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Essence of Care

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Essence of Care is the government’s strategy to improve the quality of the fundamental aspects of nursing care. It arose because of unacceptable variations in standards of care across the UK.

It was launched in 2001 with a toolkit and came out of the government’s earlier nursing strategy Making a Difference (1999).

It uses best practice evidence to structure a patient-focused approach to care and contributes to the process of clinical governance – the umbrella term for everything that helps to maintain and improve high standards of patient care.

Essence of Care is about benchmarking aspects of care in a structured approach. It provides process for sharing and comparing practices, enables nurses to identify best practice or develop action plans to remedy practice that is identified as needing improvement.

It stresses the need for good practice to be shared to make sure that improvements are passed on and poor practice is identified. It has 10 fundamental aspects of care that were identified by patients and carers as being crucial to their experience of healthcare and things that really matter to them.

The 10 benchmarks are communication between patients, carers and health care personnel; continence and bladder and bowel care; personal and oral hygiene; food and nutrition; pressure ulcers; privacy and dignity; record keeping; safety of clients with mental health needs in acute mental health and general hospital settings; principles of self-care; and health promotion.

Each of the benchmarks specifies a number of areas that must be addressed – for example, food and nutrition includes such topics as identifying patients’ needs, assessing whether they need help when eating, and monitoring what they eat.

Most NHS organisations have a lead member of staff for Essence of Care or have it incorporated into the clinical governance process.

Initially, Essence of Care covered eight areas, but communication was added in 2003 and a new benchmark for health promotion was added in March of this year, leading on from the aims of the government’s publication of public health White Paper Choosing Health: Making Healthy Choices Easier in 2004.

Essence of Care can have a beneficial effect on patient care if nurses are given enough support to implement the benchmarks.

However, a NT survey carried out in 2004, found that although trusts were implementing Essence of Care, many were tackling one benchmark at a time and were choosing to implement the more highly visible ones first, such as nutrition, before others that were considered as less easy to quantify.

More information is available at the Department of Health website

Updated: September 2006

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