Commission discusses public comments

October 30th, 2009

Reflecting on views from the public and professionals, and considering how it will formulate its report, were major topics discussed at the Commission’s fifth meeting.

The commissioners met in London on 23 October, the day after a national deliberative event where they listened to a range of opinions on nursing and midwifery in England. Health service users, new mothers (and babies), nurses, midwives and members of the public told commissioners what they thought of the commission’s vision for the future. They also commented on the 10 hot topics on which commissioners are seeking fresh thinking and innovative solutions.

At their own meeting, commissioners also exchanged views on what they have been hearing during the series of listening events hosted by Strategic Health Authorities in each English region. One emerging issue was the fact that the public is not always fully aware of the range of nurses’ and midwives’ roles and how they have changed to reflect current health knowledge and needs.

Commissioners agreed how to structure the report that they will launch by next March. As well as a written text in a traditional format, its key messages will be communicated to different audiences using a variety of media and formats, to reach as many people as possible.

Finally, the commissioners discussed the main system barriers and forces that prevent nurses and midwives from fulfilling their full potential. They agreed that the biggest impact in future will come from relocating care from hospitals to home and community settings.

National listening event

October 29th, 2009

Ann Keen MP, chair, and Commissioners listened attentively during a national listening event held in London on 22 October 2009. Delegates were asked for their views on the hot topics and themes that have emerged from the Commission’s Second Phase.

Supporting people in hard times

October 16th, 2009

Judith GriffinJudith is Chief Executive of NHS Blackburn with Darwen. Judith trained as a Nurse Cadet in the 70s, becoming a Community Nurse, Health Visitor and then a Midwife. She is leading plans to integrate health and social care commissioning to tackle health statistics and work, solving longstanding poor health and health inequalities by establishing a pioneering NHS Care Trust Plus organisation.

To get the best out of our workforce we need to support staff and acknowledge that we all have issues outside of work that will impact on our day to day lives.  This is more important than ever in the difficult financial times we are experiencing.

In Blackburn with Darwen we are just launching a service that will give every member of staff and all members of their families access to 24 hour advice, support and counselling on any issue, from advice on money worries to practical information on parenting.

Too often care can be seen to start and end at the door to the hospital, treatment room or surgery. Even in people’s own homes when we feel under pressure and are rushing to the next visit we may end up thinking just about the treatment rather than the person we are caring for and all their concerns.

The things that we worry about as individual members of staff are often the things that worry patients and members of the public – a good education for our children, having enough information to make sensible choices about our lifestyles or choosing the best services to meet our needs. We want homes that are safe and warm, sufficient income to pay the bills, and to live in communities where we feel safe and are valued as individuals with equal rights.

When people do not have these things, we know inequalities occur. Those who live in deprived communities, in poorer houses or have neither the skills nor the means to get the best out of services will die earlier than those who are better educated, live in nice houses or can make their voice heard. In the NHS people who are disabled, who have mental health problems or who are unable to communicate their needs will often not get the same access or standards of care as others.

I know many nurses and midwifes share my outrage that people die earlier or live lives in greater ill health just because of where they are born or the lack of opportunities available to them.

Each day every one of us will encounter someone who has some form of disadvantage and thus experiences a ‘lesser’ standard of care. By seeing others in the context of the lives they live outside their contact with the NHS and being prepared to advocate and stand up for patients who need a greater level of support or care every one of us, each and every day, can start to address inequalities and ensure everyone receives the care and compassion we all expect and need.

Steady stream of bad press stories

October 15th, 2009

Janice SigsworthProfessor Janice Sigsworth took up her post as director of nursing at Imperial College Healthcare NHS Trust in 2008, coming to the Academic Health Science Centre from the Department of Health. As deputy chief nurse (England), she worked extensively to modernise nursing careers and on the nursing contribution to the Department of Health’s Next Stage Review.

I am not sure if I’m the only one, but the whole focus of improving patient care and the patient experience seems to have fallen at the feet of the ward sister or charge nurse.

In many ways this is true, but is it the answer to the steady stream of bad press stories and the sad and distressing relative’s stories published by the Patients Association?

The NHS Institute, inventor of ‘Productive Ward’, gives ward sisters and charge nurses the tools and techniques to challenge their practices and help staff spend more time at the bedside caring for patients. Here at Imperial College Healthcare Trust the Productive Ward has been well received by clinical staff as a way of improving practice and care.

But is this enough? My own experience and early outcomes from our Productive Ward programme show that it is the bigger systems, processes and environments of care that we need to get right, as well as the work of the individual staff themselves. By this I mean how beds are managed; how doctors work, when stores are delivered, how well bank and agency systems run, how quickly ‘take home’ tablets get to the ward once the doctor has ordered them. I am sure you can think of many more.

So it’s not as simple as sorting out the ward sisters and charges nurses, we have to get the whole organisation lined up behind them and the patient to truly deliver a good patient outcome and experience.

Staff survey results are a helpful balancing act: broadly, if staff are content and happy in their work then you generally find content patients. So let’s focus on the systems as rigorously as the staff themselves, otherwise I fear both will fail.

The Pensioner’s Bulge

October 14th, 2009

Claire RaynerClaire Rayner is president of the Patients Association and a nationally known author, journalist, broadcaster and agony aunt. After leaving home at 14 for a nursing job, she later trained as a nurse, won a gold medal for outstanding achievement in 1954, and studied midwifery before starting her writing career in 1960. She was the agony aunt on The Sun and Sunday Mirror and has written over 90 books about home nursing, family health, sex education, and baby and childcare. She believes passionately in standing up for patients.

We live in an ageing country. At the start of the 20th century most women could find a husband, and vice versa. Family sizes were fairly large – four, five or even six children per household was not unusual and even in small houses, grandparents lived with the family. Few people lived much later than about 70, a great many more only reached their sixties; 65 was set as Old Age Pension time because most people died well before.

Massive changes resulted from the two world wars. So many young men were swept away in a morass of mud and blood during WW1; a similar carnage, this time including women and children, occurred in WW2. Today’s pensioners grew up in a female-dominated world run by women whose potential spouses were dead… Our teachers were all single women; our hospital and district nurses were all single women; offices, shops and all sorts of institutions knew they could rely on hard-working female staff.

But enough men survived WW2 to come home and father the next generation and they did so with such enthusiasm, as did their wives, that the birth rate leapt. The Baby Bulge it was called – and it is now becoming a Pensioner’s Bulge.

This is the background to our current dilemma. People’s bodies and attitudes age less quickly. In the mid-Fifties, 40 was well into middle age. I had my first baby at 28, and was described by my midwife as ‘an elderly primipara’. Now, with IVF clinics working flat out, motherhood at 40-plus is not uncommon.

I offer this précis of what has happened to the population because of its huge importance to graduate nurses. You have to accept that most of your patients are likely to be very old. So many people in their seventies, eighties, and nineties, stay safely home now, with caring GPs and Community Nurses and family support. Those who are frail and need hospital care will be very dependent indeed.

If you are one of those who find helping to keep an incontinent old person clean a ‘menial’ task, you may need to change your career.

If you think it a waste of the time of a nurse educated to degree level to feed a helpless old patient, you too are in the wrong job.

Commission sets out future

October 2nd, 2009

A vision that will allow nurses and midwives to transform quality of care has been set out by the Prime Minister’s Commission on the Future of Nursing and Midwifery. Commissioners have also identified ten hot topics that they wish to probe and debate further such as the need to address the confusion over roles and titles of nurses and midwives, and the role of nurses and midwives in putting users of health services in charge of their own care.

Health Minister and Commission Chair Ann Keen said:

“We have had an overwhelming response to the first stage of our crucial work in shaping the future of nursing and midwifery and received over 2,500 individual and organisational responses reflecting the views of many thousands of people.

“The Commission has reflected on these responses and identified some hot topics that we want to hear more views on during the autumn. As a nurse, I believe these issues go to the very heart of shaping the future of our profession and I look forward to hearing detailed suggestions on how we can tackle them which will help shape the detail of our report.”

Read the Summary vision and add your views.
Read the Hot topics and add your views.