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Shaping the future of our NHS

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Hilary Garratt, director of nursing at NHS England, explains how nurses are crucial in helping to deliver the ‘NHS Five Year Forward View’. 


Ahead of the Nursing Times Leaders Congress, I wanted to take the opportunity to discuss the vital role nurses play in delivering the Next Steps on the NHS Five Year Forward View, which sets out how we will continue to deliver high-quality care now and for future generations.

Next year the NHS turns 70 and it increasingly offers new treatments for a growing and ageing population, meaning that pressures on the service are greater than they have ever been.

Despite this, outcomes and experience are generally much better than 20 years ago and, as a profession, we have much to be proud of, with 93% of people saying they trust nurses above any other profession.

We do, however, know the NHS needs to adapt to meet these challenges and take advantage of opportunities such as new treatments and scientific breakthroughs.

“I want to encourage you to support the small changes that can make significant differences to patients.”

As team leaders, you have an important role and fantastic opportunities to shape and deliver care, as well as foster the talents of your teams to achieve this. You are often in a good position to see where changes could significantly improve outcomes and experience for individuals and make better use of resources.

Nursing, midwifery and care staff also play a crucial role in treating more people in the community and closer to home, as the NHS transforms the way that we deliver care.

For example, many of you will know people, particularly with dementia, are admitted with a urinary tract infection, which with the right support can often be managed in a patient’s home. This is particularly important for people with dementia, because they often become more disorientated in an acute hospital ward and stay in a hospital bed for longer than necessary, when they could be better cared for in their own home.

With winter preparedness and leadership in mind, I want to encourage you to support the small changes that can make significant differences to patients.

This includes encouraging all those who are eligible to get their flu jabs, supporting our most vulnerable to stay warm and making sure they have the medicines they need over the winter period.

“By continuing to adapt, we can build a better, more sustainable service for future generations”

There is evidence to suggest that for every 10 days of bed rest in hospital, 10 years of muscle ageing occurs in people over 80 - and building it back up again takes twice as long. So when there is no other option to treat people other than in a hospital setting, we need to embrace the #endPJparalysis campaign to get patients out of their pyjamas and gowns and into their own clothes wherever possible.

Getting patients into their own clothes and out of bed works psychologically to make them feel less sick and physically to get them moving. It often helps patients recover more quickly.

So when we consider the big challenges of an ageing population and tight resources, a simple campaign such as #endPJparalysis shows us how, as leaders, we can make changes that are small but effective.

I would therefore encourage you all to get actively involved in leading changes and shaping services, which will make a huge difference to the treatment and experience of the people you care for.

By continuing to adapt, we can build a better, more sustainable service for future generations.

Leading Change, Adding Value is a supportive framework for all nursing, midwifery and care staff. It can be used by everyone, wherever you work and whatever your role is. It has been developed with a wide range of national organisations, staff representatives, people we care for, carers and the public.

Hilary Garratt is Director of Nursing, NHS England and Deputy Chief Nursing Officer for England 

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