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

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

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

5. 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” Safety Continence Hygiene Pressure Ulcers Self Care Privacy & Dignity Nutrition Record keeping P

6. 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 Essence of Care is about…

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

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. Harnessing talents “ 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

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