SPECIAL EDITION
DECEMBER 2013
NURSINGTIMES.NET
Pride recharged
Strategy makes us proud to be nurses again p2
CNO for England’s Summit 2013
National nursing strategy ha
restored pride in the profess
Steve Ford
[email protected]
T
he national nursing
strategy for England has
“recharged pride”, after
the spate of negative publicity
aimed at nurses in recent
years, according to the chief
nursing officer for England.
In her keynote speech, CNO
Jane Cummings said that the
profession retained the
“admiration of many”, despite
high-profile care failings such
as those at Mid Staffordshire
Foundation Trust and
Winterbourne View.
She told the conference of
more than 450 senior nurses
in academic, provider and
commissioning roles that she
has seen “truly exceptional
patient care” this year, where
staff had “gone above and
beyond the call of duty and
made a real difference”.
However, Ms Cummings
acknowledged that cases like
Mid Staffordshire had
“threatened patient
confidence and challenged us
all as professionals”.
She unveiled a report on
progress made during the first
year after the launch of the
national nursing strategy,
Compassion in Practice.
The Compassion in Practice:
One Year On report paints a
positive picture of the
These are care, compassion,
competence, communication,
courage and commitment.
The 6Cs have been widely
embraced by nurses, midwives
and care staff. According to
Ms Cummings, they have
become an “exciting social
movement” at grassroots level.
She told delegates that NHS
England had been
overwhelmed with examples
“I have witnessed a widescale, positive
embrace of the 6Cs as a set of values, the
likes of which I have never seen before”
Jane Cummings
strategy’s impact so far, using
patient and staff stories and
case studies.
The three-year plan,
launched in December 2012,
includes the 6Cs – a set of
values and behaviours that
nurses, midwives and care
staff are expected to uphold.
when it asked what people
and organisations had done to
support the 6Cs.
Ms Cummings said: “The
aim was to get back to the
very essence of what great
care means for patients and
how we can put far-reaching
changes in place that translate
into real improvements.
“Over the last year, I have
witnessed a widescale, positive
embrace of the 6Cs as a set of
values, the likes of which I
have never seen before. It has
reinstilled a common purpose
and recharged pride in the
profession.”
Make it easier to celebrate the
NHS, says patient champion
P
atients and the public
who want to celebrate
the NHS and its
achievements need to be
given a better way to be
able to do so, according to
national patient champion
Ashley Brooks.
He told delegates that the
NHS and government needed
to find “avenues and ways” to
give patients a voice to
celebrate, champion and
“shout about” their good
experiences of NHS care.
Mr Brooks was speaking as
part of a panel of patients
who shared their experiences
of health – both good and
bad. The audience was
asked to listen and learn
from their stories.
“We need a reform and we
need to check ourselves
instead of always blaming
the NHS… just imagine
for one moment we didn’t
have it,” he said.
Patient leader Priscilla
Chandro explained her
involvement in the hospital
inspections that took place as
part of the Keogh review and
subsequently the Care Quality
Commission’s new rolling
programme.
2 CNO for England’s Summit Special edition / December 2013
She said, as a lay member,
she had felt very involved
in the Keogh inspection in
which she had taken part.
However, in the CQC
inspections in which she had
participated, she felt that
there was “very much a
separation” between lay
members and other CQC
inspectors in clinical and
managerial positions.
However, she added that a
culture of support, openness
and transparency was needed
in the NHS, so staff felt “free
to speak out, to challenge
incidents of poor care and
take immediate action to put
things right”.
She highlighted last
“Patient safety
warning signals
abound in all our
organisations
and we choose to
ignore them at
our peril”
Elaine Inglesby-Burke,
adviser to the Berwick
review and executive nurse
director at Salford Royal
Foundation Trust
month’s announcement of
guidance requiring trusts to
publish regular data on actual
versus planned evidencebased nurse staffing levels,
which formed part of the
government’s response
to the Francis Report, Hard
Truths, and three other
high-profile reviews.
Ms Cummings said: “We
need to do more to ensure
that we have the right teams
of staff with the right skills to
deliver the best possible care
for each clinical setting. The
guidance puts a renewed
focus on the responsibility
that healthcare providers have
in taking an evidence-based
approach to staffing.”
She added: “Our profession
is the admiration of many. We
see people at their most
vulnerable and we have a duty
to always act with compassion
for our patients and act with
the courage to challenge
anything that goes against this.
“Each one of us in the
profession needs to ensure
that we live by these principles
each and every day,” she said.
“I’m proud to be a nurse and
I know that the vast majority
of my fellow nurses, midwives
and care staff have, and
always will, deliver great care.”
HIGHLIGHTS
Minister in care-maker call
Volunteer care makers were
on hand at the summit to
help delegates. Health
secretary Jeremy Hunt called
on directors of nursing to
encourage staff to sign up as
care makers. “You can really
help the compassionate
agenda by giving a
Christmas present to [CNO]
Jane Cummings by finding
more people to become care
makers,” he said.
“Hello, my name is …”
Almost all delegates said
“Hello my name is” when
addressing the conference.
The “Hello my name is”
campaign was started by
Dr Kate Granger after she
became frustrated with staff
who did not introduce
themselves when she was an
inpatient. Dr Granger started
a campaign on Twitter
asking NHS staff to pledge
to introduce themselves.
Trying their (other) hands
Veronica Hope-Hailey, dean
of the School of
Management at the
University of Bath, made the
audience write with their
non-dominant hand to show
that change makes you feel
awkward and vulnerable.
Trending on Twitter
The summit made a big
impression on Twitter,
trending as one of the top
subjects being discussed by
people in the UK on the site
on Tuesday. In total 10,201
tweets were made about the
summit by 1,519 participants,
according to the 6Cs Live!
communication hub.
In association with Nursing Times / www.nursingtimes.net 3
Andy Paraskos
has
ession
Jane Cummings: we must act
with compassion and have
the courage to challenge
CNO for England’s Summit 2013
Patient safety data made public
to improve practice and culture
Steve Ford
[email protected]
A
range of key patient
safety data is being
published, initially by
17 trusts, as part of a new
drive on transparency in the
NHS, the chief nursing officer
for England’s keynote speech
revealed.
It is the government’s latest
initiative to make data on
factors affecting patient safety
more accessible to the public.
As part of a pilot project, 17
acute trusts in the north of
England are publishing data
on pressure ulcers developed
in hospital, falls in hospital
and figures for the healthcareassociated infections MRSA
and C difficile.
In addition, the trusts have
published their results from
the NHS Safety Thermometer
and the Friends and Family
Test, as well as patient and
staff experience survey
questions and patient stories.
The plan is that additional
northern trusts will begin
publishing the same
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“Absolute
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Jane Cummings
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Ms Cummings said:
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in standards of care and we
need to ensure that every
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4 CNO for England’s Summit Special edition / December 2013
More support needed in
coping with complaints
Steve Ford
[email protected]
F
STILL IGNORED
FOR SPEAKING UP
Many nurses still feel they are
not listened to when they
raise concerns, delegates at
a Nursing Times Speak Out
Safely seminar said.
Mid Staffordshire
whistleblower Helene Donnelly
called for more posts like her
role as ambassador for cultural
change at Staffordshire and
Stoke-on-Trent Partnership
Trust to be created to help
find and resolve issues.
“Leaving the
#CNOSummit
even prouder to be
a #care maker and
inspired to become
a nurse like those
I met today.
Thanks to all
involved! #6Cs”
@SLKehoe
“How to get
motivated. Spend
two days amongst
nurses
@#CNOSummit. I
don’t know how
many sleeps till the
next one but I’m
already counting!”
review, which was carried out
with MP Ann Clwyd.
“As nursing leaders, I think
we can really support our
nursing colleagues to make
sure they know how to handle
some of the most difficult
Tricia Hart: asked nursing
leaders how they assessed
workplace culture
conversations,” she said.
“We need to look at how we
resolve and how we learn.”
Nurses told compassionate
leadership takes courage
N
urses need to lead
from the centre and
from within,
according to deputy chief
nursing officer and director of
nursing for the South, Liz
Redfern.
She told the summit that
being a nurse leader was a
difficult balance.
“We get pilloried if we
don’t get a grip and make
things happen and, at the
same time, we are having to
be compassionate leaders –
and sometimes we get
squashed in the middle,”
she said.
She told delegates that
nurses had to stand up for
what they believed and that
compassionate leadership was
not about being soft.
“As compassionate leaders,
we need to protect each
other from becoming
tired and burnt out and I
think having compassion
demands courage.”
She said that trying to
“keep ourselves small” as a
profession risked nurses
“disconnecting from others
and serves absolutely no
purpose.”
Ms Redfern recently
announced she would leave
her two roles in March 2014
after more than 30 years in
the profession.
@unisonnurses
“Loved my 1st
#CNOsummit.
Loads of fab ideas
and leadership
demonstrated in so
many forms”
@Hanna_M_Murphy
“Listening to
patients is key, but
only if we ‘do’
something about
what we hear
#CNOSummit”
@pmjp97
“So many
committed nurses
& midwives at
#CNOSummit this
week. All dedicated
to improving the
NHS & care to
patients”
@JaneMCummings
In association with Nursing Times / www.nursingtimes.net 5
Andy Paraskos
rontline nurses need
more support and
training in coping with
complaints from patients,
nursing leaders have been
told by the author of an
NHS review.
Professor Tricia Hart, a
nurse and chief executive of
South Tees Hospitals
Foundation Trust, co-authored
a recent report into the way
the NHS handles complaints.
She repeatedly challenged
senior nurses to reflect on
whether they were adequately
supporting their staff – and
asked them how they were
assessing their culture.
Professor Hart also
highlighted the lack of staff
training on dealing and
coping with patient complaints
that was identified in her
TWEETS
CNO for England’s Summit 2013
SUMMIT VIEWS
“There isn’t
a pill for
every ill and
we have to think
about health
protection and
nurses’ role in it”
Professor Viv Bennett, nursing
director, Department of Health
and Public Health England
“The good
thing about
the NHS is
it’s good at hitting
mandated targets
and the bad thing
is it’s good at
hitting them”
Dean Royles, chief executive,
NHS Employers
“If you
stand
together in
a positive,
professional way
you will win but,
more importantly,
patients will win”
Robert Francis QC
“We must
get rid of
the crazy
divide between
general practice
nursing and
community
nursing”
Professor Steve Field, chief
inspector of general practice
“There are
little bits of
Mid Staffs
everywhere”
Sir Bruce Keogh, medical
director, NHS England
Minister praises staff
efforts in “difficult year”
Steve Ford
[email protected]
T
he health secretary has
commended health
service staff for their
efforts to embrace
transparency and embed
compassion after what he
described as a “very difficult
year” for the NHS.
Jeremy Hunt focused much
of his address on the
government’s response to the
Francis report – Hard Truths
– which was published the
week before the summit.
“We have done something
very brave. Confronted with
the tragedies of what happened
in Mid Staffs, we have chosen
to face up to them and deal
with them,” he told delegates.
He thanked directors of
nursing and other senior
nurses and midwives for their
leadership and work to
improve care and compassion
in their organisations.
Jeremy Hunt: “The biggest impact will be a reaffirmation
of the importance of nursing inside the NHS”
He told delegates he had
“distilled” the lessons from
the Francis Report into four
critical areas, which he hoped
would lead to “fundamental
change” in the NHS.
The first, he said, was to
“redefine what success means
in the system so that
compassionate care is at heart
of it”. He noted that, though
“We’ll never succeed in culture change if
we view compassion as some new value
that has to be imposed from outside”
Jeremy Hunt
Mr Hunt said his visits to
the frontline had revealed
“how incredibly hard people
are working”, and he
acknowledged that acting with
compassion was “sometimes
harder than it should be”.
He called on NHS leaders to
“look at the barriers to
compassionate care and
do what we can to remove
those blocks”. “We’ll never
succeed in the culture change
that we need to make if
we view compassion as some
new value that has to be
imposed from outside,”
Mr Hunt added.
important, hitting waiting
time targets and achieving
financial balance had been for
“too long in the NHS the
definition of success”.
Mr Hunt said the Care
Quality Commission’s new
inspection regime was looking
at whether organisations were
putting patients first.
“It won’t be possible to be a
good or outstanding hospital
unless you have good or
outstanding patient care,” he
said. “The biggest impact will
be a reaffirmation of the
importance of nursing inside
the NHS.”
6 CNO for England’s Summit Special edition / December 2013
Mr Hunt said another area
needing transformation was
the NHS’ attitude to patient
safety. A move to a more open
culture would be partly driven
by plans to revise the Nursing
and Midwifery Council’s duty
of candour to require nurses
and midwives to speak out
about “near misses” as well as
instances of harm, he said.
Third, he looked at safe
staffing levels, which he said
were “immensely complex to
get right”. “It’s not possible to
give… compassionate care
unless you have the right
numbers of staff on all the
different wards,” he said.
He highlighted guidance
requiring trusts to publish
ward staffing levels regularly
(see page 7), based on work
done by trusts with the best
safety records. “That, I have to
be honest, is going to put
pressure on hospital finances
because hiring more staff is an
expensive business,” he said.
Finally, he focused on the
need to change education so
“we have the right people in
the nursing and midwifery
professions”. He said this
work included evaluating the
pilot schemes where potential
students will spend up to a
year as healthcare assistants.
Guidance on staffing levels should
make best practice the norm
Helen Mooney
[email protected]
T
he government’s new
guidance on staffing
levels should be seen as
a “giant step forward” to
“normalise” what is already
“business as usual” in some of
the best NHS organisations.
The guidance, announced
last month as part of the
government’s full response to
the Francis report – Hard
Truths – expects all hospitals
to make staffing levels public
on a ward-by-ward, serviceby-service basis, together with
the percentage of shifts
meeting safe staffing
guidelines, from April.
Ruth May, NHS England’s
director of nursing for the
Midlands and the East, led the
development of the guidance
for boards on staffing, which
is supported by the National
Quality Board.
She said that while there
was evidence poor staffing
could lead to overly restrictive
or abusive practice, it was not
up to the government to set
“This is about us
as leaders using
our expertise to
decide what is
best locally”
Ruth May
minimum staffing levels.
“It is a board’s
responsibility to ensure safe
staffing on a shift-by-shift
basis…. This is about us as
leaders using our expertise to
decide what is best locally.”
Dr May also warned that
boards would need to watch
closely for any “unintended
consequences” of changes
they made in staffing levels.
“We need to be extremely
careful in fixing the problems
of today that we are not
creating another for the
leaders of tomorrow,” she said.
She reiterated that the
National Institute for Health
and Care Excellence would be
publishing guidance on acute
adult inpatient staffing levels
in July, which would apply to
other areas from August.
Dean Royles, chief executive
of NHS Employers, said
boards should use the
evidence and tools available to
make professional judgements
about staffing. He warned
setting a national minimum
could have unintended
consequences, such as staff
being moved to meet targets.
“You will hit it in one area
but at the expense of
something else,” he said. “It is
really important that boards
make their own judgement.”
Andy Paraskos
This special issue is brought to you by the sponsors of the CNO Summit. Our thanks to them.
In association with Nursing Times / www.nursingtimes.net 7
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