The Essence of Care ‘the English experience- a welding of talents’

1. The Essence of Care‘the English experience- a welding of talents’ Maria Sinfield Project Manager Cheshire and Merseyside SHA

2. Objectives • To consider the drivers in developing the Essence of Care • To explore the journey from development to implementation across the country • To recognise some key influences to sustainability and spread • To examine the lessons learnt and the way forward

3. National Perspectives • Emphasis on the importance of getting the basics right, and creating a modern NHS that delivers high-quality services • The drivers-putting quality at the heart of healthcare • adverse media reports, • the “I was lucky” syndrome • lack of public confidence • Areas of care identified from: • Patient/health carers concerns • Complaints • Ombudsman reports

4. The context “The aspects of things that are most important to us are hidden because of their simplicity and familiarity” Professor Ludwig Wittgenstein 1889-1957

5. Hygiene Pressure Ulcers Continence Self Care Safety Privacy & Dignity Record keeping P Nutrition Communication The fundamental aspects of care • Benchmarks developed • workshops held which included patients, carers & their representatives, Allied health professionals, nurses from both acute & primary care, voluntary organisations, Central principle- • patient centred • All benchmarks are interrelated & relevant to all health & social care setting “seeing things through the patients eyes”

6. Essence of Care is about… • working together to compare, share and achieve best practice in fundamental care • what matters to patients, carer’s and health care professionals • being integral to good clinical governance management

7. The journey • Launched 2001 by the Department of Health (DH) • 2000-Eight regional facilitators trained to use the toolkit. • Supported local facilitators in each NHS acute and primary care Trust • Copies of the toolkit sent to each regional office in February 2001 • Became part of Modernisation Agency within nurse leadership centre • Programme Director appointed • Subject to Ongoing review • Project manager appointed • Communication benchmarks commissioned

8. Embedding • Integrated into Clinical Governance Support Team May 2002, • Document revised in direct response to comments from those using the tool • Format simplified-to maintain focus on practice not the score • Copies of revised toolkit widely distributed • Partnership working with leadership programmes, the CGST and the wider NHS Modernisation Agency • To satisfy demands from the UK and beyond! a downloadable version available on the CGST website .

9. Embracing • Challenges and breaks down traditional boundaries between professional groups and organisations, replacing them with an integrated patient focus. • Good leadership is critical to maintaining the drive and direction of healthcare teams • Nationally the principles of essence of Care have been embraced as fundamental to the implementation and delivery of good clinical governance. .

10. Finding the ‘G’ Spot! Finding the G Spot! • Governance! • Clinical Governance is about the ability to produce effective change so that that high-quality care is achieved

11. Supporting success “If we always do what we’ve always done, we’ll always get what we’ve always got” Mark Twain

12. Belief in human potential • people drive success-using creativity, energy and innovation • culture of the team values people and encourages development • ability is what you are capable of doing, motivation determines what you do & attitude determines how you do it! • those closest to the patient often have best & most intimate knowledge of problems

13. “ Eden was never about plants and architecture, it was always about harnessing people to a dream and exploring what they were capable of…” Tim Smit Harnessing talents

14. Lessons on the way • has to become part of the culture within organisations • needs to be driven by leadership at all levels • shaped by local ownership, bottom up! translation into meaningful actions • Small changes make biggest differences

15. Lessons learnt • Visibility • staff as well as patients need to see it makes a difference! • recognition of effort and achievements KISS • Keep it real/ bite sized pieces/Time scales • Change management • Dealing with Scepticism

16. Where are we now? • Being able to make that difference! • Benefits far beyond any expectations • Challenging the status quo! • Not just ‘nursing’ powerful catalyst to get patients and teams to explore improvements with patient focus • Keeping the patient at the heart of any activity • Robust framework that provides evidence of continuous quality improvement

17. Does it made a difference? Yes! …. So long as it • it is an active pursuit driven by, and focused on, quality • recognises the complex nature of health care systems, and is built from local ownership • is not strangled by paper and procedure

18. Into the future… • April 2005 locally rather than centrally driven • More democratic and locally responsive • Will continue its contribution to NHS improvement and modernisation • Relevance and value • Recognised as a key mechanism for driving continuous quality improvement in patient care • Making the Links with healthcare standards • Essence of Care becoming • integral within policy development at a local, national and international level, i.e. patient choice, greater consumer involvement, long term conditions, NSF’s • Development of networks-to influence policy agenda

19. Into the future… Be brave, never hang back…get out there and go for it!

20. Remember, • Essence of care is not just about structures and processes, Its about people • it belongs to patients, but they need you to deliver it!

21. Thank you! • Wishing you every success with your Essence of care journeys