workforce intelligence, research and advice to support planners, clinicians and commissioners to meet the quality and productivity challenge. CfWI is central to the strategy for strengthening the workforce planning and development system, as set out in Planning and Developing the NHS Workforce: The National Framework.

Preceptorship Framework
This framework was originally developed for nursing but, following further discussion, it has been extended to midwifery and AHP staff. It will help ensure that our newly qualified health professionals have protected time and expert support to help them make the transition to confident practitioners. The framework provides a resource for those in NHS organisations with responsibility for establishing organisational systems for the management and development of the non-medical workforce. It will also be of interest to newly registered practitioners and those directly responsible for preceptorship.

International Dementia Excellence Awards
Applications are now open for these awards, which recognise organisations and individuals who have improved the quality of life of people with dementia. There are seven categories, including Nurse of the Year,
which is sponsored by the Royal College of Nursing. The awards are organised by the Dementia Services Development Centre at the University of Stirling, and are open to anyone who works with or supports people with dementia. The closing date for applications is 20 August. The awards will be presented as part of the fourth International conference, Coming of Age: Dementia in the 21st Century, at the ExCel London, 19-21 October 2010.

Florence Nightingale scholarships: apply now
Would you like to take your career to the next level and be awarded up to £15,000 to help you get there? The Florence Nightingale Foundation is offering scholarships to nurses and midwives who aspiring leaders, or are already in leadership roles. Recipients of the Florence Nightingale Leadership Scholarship undertake a bespoke programme geared to his or her individual needs, based on an assessment of current performance. Your organisation is expected to support your application and agree that you are capable of being fast-tracked to more senior leadership positions. The scholarships are supported by the Chief Nursing Officer and are made possible thanks to The Burdett Trust’s partnership with the Foundation. The closing date for applications is 27 September 2010.

£10,000 scholarships for children’s nurses: last chance!
The Florence Nightingale Foundation is also offering scholarships specifically for nurses working within children’s and young people’s services in England. Applications are welcome from children’s nurses who aspire to a leadership position, or who may wish to become a director of nursing or leader in new and emerging children’s services, and who have the skills and self-confidence to contribute in this area. The closing date for applications is 25 June.

Tool to fight infant mortality
The Health Inequalities Intervention Toolkit has been developed by the DH and the Association of Public Health Observatories to help address inequalities in infant mortality and life expectancy. The infant mortality tool illustrates recent trends for SHAs and identifies factors - such as smoking in pregnancy, poverty and maternal obesity - that are contributing to higher death rates in the Routine and Manual group. The life expectancy tool shows what is driving low life expectancy in the spearhead areas - those considered to have the worst health and deprivation. Both tools allow users to identify actions which will reduce inequalities.

Resource helps give patients tailored information
Nurses and other healthcare professionals are encouraged to use the online Information Prescriptions Service (IPS) to find tailored information to give to patients about their care and treatment. The information has been provided by the NHS and major charities, and has been quality assured. The IPS can also provide a dispensing history that shows what information has been given to patients, and there is an option to add personal notes to the patient, highlighting key facts and summarising the consultation.

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