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Nursing improvements under threat as quangos face cull


Attempts to transform nursing care are threatened by plans to axe national bodies in charge of quality improvement, patient safety and public health, nurse leaders have warned.

The government is scrapping the NHS Institute for Innovation and Improvement, the Health Protection Agency and the National Patient Safety Agency as part of a £180m savings drive.

Nurse leaders are particularly concerned about the abolition of the NHS Institute, as it is not clear whether or not its work will continue at another organisation.

Nurses fear that programmes such as the institute’s Productive Ward series will be jeopardised.

Productive Ward has helped free up nurses to spend more time with patients by streamlining
processes such as handovers. The institute has also been involved in rolling out the high impact actions for nurses
and midwives, aimed at helping the NHS save £9bn.

Chief nursing officer for England Dame Christine Beasley told Nursing Times: “The NHS Institute for Innovation and
Improvement has played a valuablerole in supporting improvement and quality activity.

“While this work has been practically completed by the institute, it will now be further spread and embedded as part of the wider quality and productivity agenda [QIPP] and will be taken forward by the NHS at a local level.”

However, others have questioned how lessons learnt from this work will be disseminated across the NHS without coordination by a central body.

National Nursing Research Unit director Peter Griffiths said:”It does seem clear that it will be harder to develop, coordinate and marshal resources behind these sorts of developments in a more decentralised system.”

Strategic health authorities’ role in supporting the high impact actions and Productive Ward Series has also been important, but these too are being abolished from 2012 onwards, he added.

Around 90 per cent of trusts have been involved in Productive Ward.

Professor Griffiths’ evaluation of the programme, published earlier this year, found it had a “huge perceived valueand local impact”. It had led to improved ward level leadership and patient experiences, cost savings and
higher staff satisfaction and retention.

Royal College of Nursing head of policy Howard Catton said: “The NHS Institute filled a role in identifying, supporting and sharing good practice. My concern is this function will become

The Department of Health review of arm’s length bodies, which set out the changes last week, said responsibility for improving patient outcomes should be at “every level of the NHS” rather than just quangos. The NHS commissioning board will also play a leading role.

The DH will consider whether the institute could continue on a more commercial basis, for example as a social enterprise.

Institute chief executive Bernard Crump said this could secure better “buy in” from trusts because organisations would need to decide for themselves which services they were prepared to invest in.

However, Nursing Times understands that the institute does not own the intellectual property rights to its products and would need permission for them to be handed over from the Crown.

Lynne Maher, director of innovation at the institute, said programmes would be “accelerated” between now and 2012, when the organisation is due to close.

NHS South West director of patient care and nursing Liz Redfern said it was up to nurses to continue the work after that date. She said: “Even though they [Productive Ward programmes] have been heavily badged with the institute, I don’t think they’ll end in demise.”

Imperial College Healthcare Trust director of nursing Janice Sigsworth agreed, saying it was “absolutely essential” that senior nurses also championed the high impact actions and nursing metrics.

The shake-up will put some nurse jobs at risk. More than 200 nurses work at the HPA, which is being transferred into the new public health service, accountable to health secretary Andrew Lansley.

The NPSA, which employs 21 nurses, is also being abolished, with some responsibilities related to reporting on and learning from patient safety incidents being moved to the NHS commissioning board.

A Department of Health spokeswoman said that some jobs would be transferred and that the department was working closely with HR teams.


Readers' comments (13)

  • Can we really mourn it's passing? Stuffed full of unseated Trust executives the last administration thought too expensive to get rid of, the 'Institute' is a bit of an embarrassment isn't it? The Productive Ward project is one such example of their folly. As far as I can see is well past it's sell by date, not that it should have ever seen the light of day in the first place. Often it's used as an example by Trusts to demonstrate to the great unwashed (sorry - not the patients) that they are 'striving to improve the patient's experience' or some such other saying dreamed up by the Trust communications department. Actually it's a jolly good way of reducing nursing establishments by first of all 'releasing time for care' - then taking it away as a savings target and convincing nurses that they are no worse off - surely not I hear you cry...mmm.

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  • I have to agree with Anonymous | 3-Aug-2010 9:01 am, that pathetic Beasley woman is only speaking out (finally) because it is her an her ilk (namely nomark non job wasters) who populated these quangos that are at risk of losing their jobs.

    Why not be more concerned that front line Nurses are losing their jobs too you vaccuous contemptable woman? That will have a far greater affect on patient safety!

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  • This just goes to show how out of touch the nursing hierarchy are in respect of improving nursing care. Do they not read the national and nursing press!!

    I agree entirely with anonymous.

    If the money we spent on quango's went into supporting local nursing initiatives, that could then be rolled out across the nursing profession, we are more likely to see widespread improvements in nursing practice.

    As always there are the talkers and those that put ideas into practice.

    I for one will not mourn the passing of these organisation on the basis of practice rather than philosophy.

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  • I so agree with the above posts. It's a pity that Beasley and her ilk aren't out on their ears tomorrow. And I'm pretty sure that Beasley will not suffer any hardship whatsoever following the demise of her destitute institute. She will undoubtedly amble over to and sit upon the next ineffectual quango, sucking up precious money and spewing out vapid pronouncements........for us all to throw our hands up in despair.

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  • Halleluyah! Perhaps now we can get rid of the Band 8's whose sole role it is to swan around the wards brandishing clip boards to place ticks in boxes. With the money that is saved from their salaries lets get more real nurses who have time for quality patient care.

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  • Yes indeed anonymous but we must also mention- the navy blue clip board brandishers always come in pairs!!

    My observation is at the weekends and bank holidays our vast staff carpark is almost empty, but in the week it is hard to find a parking space. However, the patients are still being cared for! Who are all these 9-5 ers? I know we need some -but frontline staff are clearly outnumbered!

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  • The two anonymous' above me, it is not the band 8 itself that needs to go, it is the focus on management and ridiculous non job clipboard wielding pointlessness that is ruining this profession at the higher tiers. The focus should be much more on clinical band 8's, those able to improve patient care and treatment with advanced clinical care, not fill in tick boxes. The big question is, are Nurses medical/clinical staff, or management/admin staff?

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  • Yes indeed anonymous but we must also mention- the navy blue clip board brandishers always come in pairs!!

    My observation is at the weekends and bank holidays our vast staff carpark is almost empty, but in the week it is hard to find a parking space. However, the patients are still being cared for! Who are all these 9-5 ers? I know we need some -but frontline staff are clearly outnumbered!

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  • Yes ok, some initiatives might be time consuming and stir things up. And nurses dont like change much. Has anyone thought of auditing how much productive ward has cost the NHS and compared that to the number of nursing posts that could have been funded instead? I bet new posts would have released time to care!

    Quangos deal with issues that are hard to champion on the shop floor and sometimes feel far removed. BUT the NPSA has co-ordinated national infection control measures amongst other things that have impacted on the ward. The HPA does great work with public health and infectious diseases that needs national co-ordination as well. Although they seem removed from our jobs, they serve a purpose. And, without them, whats going to happen? Yet more tasks will be thrust upon nurses involved in patient care in some way. I'm sure we can do it though. We've taken on IV drugs, venepuncture, cannulation, catheterisation, bed management, prescribing, examinations and a whole host of other jobs. Why not give us more work for no money? Us pack horses can take it. In fact, why don't the government just hand over as much as they can to us? It's not like we're all overworked and stressed or anything! Might as well give us a pay cut while they're at it! We'll manage...

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  • I wholeheartedly agree with every sentiment expressed above. Each week we are presented with a new 'task' that 'must' be done to satisfy some 'directive' or else....As nurses on the shop floor our time with the patients is gradually diminishing as the 'nurses' who are 9-5 and fill the car parks up try to verify the need for their job's existence. Just imagine what patient care would be like if they all retuned to clinical care, then again....
    Oh and the person who decided that a nurse should spend 20 minutes every day observing hand washing practice on the ward instead of delivering the care that she is already behind on, should get out there and do it themselves. The only reason hand washing practice might not be all it should be is because we CANNOT do three things at once - please someone in government - GET REAL!!

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