The chief nursing officer for England has unveiled a new four-year plan for nurses, midwives and care workers focussed on how the profession can drive changes to services and help reduce unwarranted variation in health and care provision.
“The key thing for me about the framework is recognition of the role that nurses, midwives and care staff play”
Called Leading Change, Adding Value, it is centred on 10 commitments, which include having the “right staff in the right places at the right time”, leading research to show the impact of practice, and increasing the visibility of nurse and midwife leadership and input in prevention (see box).
Speaking to Nursing Times ahead of the framework’s planned launch today, Jane Cummings said it was about demonstrating the impact nursing had and how it could help change the way services work.
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The earlier Compassion in Practice strategy, she said, was aimed at restoring pride and respect in the profession in the wake of the Francis report into care failings at the former Mid Staffordshire NHS Foundation Trust.
However, she confirmed that the new framework would retain the previous strategy’s “6Cs” nursing values – care, compassion, competence, communication, courage and commitment.
Ms Cummings said the framework would support nurses in delivering the aims of the NHS England’s Five Year Forward View, especially reducing gaps between health and wellbeing, care and quality, and funding and efficiency.
“The best way of doing that is to focus on variation and in particular unwarranted variation,” she said, noting that the framework included tools and guidance to help achieve this aim.
“We’ve made a real effort to engage with social care, other care settings, academics and the whole system”
Asked how the framework would tackle staffing issues, she said it would be linked to the new care hours per patient day metric, which is due to be rolled out across NHS hospitals and combines the amount of care provided by both nurses and healthcare assistants per patient in a 24-hour period.
Ms Cumming said the 10 commitments were “generic enough to be adapted to whatever field you work in”, when asked how staff in different settings and sectors would be able to use the framework.
“The last strategy – although it was talking about the whole system – in reality it was predominantly picked up by the NHS,” she said. “This time we’ve made a real effort to engage with social care, other care settings, academics and the whole system.”
She later noted there were examples from across different sectors featured within the framework, including one which demonstrated reducing unwarranted variation in rates of pressure ulcers between care homes with similar types of patients, staffing and local populations.
Improving the visibility of nurse leaders, particularly for those working in prevention, was also a key part of the framework, said told Nursing Times.
“It’s about how can we work together and, importantly, how we can evidence the impact”
Asked how it would ensure leaders working in prevention continued to be developed when public health jobs were at risk from council cuts, Ms Cummings said she was “passionate” about ensuring the recent increase in health visitors was not lost.
She added that the framework was designed to “truly integrate the role and the work of nurse and midwives across traditional boundaries”.
“It’s about how can we work together and, importantly, how we can evidence the impact. If you’re working in a local authority or being commissioned by one, being able to demonstrate the impact of the work you’re doing is significant.”
The CNO also highlighted framework’s commitment to nurse-led research and the importance of using evidence in practice.
However, the CNO acknowledged the framework was not backed by funding, stating that “you don’t need lots of money make a big impact”.
She said its commitments could be achieved through programmes that were already funded, such as work on safe staffing and maternity services.
“The key thing for me about the framework is about a recognition of the role that nurses, midwives and care staff play. It’s about reminding them and everybody else what it is and the potential we’ve got. Secondly it’s about recognising that you can start small but have a big impact,” she said.
10 commitments in Leading Change, Adding Value framework
- We will promote a culture where improving the population’s health is a core component of the practice of all nursing, midwifery and care staff
- We will increase the visibility of nursing and midwifery leadership and input in prevention
- We will work with individuals, families and communities to equip them to make informed choices and manage their own health
- We will be centred on individuals experiencing high value care
- We will work in partnership with individuals, their families, carers and others important to them
- We will actively respond to what matters most to our staff and colleagues
- We will lead and drive research to evidence the impact of what we do
- We will have the right education, training and development to enhance our skills, knowledge and understanding
- We will have the right staff in the right places and at the right time
- We will champion the use of technology and informatics to improve practice, address unwarranted variations and enhance outcomes