Ward Sister Charge Nurse and Team Leader Conference

1. Ward Sister Charge Nurse and Team Leader Conference Charlotte Mcardle Chief Nursing Officer DHSSPSNI

2. NI local issues • Financial climate • Demographics • Public health • Media reports • Francis Inquiry Transforming your Care Fit and Well-changing lives 2012-2022 Quality 2020

3. How will N+M Lead TYC • It is a big challenge but also a great opportunity • Our professions are best placed to lead this change alongside others • We must continue to be the advocate for the public • We must be truly person centred supporting people to make their decisions about care • We must be open to change and create change for the right reason • New roles and opportunities to push the boundaries • Must engage with technology

4. Q2020 • 10 year strategy to improve quality in health and social care in NI • Based on principles of safety, effectiveness and patient & client focus • Avoidable and preventable harm • Right care in the right place at the right time with the best outcome • All patients and clients fully involved in their care and treated with respect and dignity

7. Robert Francis Press Conference Statement 6/2/13 “We need a patient centred culture, no tolerance of non compliance with fundamental standards, openness and transparency, candour to patients, strong cultural leadership and caring, compassionate nursing, and useful and accurate information about services” “The Trust Board was weak. It did not listen sufficiently to its patients and staff or ensure the correction of deficiencies brought to the Trust’s attention. It did not tackle the tolerance of poor standards and the disengagement of senior clinical staff from managerial and leadership responsibilities. These failures were in part due to a focus on reaching targets, achieving financial balance and seeking foundation trust status at the cost of delivering acceptable standards of care” “Conventionally, some might say depressingly, when a disaster has occurred in the NHS the usual approach has been to blame and sack individuals or to propose major reorganisations. What has been found to be wrong here cannot be cured by finding scapegoats, and/ or recommending major reorganisations yet again”

8. Key themes of the recommendations • Putting the patient first • Common culture • Standards of service • Professional regulation of fitness to practice • Regulating healthcare systems • Complaints handling • Performance management • Medical training and education • Openness, transparency and candour • Nursing • Leadership 290 recommendations in total

9. Nursing • The Department of Health and NMC should introduce the concept of a Responsible Officer for nursing, appointed by and accountable to, the NMC • Without introducing a revalidation scheme immediately, the NMC should introduce common minimum standards for appraisal and support with which responsible officers would be obliged to comply. They could be required to report to the NMC on their performance on a regular basis • As part of a mandatory annual performance appraisal, each nurse, regardless of workplace setting, should be required to demonstrate in their annual learning portfolio an up-to-date knowledge of nursing practice and its implementation

10. Nursing • There should be an increased focus in nurse training, education and professional development on the practical requirements of delivering compassionate care in addition to the theory • There should be a national entry-level requirement that student nurses spend a minimum period of time, at least three months, working on the direct care of patients under the supervision of a registered nurse • The NMC, working with universities, should consider the introduction of an aptitude test to be undertaken by aspirant registered nurses at entry into the profession, exploring, in particular, candidates’ attitudes towards caring, compassion and other necessary professional values

11. What could it look like? A system built on standards with Safety and Quality the driver …………….clear fundamental set of standards, driven by the interests of patients, and devised by clinicians; a “bottom up” as opposed to a “top down” system .

12. Ensuring SafetyImproving QualityTesting the patient/client Experience … Nearly will not do  130 mph )))))))

13. The Person-centred Nursing Framework (McCormack and McCance, 2006)

14. Prerequisites Care Environment Care Processes OUTCOMES • Appropriate skill mix • Shared decision making systems • Effective staff relationships • Supportive organisational systems • Power sharing • Potential for innovation & risk taking • The physical environment • Professionally competent • Developed interpersonal • skills • Commitment to the job • Clarity of beliefs & values • Knowing ‘self’ • Working with patient’s beliefs and values • Engagement • Having sympathetic presence • Sharing decision making • Providing Holistic Care • Satisfaction with Care • Involvement with Care • Feeling of Well-Being • Creating a therapeutic Culture McCormack & McCance, 2010

15. How will N+M Lead Q2020 • We have a key role through SQE • Priority to deliver the regional KPIs • Priority to focus relentlessly on QI • Priority to be transparent about practice and the standard of care with the public • Priority to embed patient stories for learning • Continue to do good work on 5 standards for client experience • Continue to embed the person centred nursing framework

16. Key messages • Be proud and stay true to the principles of the profession • Make a difference to peoples lives • Be a flag bearer of compassionate care • Work in partnership with patients and the public • Ensure Safety. Improve Quality and test patient Experience as you go. • Nurses are never afraid of challenge • Nursing is full of challenge