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We are taking great strides to strengthen nursing roles

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Nicola Sturgeon on how Scotland is clearly defining nursing roles to help ensure effective care delivery

Whenever I meet patients on my travels around Scotland, I’m always struck by the number of times I’m told about the nurses who made a difference to their care.

Whether it’s the concerned mother whose child needed a blood test or the lonely elderly gentleman who just appreciated a warm smile and a chat, I’m in no doubt that nurses can, and do, make that connection that puts patients at ease and brightens up a stay in hospital.

It’s in recognition of the great value that patients put on nurses that the Scottish Government has taken great strides to strengthen and enhance their roles.

In our action plan for a healthier Scotland, Better Health, Better Care, the Scottish Government set out a commitment to what we have termed “mutuality” in our NHS. This means developing an understanding among staff and patients that they are co-owners of our public health service and that everyone shares a stake in its success.

‘In Scotland we have recognised the need to clearly define the senior charge nurse role and to empower these nurses to be clinical leaders and guardians of safety and quality’

Our commitment to mutuality means we see quality not just in terms of the clinical performance of our healthcare staff, but also in terms of the role of patients and their families and their experience of care.

As an important and visible part of the healthcare team, nurses have a critical role in translating policy initiatives - such as our national action plan to fight healthcare associated infections, the Scottish Patient Safety programme and theHealthcare Quality Strategy for Scotland - into good practice on the ground.

The quality strategy represents a unique and important opportunity for all of us to work together to make our NHS even better, for everyone. By focusing on what really matters to people, we will raise the quality of healthcare so that it is world leading.

A major part of this involves defining more closely expectations, roles and responsibilities, combined with a shared commitment to take the action required to ensure that our NHS delivers the very best for us all, now and into the future. Nurses are now taking forward several key initiatives as part of this agenda.

The senior charge nurse (SCN) has always had a pivotal role in ensuring person centred, safe and effective clinical practice, managing and developing clinical teams and enhancing the patient experience. In Scotland we have recognised the need to clearly define this key role and to be sure that they will be visible and accessible to patients and their carers.

Therefore, through our review into the SCN role, Leading Better Care, we are empowering SCNs to be clinical leaders and guardians of safety and quality in their area. Led and supported by NHS executive board nurse directors across Scotland, Leading Better Care established a national role framework for SCNs working in hospitals across NHS Scotland.

In addition, the linked development, testing and rollout across Scotland of clinical quality indicators for falls, pressure ulcer prevention and food, fluid and nutrition have led the way at a UK level. These are designed to ensure nurses of all levels know what is expected and that their contribution to care is properly recognised.

These indicators are further complemented by the ward profile, which allows SCNs to collect data on a number of significant factors such as staffing, sickness and absence, and patient activity. These measures provide real support to the SCN in improving care quality.

We have also sought to make close links between Leading Better Care and the rollout across our NHS boards of Releasing Time to Care: the Productive Ward programme. Releasing Time to Care focuses on improving processes to help nurses, therapists and others to spend more time on patient care, thereby improving safety and efficiency.
Following a successful pilot in wards in NHS Scotland, this programme has now been offered to all NHS boards and its scope expanded to include mental health and community hospital settings. Linking together these initiatives is now driving and sustaining real changes in care quality - and that has got to be good for patients.

Leading Better Care and Releasing Time to Care both aspire to improving the quality of care as well as the experience of healthcare and are closely linked to the Better Together national patient questionnaires. The information gathered through Better Together responses will complement local data and will be used to drive improvement.

Of course, these nurse led initiatives are part of wider, cross professional approaches to quality, but early indications are that - alongside an increase in direct patient care time - staff recognise improved leadership ability, greater efficiency, enhanced morale and team working, and a care environment that is safe and secure.

I have always valued what nurses bring to their caring role, but I believe more than ever that empowered and motivated staff in well structured nursing roles are able to ensure that dignity, privacy and compassion underpin clinical practice. For me, these are the watchwords of nursing and I’m in no doubt that by enabling nurses to do what they do best, we’re helping to put patients and their families at the centre of all care provision in Scotland.

Nicola Sturgeon is cabinet secretary for health and wellbeing, Scottish Government

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