Promoting the Context and Value of Nursing
in the North West
Project Report - Phase 1
Supplementary Paper - Revised Outline
Proposals
Presented by: The Symmetric Partnership
Date: June 2013
Table of Contents
1.
INTRODUCTION ........................................................................................................................ 3
2.
PHASE 2 ....................................................................................................................................... 3
3.
RESOURCES................................................................................................................................. 4
4.
CONCLUSIONS ............................................................................................................................ 4
PROJECT 1 - INSPIRING CULTURAL CHANGE THROUGH LEADERSHIP AND
TRAINING - PROJECT SPONSOR, COLIN DUGDALE .................................................................... 5
PROJECT 2 - DEVELOPING OPTIONS FOR GUIDED REFLECTIVE PRACTICE TO
IMPROVE THE QUALITY AND CONSISTENCY OF THE NURSING OFFER - PROJECT
SPONSOR, MICHAEL MCCOURT ........................................................................................................ 6
PROJECT 3 - IMPROVING PHYSICAL HEALTH CARE FOR MENTAL HEALTH AND
LEARNING DISABILITY SERVICE USERS - PROJECT SPONSOR, GAIL BRIERS .................... 7
PROJECT 4 - DEVELOPING COMMON PRINCIPLES TO GUIDE NURSE STAFFING
LEVELS AND SKILL MIX - PROJECT SPONSOR, ANDY ROACH .................................................. 8
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1. Introduction
1.1.
The 9 Mental Health and Learning Disability Trusts in the North West of
England have been working collaboratively to improve the quality and
reputation of their Nursing services. The Directors of Nursing network
agreed a statement of intent and secured funding to support the
process. A Project Board has now been established to oversee the
development and implementation of individual projects.
1.2.
At its first meeting on 13th May 2013, the Board agreed 4 key areas for
development work, together with project sponsors. In summary, these
are as follows;
Project Area
Project Board
Sponsor
a)
Inspiring cultural change through leadership
and training
Colin Dugdale
b)
Developing options for guided reflective
practice to improve the quality and
consistency of the nursing offer
c)
Improving physical health care for Mental
Health and Learning Disability service users
d)
Developing common principles to guide nurse
staffing levels and skill mix
Michael McCourt
Gail Briers
Andy Roach
2. Phase 2
2.1.
This paper provides revised outline proposals for each project area,
based on discussions at the Board meeting. Project Sponsors are now
responsible for taking these forward into Phase 2 of the project - for
setting up task and finish groups and, with those groups,
commissioning any external support required. A first task for the groups
in June/July 2013 will be to build on the outline proposal and agree a
detailed set of terms of reference for the project area, together with an
action plan and project costing.
2.2.
Michael McCourt will continue to play a coordinating role for the whole
project. He and Heather Tierney-Moore as Project Board Chair, will
sign off the detailed proposals for each project area, on behalf of the
whole Board to enable projects to start in July.
2.3.
The overall project plan, previously circulated with the Board papers,
remains as the guide through the next phase of this work and, as
indicated in it, the next meeting of the Board will be set up for October.
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3. Resources
3.1.
A summary of the provisional costs is set out below, revised from the
initial Phase 1 Project Report;
Phase 2 Developments
1
2
3
4
Inspiring culture change
Guided reflective practice
Improving physical health care
Nurse staffing levels and staffing mix
5 Project management
Total
Provisional Cost
2013/14
2014/15
Total
£50,000
£40,000
£50,000
£40,000
£50,000
£20,000
£20,000
£40,000
£200,000
£95,000
£295,000
£25,000
£100,000
£40,000
£75,000
£40,000
Funding available
£358,000
Balance available
£63,000
3.2.
This includes an element for ongoing project management costs
throughout Phase 2 to support the Project Sponsors. Michael McCourt
will agree these arrangements separately in the context of his role as
coordinator for the whole Project.
3.3.
As indicated, subject to tender and any further revisions to the brief,
this suggests a provisional surplus of £63,000 against the overall
funding available.
4. Conclusions
4.1.
The work for Phase 2 is now set out in a format that can be built on by
the 4 Task and Finish groups, and monitored through the Project Board.
Provisional budget costs indicate that these developments are
affordable within the funding secured by the DoNs network. Clearly, the
position needs to be reviewed, through the Project Board, once the
work has been specified in more detail by the Task and Finish groups
and the results of ant external tendering decisions known.
4.2.
This now completes the work scheduled for the Symmetric Partnership
in Phase 1 of the project. We have enjoyed working with the DoNs
network and with the newly formed Project Board. We wish everyone
every success in Phase 2 and look forward to working with you again.
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PROJECT 1 - Inspiring cultural change through leadership and
training –
Project Sponsor, Colin Dugdale
Context
A critical element of the changes described in ‘Compassion in Practice’ and
the second ‘Francis’ report will be about ensuring the right context and
organisation culture to enable ‘care’ and ‘compassion’ to become the norm.
However, if change in nursing services is to be effective, it will need to be
nurse led. This in turn means that nurses need to be empowered to deliver
that change.
One approach would be to identify ‘Nurse Champions’ who, following further
training and development, would lead local change programmes.
Outputs and working method
The key outputs will be;
1. The identification of ‘Nurse Champions’ across the North West to help
design and then lead the process of change
2. A ‘Nurse Champions’ training programme, run across the North West
3. A broader programme of cultural change, to enable nurses to focus
better on ‘Care’ and demonstrate ‘Compassion’ in practice - led locally
by the Nurse Champions
4. Measurable improvements in ‘Care’ and ‘Compassion’ across nursing
services
Work will be progressed via an agreed task and finish group. It is anticipated
that the group will need to commission specialist nurse consultancy support to
progress the work; and that the group will want to link with the Leadership
Academy nationally, both to seek additional guidance and to promote the
work being done.
As with all of the project areas, the Task and Finish group will need to take
account of the extent of existing initiatives already underway within each of
the Trusts. This will enable Trusts to select appropriate elements of the
programmes available, avoiding any local duplication.
Resources
Subject to tender, a provisional budget of £100k is suggested. The main costs
will be that of the external consultancy. The working assumption is that other
costs will be covered by Trusts themselves – such as the costs of staging
local events or any cover required for staff to attend sessions.
Timescale
The preparation of a specification, tendering and selection of a consultant will
take up to 4 months. The design of the programme itself is likely to take a
further 4 months, followed by an implementation period, which is likely to be
around 8 months. So, provisional completion of the work would be in the
Autumn of 2014.
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PROJECT 2 - Developing options for guided reflective practice
to improve the quality and consistency of the nursing offer
Project Sponsor – Michael McCourt
Context
Against the background of broader cultural change described in Project 1,
how can sustainable improvements to the quality and consistency of day-today nursing practice be secured? In the past, the process of Clinical
Supervision has been used to help drive up standards. However, it’s use has
been neither consistent or widespread. This may be for reasons of poor local
organisation, or because people have got out of the habit, or a lack of
resource.
So, how can the process be re-imagined for the current context?. This project
area will focus on options for developing guided, reflective practice in nursing,
which can be delivered in a cost-effective way.
Outputs and working method
The key outputs will be;
1. An overall framework for guided reflective practice to be adopted
across the North West.
2. A provisional action plan to guide further implementation across the
North West, together with an assessment of resource implications
Work will be progressed in conjunction with an agreed task and finish group.
The group may need to commission external research as part of the work
and/or second appropriately qualified staff to undertake some elements of the
brief.
Resources
A provisional budget of £40k is suggested. This will support research, project
management and expenses incurred in running the task and finish group itself.
Timescale
It is anticipated that this work could be delivered within a reasonably short
timeframe – say 4 to 6 months.
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PROJECT 3 - Improving physical health care for Mental Health
and Learning Disability service users
Project Sponsor – Gail Briers
Context
Growth in the number of people with Long Term Conditions is seen as one of
the major challenges facing the NHS, both now and for the foreseeable future.
Clearly, people using Mental Health services are increasingly presenting with
a number of co-morbidities and Directors of Nursing are concerned about the
quality of physical health care available from the Mental Health services. In
addition, people with SMI often experience health inequalities when it comes
to accessing physical health lifestyle services. Whilst the latter is being
reviewed as part of a separate project, work here will focus on looking at
developing the most effective strategies to ensure service users have access
to appropriate care and support from Mental Health nurses. The aim is to
develop capacity and capability, whilst avoiding any reduction in core mental
health competence.
Outputs and working method
The key outputs will be;
1. Peer-reviewed standards on the care to be available from mental
health services for users with the more common LTCs (such as
diabetes, asthma and heart disease)
2. An outline training programme, which can then be implemented by
local Trusts according to need
3. A provisional action plan to guide further implementation, together with
an assessment of resource implications
The project will build on the work already done by 5BP and will be progressed
in conjunction with an agreed task and finish group. Membership could extend
in this case to colleagues from the Acute hospital sector and a local HEI as
required. The group will commission external research as part of the work
and/or second appropriately qualified staff to undertake some elements of the
brief.
Resources
A provisional budget of £75k is suggested. This will support research, project
management and expenses incurred in running the task and finish group itself.
Timescale
Whilst there are several strands to this development work, they can be
commissioned in parallel so it would be feasible to complete work within a 12month period.
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PROJECT 4 - Developing common principles to guide nurse
staffing levels and skill mix
Project sponsor – Andy Roach
Context
In the past, provider Trusts have faced the challenge of responding to
Commissioner requests to develop new services without having suitable
reference costs. The advent of Payment by Results and the adoption of Care
Clusters may help but specific guidance on the nursing components would be
helpful. Whilst the Mental Health NSF did contain information on staffing
levels, this has been seen by Directors of Nursing as being too prescriptive.
As an alternative to a set of formulae, a set of principles would be developed
and would be available for use across the whole network.
Outputs and working method
The key outputs will be;
1. A set of principles to guide future nurse staffing levels and skill mix
across the North West, set against the (relevant) Care Clusters
currently being used for Payment by Results in mental Health services
2. A provisional action plan to guide further implementation, together with
an assessment of resource implications
The project will build on the work already done by Cumbria and will be
progressed in conjunction with an agreed task and finish group. The group
may need to commission external research as part of the work and/or second
appropriately qualified staff to undertake some elements of the brief.
Resources
A provisional budget of £40k is suggested. This will support research, project
management and expenses incurred in running the task and finish group itself.
Timescale
It is anticipated that this work could be delivered within a reasonably short
timeframe – say 4 to 6 months.
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