Nursing and Midwifery Strategy
Whipps Cross University NHS Trust
2008-2011
“Nursing and midwifery will be at the centre of clinical decision making and the
driving force to influence the changing model of health care delivery, which will
be delivered by competent practitioners.”
1
Table of Contents
1. Introduction
2. Vision
3. Strategic context
4. Nursing and midwifery strategy
5. Strategic objectives
6. Measuring success
7. Trust values and engagement
8. Vision into action
9. Summary
2
1. Introduction
This Nursing and Midwifery Strategy has been developed to
ensure that our nursing and midwifery staff
continue to contribute to achieving the Trust vision, values and
objectives. We recognise that our nursing and midwifery staff
provide the majority of care to our patients to support them
throughout their stay.
This strategy links with the Trusts clinical
strategy, workforce strategy and education
and training strategy and
To ensure the future development of the
organisation as a Foundation Trust it is
essential to develop and retain a nursing
and midwifery workforce that will continue
to grow in terms of skills and abilities to
work in a changing environment with new
ways of working and this strategy aims to
address these needs.
Through education, research and development programmes
nurses will challenge practice and lead the implementation of
evidence based care, which meets the patient’s individual
requirements.
The nursing and midwifery workforce will ensure that services
are;
 Patient centred
 Focussed on quality
 Clinically driven
midwifery will be
 Flexible
Nursing and
at the centre of clinical
decision making and the
driving force to influence the
changing model of health care
delivery, which will be
delivered by competent
practitioners
2. Vision
Nursing and midwifery will be at the centre of clinical decision
making and the driving force to influence the changing model
of health care delivery, which will be delivered by competent
practitioners
Nurses and Midwives will provide excellence of care having
developed clinical competence and confidence to meet the
challenges of the Modernisation agenda for the NHS. Their
roles will be clearly defined, complementing other members of
the multi disciplinary team.
Within an organisation that;
 Values people and
 Promotes life long learning
3. Strategic context.
The refresh of the strategy for Nursing and
Midwifery originally created in 2004
offered an opportunity to review the vision
for Nursing and Midwifery, which would progress the
development of nursing and midwifery practice. The strategy
provides scope to continue to develop an exciting agenda
within Nursing and Midwifery based upon the national drivers
of the Nursing and Midwifery strategy.
In developing a local strategy Nurses and Midwives have
listened to the views of Trust and Educational colleagues, and
the local community. This strategy therefore reflects not just
the national agenda but the needs of the users of the service.
To ensure that a wide base of staff and other stakeholders
could influence the development of the strategy an open space
event took place in August 2007. All the stakeholders met to
share information, to be involved and to identify areas of
3
common purpose. Everyone participated in looking at the past
and present of Nursing and Midwifery in the Trust and in
making decisions about the future priorities.
The strategy has a strong focus on quality and leadership and
thereby recognises the significant contribution, which Nurses
and Midwives can have on standards of care for our local
population.
High Quality Care for all - next stage review 2008 published by
the Department of Health sets out the national priorities for the
delivery of health care services over the coming years. It is
vital that Nurses and Midwives make the most of the
opportunities that this poses, whilst championing the patient
experience. In effect Nurses and Midwives must continue to
take traditional values forward and apply them in a modern
context, acting as advocates for patients first, and for our
profession second. This is what patients expect of us and this
is what we must commit to delivering.
The main system reform and improvement developments
which influenced the development of the Nursing and
Midwifery strategy are:
 NHS “Improving Lives Saving Lives” strategy
 World Class Commissioning programme
 Implementation of the European Working Time
Directive (EWTD)
 National “People Matters” Framework
 Modernising Nursing Careers (MNC)
 Patient choice and the private and voluntary sector’s
involvement in provision of health care
 Modernising Professional Regulation/NHS Careers
NHS Connecting for Health
 Medical and technological advances
 Standards for Better Health (SfBH)
 “Our Health, Our Care, Our Say”, White Paper



1st October / Nurses in Society
Every Child Matters – safeguarding agenda
Maternity matters: choice, access and continuity of
care in a safe service.
The key elements of the Trust Clinical Strategy influencing the
development of the nursing and midwifery strategy include;
 WXUH will be a major acute hospital serving the
population of North East London with the aim of achieving
Foundation Trust status.
 Provision of care will be designed on levels of care
required based on acuity and the services and skills set
required rather than speciality
 WXUH will serve as one key component of local urgent
care networks – closely integrated with primary care, out
of hours care, ambulance services, social care and mental
health services;
 Accident & Emergency facilities at WXUH will be
supported with the essential set of acute care services
and resources to ensure patient safety;
 Beyond these services there will be a focus on developing
and expanding clinical services which will bring maximum
value in terms of quality of care and financial value.
 Traditional organisational boundaries will be overcome –
clinical staff from both WXUH and PCTs will straddle both
primary and secondary care settings.
 Patients require integrated services and true integration
will be developed from seeking to implement best clinical
practice and innovation
 Research, education and training is an integral part of the
strategy and will continue to be a core service in ensuring
that we are providing the best care to our patients.
4. Nursing and Midwifery strategy
4
In line with the corporate objectives this strategy incorporates
the seven domains of the annual health check.
Clinical and cost effectiveness
Nurses and Midwives are key to ensuring that evidence based
standards are implemented in order to ensure the
effectiveness of the care and services that patients receive.
5. Strategic Nursing and Midwifery Objectives:
5.1 Patient safety
Patient safety matters at every level of the organisation and is
everyone’s business.
By 2009 we will
1. be using the patient safety/quality tool in all clinical areas
and report quarterly to Director of Nursing with relevant
action plans in progress
2. senior clinical staff will work clinically every Wednesday
and review care giving feedback to matrons and engaging
them in decision making
3. all staff are enabled to achieve appropriate skills e.g.
ESAC for qualified staff and HCSW with 60% achieving
initial competencies, slips trips and falls, blood transfusion
and skills and drills for midwifery staff
4. changed the wristband identification policy and audited the
effect
5. have all ward areas at 100% compliance on the high
impact intervention monitoring to facilitate a reduced HAI
By 2010 we will
1. Have revised the patient safety tool and reviewed its usage
across the trust
2. Senior clinical staff will regularly work in different areas to
provide a robust audit and learning process across the
trust
3. All staff are enabled to achieve appropriate skills reviewed
the policy for safeguarding children and vulnerable adults
By 2009 we will
1. Have introduced productive ward in two clinical settings
and created a rollout plan for the rest of the Trust
2. ensure that all our patients have a robust admission and
discharge plan set in conjunction with the rest of the health
care team to ensure timely and appropriate care.
3. the patient journey is appropriate, safe and effective
4. ensure that 50% of our clinical policies are reviewed and
reflect best practice
By 2010 we will
1. Have introduced productive ward in six clinical settings and
created a rollout plan for the rest of the Trust
2. ensure that all our patients have a robust admission and
discharge plan set in conjunction with the rest of the health
care team to ensure timely and appropriate care.
3. ensure that 100% of our clinical policies are up to date and
reflect best practice
what about tissue viability here?
Governance
The strategy compliments the ‘High Quality Care for All’
document – which requires by April 2010, trusts to produce
quality accounts. The governance agenda is fast becoming
embedded within the organisation, along with standards that
the organisation are being measured against, ensuring that
delivering a quality service is second nature rather than being
seen as an add on.
By 2009 we will
1. have offered leadership and management development to
at least 10% of band 6 and 7 staff
5
2. have audited 2 of the national Essence of Care
benchmarks
3. ensure that all of our band 7 and 8 staff are familiar with
the requirements for HCC and NHSLA
4. review the role of the matron and protected the key
elements of the role
By 2010 we will
1. have offered leadership and management development to
at least 25% of band 6 and 7 staff
2. have audited 5 of the national Essence of Care
benchmarks
3. ensured that all our staff are familiar with HCC and NHSLA
standards
4. have a succession plans in place for ward sisters and
above across the nursing and midwifery workforce
reviewed the roles of the CNS in
leadership and
management aspects of nursing and midwifery care
Patient focus
Nurses and midwives make up the majority of the health care
workforce and therefore play a key role in ensuring that
WXUHT delivers efficient and effective health care.
By 2009 we will
1. have focused on themes in our complaints and comment
cards / patient survey and devised ways to learn from
these across the Trust for the top 5 themes
2. commence the Dignity in care challenge
3. have implemented new documentation in adult settings
ensuring that all patients are appropriately assessed with a
full care plan documented
4. have implemented the high impact interventions with
weekly review
By 2010 we will
1. have focused on themes in our complaints and comment
cards / patient survey and devised ways to learn from
these across the Trust for the top 10 themes
2. continue with the Dignity/Privacy in care challenge
3. have audited new documentation in adult
settings
ensuring that all patients are appropriately assessed with a
full care plan documented and reviewed the
documentation used in midwifery and paediatric settings
4. review the need for communication training and agreed a
way forward
Accessible and responsive care
Nursing and midwifery staff are key to ensuring that
By 2009 we will
1. be using the acuity and dependency benchmark tool with
the S drive to review our staffing levels in all adult areas
2. have implemented a recruitment strategy aiming for no
more than 8% vacancies
3. all staff to have had an appraisal and objectives set
By 2010 we will
1. be using the acuity and dependency benchmark tool and
benchmarked our results with other Trusts in London
2. have implemented a recruitment and retention strategy
aiming for no more than 5% vacancies
3. all staff to have had an appraisal and objectives reviewed
and reset
4. considered the role of the nurse and midwife in service
redesigns to ensure that patient care remains safe and
staff have the opportunity to develop with new roles
Care environment and amenities
We will work within, and create for others, safe, friendly, clean
and respectful environments. We will work closely with estates
6
services, contractors, staff, patients and the public to
continuously improve the environment for everyone.
By 2009 we will
1. Have met at least 50% of the nutrition action plan in all
clinical areas and introduced MUST
2. Introduced the Code of behaviour across the Trust
3. reviewed the Equality and Diversity plan and ensured that
the mixed sex wards policy is complied with
4. maintained a green score in PEAT
By 2010 we will
1. Have met at least 50% of the nutrition action plan in all
clinical areas
2. audited the Code of behaviour across the Trust
3. review the role of the matron and ward sister in relation to
cleaner safer hospitals
Public health
By 2009 we will
1. Commence midwifery staff training in regards to
breastfeeding
2. Have promoted healthy eating in all settings using leaflets
and posters
3. Review the slips trips and falls policy
By 2010 we will
1. Continue to encourage breastfeeding
2. Have enabled our link practitioners to provide advice in
their subject area to patients
3. Commenced a training programme for other staff to advise
patients re weight loss, smoking sensation, etc
4. Participate in the bone and joint decade aiming to reduce
slips, trips and falls in hospital .
6. Measuring Success:
The Trust will need to ensure that these objectives are met
through the measurement of outcomes in terms of defined
success factors.
6.1 Our Patients will say:
“What a wonderful service”
“I want to be treated at WX”
“I felt valued and treated as an individual”
“Nothing was too much trouble”
“You should go to WX
6.2 Our visitors will say
“The staff are so welcoming”
“My relative was so well cared for”
“I felt involved in the planning of the care”
“The staff are so friendly”
“There was great communication”
6.3 Our Staff will say
“I want my relatives to be treated at WXUHT”
“It is a great place to work”
“I feel supported”
“Everyone is so friendly and helpful
“My opinion is valued”
“What a dynamic, progressive place to work”
“I feel involved”
6.4 Students will say:
“I have learned a lot”
“I want to work here when I’m qualified”
“It’s such a friendly place
“I feel well supported
“I want to be like my ward sister”
6.5 Local people will say:
7
“We are proud of our local hospital”
“It is part of the community”
“I want to be treated there”
“I’ve heard it’s excellent”



6.6 Our primary & social care colleagues will say:
“I always recommend WXUHT hospital to my patients”
“We work together as a team”
“We want the same thing for patients”
This strategy will be reviewed and revised quarterly at the
Nursing and Midwifery executive group with updated copies of
progress being sent to very ward manager/ CNS etc in the
trust to ensure this remains responsive to our patients and
staff needs.
7. Trust Values and Engagement
We are committed to working with all members of our staff to
achieve our Workforce Strategy. We strongly believe that
motivated and involved staff are better placed to know what is
working well, and how to improve services for the benefit of
patients and the public. We would encourage staff to work in
true partnership in delivering improved patient care.
8. Vision into Action:
Our approach to achieving our Nursing and midwifery Strategy
through the implementation of our strategic objectives will be
to build on the progress we have already made.





Allocating responsibility for making things happen within
specific timeframes
Developing a real-time performance information system to
let us know how we are doing
Providing the necessary support, resources and training to
people
Holding people accountable
Making the strategy part of everybody's job
Learning as we go, from both our mistakes and our
successes
Celebrating our achievements
Reviewing and improving the strategy on a continuing
basis
Our nurses and midwives need to help us deliver the quality of
care local people deserve and expect by embracing this
strategy and working with us to make it happen
9. Summary
As the Trust moves forward with its clinical services
development and workforce strategies it is important that the
development of the nursing and midwifery strategy is in
alignment to the changes expected in the next few years.
Our Next Steps include:
 Communicating the strategy to as many people as possible
including patients and the public
 Cascading the strategy across the Trust
 Developing more detailed delivery plans and timetables for
particular elements and themes
8