The Context Clare Culpin Director of Nursing and Quality Kettering General Hospital

The Butterfly Effect A small change in one place in a complex system can have a large effect elsewhere All aspects of the NHS system are connected together

1.Individuals Roles changing and adapting to the ever evolving needs of patients Relationship with patients Patient empowerment Safeguard our vulnerable patients and be their voice Patient expectations and demands Responsibility and accountability Healthcare professionals are a team Engage and participate Account for care and decisions Revalidate registration

2.Teams and organisations Efficient and productive Communicate and inform Patient outcomes are monitored closely Experience Mortality Harm Teams are more diverse New roles being introduced Expert teams Organisations are becoming more Clinically led

3.Regional/National New structure Regulation Compliance Performance monitoring Partner organisations

4.Modern workforce Patients have a better chance of surviving on wards where more nurses have degrees Staffing levels impact on patient care, experience and outcome Multi skilled and flexible