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Call for NICE to promote more nurse-led services across health and social care

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A stronger focus on guidance that supports nurses to lead service change across health and social care should be a priority for the National Institute for Health and Care Excellence, according to a senior nurse who has joined the watchdog’s board.

There is a “great opportunity” for more guidance aimed at nurses leading and delivering services, said Elaine Inglesby-Burke, executive nurse director and deputy chief executive at Salford Royal NHS Foundation Trust.

“Health and social care is much broader than an ill-health model”

Elaine Inglesby-Burke

Ms Inglesby-Burke, who became a NICE non-executive director this month alongside her role at Salford, told Nursing Times she also hoped her nursing perspective on the board would ensure NICE’s work focussed on providing person-centred as opposed to just “medical” care.

Her trust, which last year became only the second in the country to be rated “outstanding” by the Care Quality Commission, is regularly praised for its provision of person-centred care and quality of nursing.

“A lot of out-of-hospital health and social care services are nurse-led and delivered and I see a great opportunity for NICE to be developing guidelines that, not only support nurses in leading and delivering those services, but also enable the public to understand what they can expect from services to stay well,” she told Nursing Times.

She pointed to the experience she would gain from her own organisation as it became an integrated provider of health and social care, taking on responsibility for the oversight of care homes and domiciliary services in the local area.

“As a nurse who is now overseeing that health and social care system, I bring not only experience, but challenge and a different perspective,” said Ms Inglesby-Burke, who replaces Professor Rona McCandlish on the NICE board.

“Guidance produced by NICE could enable organisations to go further, faster”

Elaine Inglesby-Burke

She said she wanted to ensure nurses did not just deliver a “medical model” of health and social care delivery, which she defined as only treating someone’s disease, rather than for their holistic needs as well. She highlighted recent NICE guidance on cold homes as good practice in this area.

“Health and social care is much broader than an ill-health model. It is about supporting nurses, professionals and the public in recognising, for example, what can be done to keep well and prevent illness associated with living in a cold home,” she said.

In addition, she said she would support more guidance that sped up the use of technology to help patients self-manage their conditions and be cared for closer to home, such as electronic record sharing and telehealth.

“There are multiple applications out there and guidance produced by NICE could enable organisations to go further, faster because they then would not need to pilot – they would know what the guidance says and where you can start,” she added.

Last year NICE was controversially told to stop carrying out its former programme on nurse staffing levels, with NHS England citing one of the reasons being a lack of research on safe staffing outside of acute settings and that a new approach was needed.

Nursing Times asked Ms Inglesby-Burke if she would like to see the NICE produce more guidance on nurse safe staffing.

Ms Inglesby-Burke highlighted that the guidance NICE had already published on nurse staffing before the programme was halted – for inpatient wards and maternity services – remained active.

“The guidance that was produced was robust and drew on the best available evidence, both clinical and economic,” she told Nursing Times.

Any future staffing guidance “will [also] have to be produced using best available evidence and the professional judgement of the profession”, she noted.

“The safe staffing responsibilities have now moved to NHS England and NHS Improvement, and we have to wait to see what is produced there,” she said.

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