Compassion in Practice The Journey So Far… Presented by Suzie Loader Assistant Nurse Director NHS England (Midlands & East) GP Practice Nurse Forum 06 February 2015

Wider Policy Context

Six Areas for Action Helping people to stay independent, maximising well-being and improving health outcomes Working with people to provide a positive experience of care Delivering high quality care and measuring impact Building and strengthening leadership Ensuring we have the right staff, with the right skills in the right place Supporting positive staff experience Notes from left to right Deliver evidence-based care & extend evidence through research Explicitly demonstrate our impact on outcomes Make ‘every contact count’ to promote health and wellbeing Support people to remain independent Maximise the contribution to specialist community public health nursing Design our services so people, and their carers and family are active participants in their care Prioritise patients and the people who receive care in every decision we make Collect, listen to and act on feedback and complaints Promote personal responsibility for health and wellbeing Follow evidence-based best practice to deliver high quality outcomes to those that use health and care services Measure what we do and our contribution to quality Be transparent and publish the outcomes Promote careers in research to strengthen the focus on evidence based practice Ensure all registered nurses & midwives understand their leadership role with the wider care-giving team Free our leaders to have time to lead e.g. supervisory status, better use of technology Empower nurses, midwives & registered managers to make local changes to improve care. Use evidence based staffing levels Commit to and support life long learning for the whole care-giving team Recruit staff with the right culture & values Create worthwhile & rewarding jobs Create equality of opportunity Support each other & new entrants to the professions Be professionally accountable Embrace new technology Be productive and efficient

Developing the culture of compassionate care CNO Jane Cummings launched the nursing & midwifery 3 year strategy at the 2012 CNO conference. The National lead is Juliet Beal and our Regional lead is Suzie Loader, supported by Vicky Reed (Programme Manager). With the findings of the Keogh Reviews, and the Don Berwick review on the NHS, Compassion in Care has become even more relative in these changing times.

A Celebration of Good Practice: taking CiP into 2015 & beyond…

The Regional Team Suzie Loader Vicky Reed Shelley Bewsher suzie.loader@nhs.net Vicky Reed Vicky.reed1@nhs.net Shelley Bewsher shelley.bewsher@nhs.net Pauline Milne Pauline.milne@nhs.net

Our Aim: Notes from left to right To capture and maximise what has already been achieved as a result of implementation of Compassion in Practice (CiP) To identify with you a plan for taking CiP into its 3rd and final year To integrate Care Makers into the delivery of the CiP strategy To develop an evidence base demonstrating the impact of CiP To enable the celebration and sharing of good practice To provide support to you and your colleagues Notes from left to right

Areas of good practice will be identified and shared on our website The Scoping Exercise… To include all innovations which fit under the CiP banner, not just those badged as CiP Identify examples of good practice, where outcomes for patients and staff have been identified All providers (independent, NHS, social care etc.) and commissioners have been asked to complete a form Data from all the forms will be analysed and feedback provided to all who participated Areas of good practice will be identified and shared on our website

Governance & Communication… Established a Regional Programme Board – 1st meeting December 2014 Identified leads for each of the 6 action areas Identified draft objectives for: providers, commissioners & the Region against each of the 6 action areas Submitted a business plan to take CIP into 2015/16 Developing a comprehensive communication plan (blogs, twitter chats, development of the 6Cs website to include a M&E community, individual letters to DONs re their care makers etc.)

Compassion in Practice Events 18 November 2014 – Away day for directors/deputies & care makers 12 January 2015 – work shop for the Open and Honest pilot organisations 23 January 2015 – Making a Difference is 6Csy conference 23 March 2015 – Community & Primary Care Nursing regional event: 5 Year Forward View / Shape of Caring debate 2015/16 – M&E Compassion in Practice awards Various CIP presentations regionally & nationally + lots planned for next year

Action Area 2: ‘Working with people to provide a positive experience of care’

AA2: What we have achieved to date Friends and Family Implementation, demonstrating improvements in practice Friends and Family Pathfinder Evaluation: Changes to FFT as a result Patients at the end of their life Patient Leader role development Patient Stories: evaluation and publication with Week of Action in September 2014 ‘Learning from Complaints’ Improvement Strategy Regional AA2 Action Plan and regular review at the Regional CIP Programme Board Path Finder FFT methodology changed following feedback to make it easier for patients and staff to understand. Patients at the end of their life want to be asked about the quality of their care, but in a general sense rather than an end of life sense. The biggest finding was that staff were reluctant to ask EoL patients Patient Leaders: Trained people to support organisations Regional Network (since before the changes) Supports implementation of best practice Patient Stories Resource hub shortly to be available on 6Cs website (April) Important to tell patient stories (and act on those stories) at every level of the organisation – should be used to improve the quality of service delivered

Action Area 3: ‘Delivering high quality care and measuring the impact’

Open and Honest Care: NHS England is committed to making more information available about the quality of care in the NHS. This initiative is a central part of NHS England’s ambition to ensure every patient gets high-quality care, and to build improved services for the future. Aim of the programme is to enable organisations to publish patient experience and harm data consistently in one place alongside improvement stories for each individual organisation. This provides patients and staff with open and honest information in a user friendly consistent format.

1. Minimise data burden on staff by using data already collated Four Overarching Aims 1. Minimise data burden on staff by using data already collated 2. Bringing available data on harm together in one place and presenting it differently to make it meaningful to improve care locally and reduce avoidable harm 3. Improvement stories describing what trusts have learnt and what improvements they are making 4. Continuous improvement over time against individual Trust aspirations (not for comparing organisations )

Open and Honest Care in M&E The 14 Pilot Organisations met on 12 January 2015 to decide on Open and Honest approach across M&E: Board Compact template Standard Operating Procedure (acute and community) Phase 1 & 2 data sets Report Format Identify what ‘Patients Want to see’… Aim to publish first set of data on organisations websites by April 2015

Action Area 4: ‘Building and strengthening leadership’

AA4: Building and strengthening leadership Key national objectives Co-ordinate the leadership of the nursing and care professions Develop a set of tools that enable organisations to measure their culture Support providers in reviewing their organisational culture and publishing the results Implement a new leadership programme for ward managers, team leaders and Directors of Nursing based on values and behaviours of the 6Cs Implement and embed the Leadership Qualities Framework for Adult Social Care     

Action Area 5: ‘Ensuring we have the right staff, with the right skills in the right place’

National Quality Board Guidance Available at: http://www.england.nhs.uk/wp-content/uploads/2013/11/nqb-how-to-guid.pdf

Hard Truths Department of Health response to the Francis Inquiry Hard Truths. The Journey to Putting Patients First; includes the requirement for that: ‘from April 2014, and by June 2014 at the latest, NHS Trusts will publish ward level information on whether they are meeting their staffing requirements. Actual versus planned nursing and midwifery staffing will be published every month; and every six months Trust boards will be required to undertake a detailed review of staffing using evidence based tools’. First published 24th June 2014 and monthly thereafter

Workforce Planning Tools Safer Nursing Care Tool (SNCT) Guidance and Multipliers updated in July 2013 http://shelfordgroup.org/resource/chief-nurses/safety-nursing-care-tool IPAD-APP developed to record SNCT acuity and dependency scores at the bedside and generate local reports – implementation plan in development Birthrate Plus - RCM published updated guidance in autumn 2013 SNCT for Acute Admission Units launched May 2014. http://shelfordgroup.org/resource/chief-nurses/aau-safer-nursing-care-tool SNCT for Children’s In-Patient Wards for approval by Shelford Group (anticipated launch Spring 2015) SNCT for Accident and Emergency Departments – beta testing planned overseen by Shelford Group (anticipated completion April 2015) Mental Health Inpatient Staffing Framework (awaiting publication through NHS England) Work underway to develop tools / guidance for Learning Disability and Mental Health Community settings

Expanding the Evidence Base NNRU Scoping report on impact of 12 hour shifts (awaiting publication through NHS England) Literature reviews undertaken for Mental Health and Learning Disability work streams Research being commissioned on: impact of supervisory status for lead sister / charge nurse or equivalent links between staff numbers and outcomes (patient and staff) More in-depth research on impact of 12 hour shifts on HCAs and patients (Hard Truths action)

Education and Training AA5 Week of action held in December – webinars / twitter chats HEE and NHS England joint work to develop an education and training package on safe staffing for nurses and midwives Working group being established – nominated representatives received

NICE Guidelines on Safe Staffing http://www.nice.org.uk/guidance/SG1/chapter/introduction http://www.nice.org.uk/guidance/sg1/resources/sg1-safe-staffing-for-nursing-in-adult-inpatient-wards-in-acute-hospitals10 Final guidelines were published 15 July 2014. Guidance for Midwifery staffing consultation closed. Final publication due February 2015 Guidance for Accident and Emergency Units consultation 12/1/15 – 6/2/15. Final publication due May 2015 Future guideline topics – mental health, community, learning disability (dates TBC)

Safer Staffing: Contact Hours Pilot Guidance published November 2014 Key points included: Clear indication that it can be used as a tool to inform the 6 monthly review of staffing requirements; Supported by staff who undertook the review; Contribution to patient care by others should be recognised; and Impact of other factors on ability to deliver care. Ability for CQC to test principles within regulatory regime Align with key stakeholders Currently aligning results with the Safer Nursing Care Tool database consisting of 100+ wards across England.

HEE’s contribution to AA5 Developed an Older Persons Nurse Fellowship Programme Values Based Recruitment 2013/14 pre-degree care pilot completed but on-going Talent for Care Strategic Framework – approved by HEE board Oct. 2014 Implementation of the Care Certificate: April 2015 Older Persons Nurse Fellowship Post-grad framework: 3 levels: foundation, specialist & higher specialist Northumbria Uni developed the National Curriculum for foundation and specialist levels and Kings College London for the Higher Specialist Kings College is currently recruiting to the fellowship programme 2 cohorts of 12 students each, completing in Oct 15 and Feb 16 Values Based Recruitment Values based recruitment to employment (led by NHS Employers) assessment tool, which helps employers to map current recruitment processes to the NHS Constitution has been well received. Available on NHS Employers website Pre-Degree Care Pilots 13/14 pilot now complete and findings presented to HEE board 27 Jan 2015 HEE will implement further where valued Vast majority of pilot students now in nursing programmes Existing pilot sites and new sites, continue to pilot across 14/15 with >350 participants across >40 employers Talent for Care Get In, Get On, Go Further… Launch & Implementation is expected early this year Care Certificate Final Care Certificate documentation published last Friday on HEE website Implementation date April 2015 National event planned for 17 Feb followed by regional events

To identify with you a plan for taking CiP into its 3rd and final year In Conclusion: To capture and maximise what has already been achieved as a result of implementation of Compassion in Practice (CiP) To identify with you a plan for taking CiP into its 3rd and final year To integrate Care Makers into the delivery of the CiP strategy To develop an evidence base demonstrating the impact of CiP To enable the celebration and sharing of good practice To provide support to you and your colleagues

ANY QUESTIONS? Suzie Loader Assistant Nurse Director NHS England (Midlands & East) suzie.loader@nhs.net