I was delighted to launch Leading Change, Adding Value in May 2016.
It was a great start to the shared national implementation of our framework and, amazingly,
when we live streamed we had over 12,000 devices linked in and through connections with Twitter
and other social media we had an estimated number of people participating as over 3.5
million.
Key messages of the framework position Nursing, Midwifery and care staff as leaders, no matter
what their role or wherever they work and that really resonated strongly on the day.
As did the principals of us identifying and addressing unwarranted variation, that is
looking at what needs to change or how services can be improved, whether that be for the experience
of our patients or for the individuals and populations that we care for, of course, and
as I witness on a regular basis many colleagues already do this as part of their everyday
practice, however, much of this essential work remains hidden and often misunderstood
and we don’t easily capture it or measure it.
So we need to look specifically at reducing that unwarranted variation and where we find
that standards of care are not equal and there are inequalities how we can change them and
how can we ensure that everyone receives the best possible care?
That has really struck a chord with the people that we are working with, I am, therefore,
very pleased to be updating you on the fantastic work that has taken place so far as we’ve
started to implement Leading Change, Adding Value.
We have received several case studies of Nursing, Midwifery and Care staff who have been identifying
and addressing unwarranted variation in their very many different organisations.
Their work shows how we can narrow those three gaps that we identified in the five year forward
view; that is Health and Wellbeing, Care and Quality, and Funding and Efficiency.
We have got examples such as the Exemplar Ward Programme at the UCLH in London, the
FINCH programme at Sandwell and West Birmingham Hospitals NHS Trust and the fantastic Hot
Potato project supporting mental health in young people in Cumbria.
These and countless other examples are very great exemplars of demonstrating Leading Change
Adding Value in action.
University College London Hospitals (UCLH) have developed an Exemplar Ward programme
that is designed to support clinical teams to implement standard processes, reduce unwarranted
variation and deliver local quality improvement initiatives in their wards and departments.
Data packs and monthly trend reports allow staff to view at a glance how their ward is
performing, identifying what is being done well and what needs to improve.
UCLH are aiming to move from reactive use of information towards a more proactive and
preventative approach to its use, ensuring that patients receive quality care at all
times and that staff work in a culture that supports and motivates them to engage in continuous
improvement.
Sandwell and West Birmingham Hospitals NHS Trust have developed a nurse-led Faecal Incontinence
and Constipation Healthcare (FINCH) service, where an integrated care pathway has been
designed to increase accessibility, streamlining of the patient pathway and provide a dedicated
service for the management of faecal incontinence and constipation.
Prior to the service being developed, patients were seeing 3 or more healthcare professionals
before seeing the right person, so patient and staff time was not being used as effectively
as possible.
The introduction of the integrated care pathway for faecal incontinence ensures that patients
are seen in a timely fashion, by the correct clinician, in the right setting closer to
their home address.
As a result of the service patient outcomes and experiences have significantly improved,
hospital admissions have reduced and savings have been made from decreased laxative and
pad usage.
In Cumbria challenges to access mental health support services had been identified and a
longer wait period compared to other similar services within the country.
To support members of a local youth theatre group understand more about mental health
issues, a student nurse developed "The Hot Potato Project" and with support from the
local Child and Adult Mental Health Service (CAHMS) created workshops where the young
people could express their fears and anxieties regarding mental health and wellbeing whilst
in a safe and secure peer environment.
A DVD of 40 monologues was produced, which is now being used as an educational tool amongst
the schools in Cumbria, educating both the young people but also the health professionals
such as school nurses who are using it
There is evidence that early intervention and prevention is particularly important in
affecting outcomes for children and young people and can have a significant positive
impact on a person's prognosis.
Within Kendal, there has been a very positive increase in young people accessing support
at an early stage when they find that they are struggling to talk about mental health.
Professor Jane Cummings, Chief Nursing Officer, NHS England:
Leading Change, Adding Value encourages us to apply the same importance to quantifying
our work as we do to ensure quality remains at the heart of all we do.
The framework aims to help support us in truly considering the outcomes of our work and showcase
the measurable positive difference that we achieve daily.
The implementation of Leading Change, Adding Value was already starting to demonstrate
and quantify our key part in the transformational change.
Our professional contribution to the five year forward view and other initiatives such
as: All Our Health, Getting it Right First Time, NHS Rightcare and other local, regional
and national work will be set out and disseminated across the country: an Atlas of Shared Learning
and a complementary Research Portfolio are currently being populated and they will provide
an interactive repository of over 200 case studies, very clear examples of good practice
and evidence based practice.
These case
studies translated into a mix of films and text demonstrate leadership from nurses , midwives,
and care staff all across the country in different roles, different sectors and different organisations
they are all sharing the work in identifying unwarranted variation and addressing how they
have worked on that and implemented changes in their practice.
I would like to thank you for all the work you have progressed so far on Leading Change
Adding Value, I really do know how busy you are and I thank you sincerely for the work
that you do in often very challenging circumstances and I want to flag up that the ways of working
described in the Framework are actually, for many of you, the way you work currently it
is just being described in a different language so I am asking those of you who might have
been hesitating about how you could put the framework into practice, look at Leading Change
adding Value Web pages, look at the examples we have got, email the team and the address
will be on the screen shortly; please share the excellent work that I know that you do
every day and help add to our Atlas of Shared Learning, spread the fantastic practice that
you do both nationally and internationally.
Thank you very much again for everything that you do.