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'We can’t have excellent patient care without excellent staff care'

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Jocelyn Cornwell points out that, in order for patients to receive the best possible care, nurses need to be taken care of themselves. 

jocelyn cornwell

Despite the winter pressures, spiralling demand on the health service, and pressures on care quality, I haven’t heard anyone in healthcare arguing against the moral imperative to make sure the NHS is safe and delivers high quality care. 

Unfortunately however, the national focus on quality, chiefly focussed on performance targets, comes at a time when the NHS is also facing sustained financial pressure.

For nurses and other health professionals, the effects of austerity have been most keenly felt in stagnant pay, but efficiency savings combined with increasing demand are having effects elsewhere as well.

We know that the numbers of NHS staff reporting work-related stress , violence at work and pressure to go to work when they feel unwell, are all high, and many such measures have become worse in recent years.

Working in the NHS is getting harder and the impact is felt directly by patients and their families.

It may sound like common sense, but we cannot afford to ignore the facts on the ground – that we will struggle to achieve excellent patient care without ensuring that we also achieve excellent staff care.

“Staff taking part in Schwartz Rounds suffered half the rate of psychological distress of those not taking part”

The work we lead at the Point of Care Foundation seeks to tackle this head on.

We are probably best known for our work helping NHS trusts and hospices establish Schwartz Rounds – a unique forum for all healthcare staff (clinical and non-clinical, including porters) to come together and reflect on the emotional and psychological impacts and the non-clinical aspects of their work.

The ‘Schwartz community’ of people involved in organising, facilitating and participating in the rounds is active and vocal, and we regularly hear about the impact they see on staff wellbeing and organisational morale.

One of the great boosts for our work last year was to see the National Institute of Health Research publish evidence from a national evaluation of the implementation of the Schwartz Rounds, led by Professor Jill Maben at Surrey University, which showed that staff taking part in Schwartz Rounds suffered half the rate of psychological distress of those not taking part.

In other parts of our work, we are directly engaged with helping front line staff improve patient care, through programmes such as patient shadowing where we work with clinical teams to improve staff awareness of patient needs.

Feedback from participants in these programmes also points to the link between patient care and staff wellbeing.

We hear stories of how responding to patients’ needs has a re-energising effect on people - for some, reminding them of why they got into the caring profession in the first place.

“There are some obvious ways that the government can address many of these issues - and there are practical tools and methods that can help employers and staff recognise the challenges faced”

As one nurse working in our end of life programme described it: “The relentless drive to be efficient in a target-based healthcare culture totally missed the point of caring. This was my antidote.”

We appreciate that right now is a difficult time for NHS nurses, with a largely unhappy workforce and particular challenges with recruitment and retention.

There are some obvious ways that the government can address many of these issues and there are practical tools and methods that can help employers and staff recognise and act on the challenges faced. We want to argue that focusing more attention and resource on staff wellbeing, and on practical ways to support staff, including the Schwartz Rounds, is an important contribution to solving workforce issues in the NHS.

We would like to see health leaders at all levels demonstrate that they understand that truly patient-centred care starts with a concern for the health and well-being of the staff that do the caring.

Jocelyn Cornwell is chief executive at the Point of Care Foundation

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