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Taking action on variations in care - Comment from CNO Christine Beasley

'The context in which we provide care is continuously changing and, currently, we are facing a tough fiscal future'


Our ability to continually focus on providing the very best care and support to patients, families and communities is as important as ever. I am privileged to visit many services during the year, and I know so many of you are leading and contributing to truly excellent services.

However, there remains too much unacceptable variation and this is one of our biggest challenges.

The impact of these variations is not simply increasing costs, but most importantly, it is the ‘cost’ to the individual on their experience of care, support and wellbeing.

This is why I particularly welcomed the opportunity this month to make the announcement about the High Impact Actions. The implementation of these actions will begin to transform the care patients receive and the support available to staff, while reducing costs.

The High Impact Actions I have announced are not new, but they still represent areas of practice where there is significant variation and waste. As a profession, we need to grasp these aspects of care and tackle the reasons for variations in practice, which have been perpetuated for so long.

‘The impact of variations is not simply increasing costs, but most importantly, it is the “cost” to the individual on their experience of care, support and wellbeing.’

Taking this work forward will be central to demonstrating how nurses and midwives can take the lead in driving up quality and making better use of resources. I know it is challenging, however we have learnt a lot from the work in reducing MRSA and C. difficile. This includes knowing how to bring about successful change across organisations and health economies, which results in demonstrable improved outcomes.

Among other things, implementing the High Impact Actions requires taking a fresh look at the challenge and a significant shift in our mindsets, which leads to a
determination to make real and sustainable changes to practice. In addition, all of us need to take on the leadership challenge wherever we work with courage
and commitment.

I began by talking about the context of care and nowhere is this more challenging than in theatres of war where many nurses and midwives work in areas of conflict across the world. This month, I would like us all to remember them and the contribution they make in difficult circumstances, continuing to provide care and support with the utmost compassion.


Readers' comments (2)

  • Valueing the very many great nursing staff we already have and raising moral by NOT capping pay and pensions would have the desired outcome?
    Who knows?

    Unsuitable or offensive? Report this comment

  • Well, this isn't a surprise, just compromise.
    I mean that statement is a load of guff that skips over any mention of the consequences of supporting a clearly doomed to failure venture in squeezing the very last drop of essence from those existing inside the health service.

    Clearly we spend more than countries that nonetheless have superb results such as Japan, New Zealand and Australia, despite their allernate methods of funding.
    Compared to France, Germany, Canada and even the USA, we spend less and boy do we spend less.

    All around us our hospitals scream of cheapness, meanness and a total divorce between the planners and managers and those forced to exist inside.

    Hospitals are built like prisons, in that no-one will ask the inmates what should be inside and where.

    And this woman, more or less condones this.
    The old 'if it ain't broke argument'
    She must notice the antipathy and the fact that she will be guided like a blind person through a maze of suddenly cleaned and polished clinical areas meeting no-one at the real frontline.

    How can someone in such a position of influence be so tepid, so lukewarm, so nonchalant, so unfazed, so blah about issues that are critical.

    Figures like her are the reason why our profession has been stagnating since the 80's.

    Let's fight our own battles!

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