1. Ward Sister Charge Nurse and Team Leader Conference
Charlotte Mcardle
Chief Nursing Officer
DHSSPSNI

2. NI local issues Financial climate Demographics Public health
Media reports
Francis Inquiry
Transforming your Care
Fit and Well-changing lives
Quality 2020

3. How will N+M Lead TYC
It is a big challenge but also a great opportunity
Our professions are best placed to lead this change alongside others
We must continue to be the advocate for the public
We must be truly person centred supporting people to make their decisions about care
We must be open to change and create change for the right reason
New roles and opportunities to push the boundaries
Must engage with technology

4. Q2020
10 year strategy to improve quality in health and social care in NI
Based on principles of safety, effectiveness and patient & client focus
Avoidable and preventable harm
Right care in the right place at the right time with the best outcome
All patients and clients fully involved in their care and treated with respect and dignity

7. Robert Francis Press Conference Statement 6/2/13
“We need a patient centred culture, no tolerance of non compliance with fundamental standards, openness and transparency, candour to patients, strong cultural leadership and caring, compassionate nursing, and useful and accurate information about services”
“The Trust Board was weak. It did not listen sufficiently to its patients and staff or ensure the correction of deficiencies brought to the Trust’s attention. It did not tackle the tolerance of poor standards and the disengagement of senior clinical staff from managerial and leadership responsibilities. These failures were in part due to a focus on reaching targets, achieving financial balance and seeking foundation trust status at the cost of delivering acceptable standards of care”
“Conventionally, some might say depressingly, when a disaster has occurred in the NHS the usual approach has been to blame and sack individuals or to propose major reorganisations. What has been found to be wrong here cannot be cured by finding scapegoats, and/ or recommending major reorganisations yet again”

8. Key themes of the recommendations
Putting the patient first
Common culture
Standards of service
Professional regulation of fitness to practice
Regulating healthcare systems
Complaints handling
Performance management
Medical training and education
Openness, transparency and candour
Nursing
Leadership
290 recommendations in total

9. Nursing
The Department of Health and NMC should introduce the concept of a Responsible Officer for nursing, appointed by and accountable to, the NMC
Without introducing a revalidation scheme immediately, the NMC should introduce common minimum standards for appraisal and support with which responsible officers would be obliged to comply. They could be required to report to the NMC on their performance on a regular basis
As part of a mandatory annual performance appraisal, each nurse, regardless of workplace setting, should be required to demonstrate in their annual learning portfolio an up-to-date knowledge of nursing practice and its implementation

10. Nursing
There should be an increased focus in nurse training, education and professional development on the practical requirements of delivering compassionate care in addition to the theory
There should be a national entry-level requirement that student nurses spend a minimum period of time, at least three months, working on the direct care of patients under the supervision of a registered nurse
The NMC, working with universities, should consider the introduction of an aptitude test to be undertaken by aspirant registered nurses at entry into the profession, exploring, in particular, candidates’ attitudes towards caring, compassion and other necessary professional values

11. A system built on standards with Safety and Quality the driver
What could it look like?
A system built on standards with Safety and Quality the driver
…………….clear fundamental set of standards, driven by the interests of patients, and devised by clinicians; a “bottom up” as opposed to a “top down” system .

12. Ensuring Safety Improving Quality Testing the patient/client Experience
… Nearly will not do 
130 mph
)))))))

13. The Person-centred Nursing Framework
(McCormack and McCance, 2006)

14. McCormack & McCance, 2010 Appropriate skill mix
Shared decision making systems
Effective staff relationships
Supportive organisational systems
Power sharing
Potential for innovation & risk taking
The physical environment
Professionally competent
Developed interpersonal
skills
Commitment to the job
Clarity of beliefs & values
Knowing ‘self’
Prerequisites
Care Environment
Care Processes
OUTCOMES
Working with patient’s beliefs and values
Engagement
Having sympathetic presence
Sharing decision making
Providing Holistic Care
OUTCOMES are the results expected of effective person-centred nursing.
Patient satisfaction reflects the evaluation a patient places on their care experience.
Involvement in care reflects the underpinning principle;e of being person-centred.
A feeling of well-being engendered by a positive care experience.
A therapeutic environment is one in which decision making is shared, staff relationships are collaborative, leadership is transformational and innovative practices are supported.
Suffice to say that the development of tools to assist in outcome measurement has been a key component of this research.
Satisfaction with Care
Involvement with Care
Feeling of Well-Being
Creating a therapeutic Culture
McCormack & McCance, 2010

15. How will N+M Lead Q2020 We have a key role through SQE
Priority to deliver the regional KPIs
Priority to focus relentlessly on QI
Priority to be transparent about practice and the standard of care with the public
Priority to embed patient stories for learning
Continue to do good work on 5 standards for client experience
Continue to embed the person centred nursing framework

16. Key messages
Be proud and stay true to the principles of the profession
Make a difference to peoples lives
Be a flag bearer of compassionate care
Work in partnership with patients and the public
Ensure Safety. Improve Quality and test patient Experience as you go.
Nurses are never afraid of challenge
Nursing is full of challenge