Three years on –
Caring in
partnership:
older people and
nursing staff working
towards the future
An RCN Nursing Older People
Strategy progress and
evaluation report
Acknowledgements
This third year review of the implementation of the RCN Strategy
for Nursing Older People is based on material generated and
collected during 2006/2007 by RCN members and associate
fellows, as well as members of the National Pensioner’s
Convention, Age Concern and Better Government for Older
People.
We are grateful to the members of Better Government for Older
People and the National Pensioner’s Convention who have worked
with us throughout the life of the strategy.
Thanks also to Matthew Rice who facilitated the review
workshop, to Pauline Ford who facilitates the strategy work, and
to Beverley Willie and Michelle Wong for their ongoing
administrative support.
The development of Caring in partnership: older people and
nursing staff working towards the future, and the subsequent
annual progress reviews, have been supported by an educational
grant from Pfizer.
We are grateful to Pfizer for their Educational Grant which
enabled the development of the Strategy and the achievement of
much of the work. We are especially appreciative of all the help
we received from members of the National Pensioners’
Convention and Better Government for Older People. Their
contribution helped us to stay grounded in the reality of older
people’s experiences and to balance this with the needs of
nursing.
Author
Three years on – Caring in partnership: older people and nursing
staff working towards the future was written by Hazel Heath,
Independent Nurse Consultant, and edited by Pauline Ford on
behalf of the RCN, its members and staff.
RCN Legal Disclaimer
This publication contains information, advice and guidance to help members of the RCN. It is intended for use within the UK but readers are
advised that practices may vary in each country and outside the UK.
The information in this booklet has been compiled from professional sources, but its accuracy is not guaranteed. Whilst every effort has been
made to ensure the RCN provides accurate and expert information and guidance, it is impossible to predict all the circumstances in which it
may be used. Accordingly, the RCN shall not be liable to any person or entity with respect to any loss or damage caused or alleged to be caused
directly or indirectly by what is contained in or left out of this website information and guidance.
Published by the Royal College of Nursing, 20 Cavendish Square, London W1G ORN
© 2007 Royal College of Nursing. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise, without prior permission of the
Publishers or a licence permitting restricted copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP.
This publication may not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of binding or cover other than that in
which it is published, without the prior consent of the Publishers.
ROYAL COLLEGE OF N URSI NG
Three years on – caring in partnership:
older people and nursing staff working towards the future
Contents
1
3
Background
1.1 Introduction
2
1.2 Strategy core principles
2
Box 1: Principles to underpin practice
Internal review of progress
10
3.1 Review of progress during 2006/2007 10
3.2 Evaluating the strategy: strengths
10
2
3.3 Evaluating the strategy:
1.3 The RCN Nursing Older People
Strategy: context and purpose
ways of working
10
3.4 Aims for 2007/2008
12
3
Figure 1: The RCN Older People
Strategy: Supporting structures and
inter-relationship with other elements
of RCN work
3
1.4 Evaluating progress
4
2
5
The developing policy context
4
Summary: older people strategy
objectives: progress to date
2.1 Policy trends around the UK, 2006-07
5
2.2 Scotland
6
2.3 Northern Ireland
6
2.4 Wales
7
6
2.5 England
8
References
1
5
13
Summary: older people strategy
objectives: plans for 2007/2008
26
Conclusions
34
35
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
1
1.2 Core principles
Introduction
The RCN Nursing Older People (NOP) Strategy
identified a set of five core principles which underpin
good nursing practice with older people (See Box 1).
In May 2004, the Royal College of Nursing (RCN)
produced its first ever strategy to promote the
contribution nurses can make to meeting the needs of
older people and ensuring their health and wellbeing.
From these principles, the RCN and its partners
developed a three-year action plan – the NOP Strategy designed to raise awareness of the nursing needs of
older people and the need for greater partnership
working, particularly with older people and their carers.
Caring in partnership: older people and nursing staff
working towards the future (Ford and Waddington,
2004) was developed by the Forum for Nurses Working
with Older People and the RCN Mental Health and Older
People Forum, together with the RCN gerontological
nursing staff and other key RCN internal stakeholders.
The Strategy was developed in partnership with older
people and some of the organisations representing
them.
The five core principles that should
underpin nursing older people
Valuing older people
by challenging discrimination; recognising and
responding to diversity; preserving the dignity of
older people; listening and responding to their
views and facilitating older people and their
advocates to contribute to decision making.
In developing the strategy, the RCN wanted to establish
its vision for nursing older people and develop a work
plan. We wanted to ensure that the strategy document
would inform good nursing practice by equipping
nurses to contribute more effectively to the changing
pattern of services for older people, in all care settings.
Maximising potential
by working with people to help them recognise their
potential, regain and maintain their confidence,
family links and social networks, and to manage
risks appropriately. Nurses need to maximise their
own potential through accessing training and
learning opportunities.
In 2004 the RCN set a demanding action plan to
implement the strategy, identifying 39 milestones we
hoped to achieve over the following three years. In these
three years, a great deal has been achieved, other
initiatives are ongoing, and some have yet to commence.
This document reviews progress.
Ensuring good quality physical, mental and
emotional care
Overview of this document
Section 1 continues to look at the background to the
Strategy’s development, its inter-relationship with the
strategic direction and practice of the RCN, and the
underlying principles informing the strategy.
by meeting the needs of the whole person;
understanding and responding to the special needs
of people with dementia and other long-term
conditions.
Section 2 discusses the developing policy context
around the UK.
Enabling through information
by sharing information with older people and their
carers about their illness, treatment and care
options and ensuring access to advocacy support
where necessary.
Section 3 discusses the internal implementation of the
Strategy, opportunities and challenges, achievements
and future aims
The tables in Section 4 summarise the achievements of
the RCN Nursing Older People Strategy over the last
three years.
Working in partnership
with older people to ensure they are true partners
in their own care; developing multi-disciplinary
partnerships to enhance the assessment and care
options that can be made available.
Tables in Section 5 set out plans for 2007/2008.
2
ROYAL COLLEGE OF N URSI NG
Figure 1 shows how the RCN Strategy, the NOP strategy,
the forum action plans and other elements inter-relate.
1.3 The RCN Nursing Older
People Strategy in the
RCN context
The NOP Strategy encompasses the whole RCN members and staff - across the UK. Their activities are
co-ordinated from the RCN’s Nursing Directorate, and
the NOP Strategy is linked to the RCN Strategy and
operational plan. There is a circular movement of
influence, with the RCN NOP Strategy influenced by the
RCN Nursing Directorate Plan, and in turn the forum
action plans. The NOP Strategy helps ensure that when
other departments are considering their own work
plans (for example, when developing their
publications), they take into account the needs of
nursing older people.
The RCN Nursing Older People Strategy (NOP) was the
first of its kind to be developed in the RCN and brings
together all RCN work on nursing older people. It
interlinks with other key elements of RCN work (see
Figure 1).
The NOP Strategy was developed just before the RCN’s
overall strategy. It brought together a range of internal and
external stakeholders, all of whom had an understanding
of, and influence over, nursing older people - they could
influence RCN members and staff, challenge assumptions,
reflect patient experiences, keep nurses grounded in
reality and ultimately help to deliver the necessary work.
Stakeholders included Help the Aged, Age Concern,
Alzheimer’s Society, Better Government for Older People
and the National Pensioners’ Convention. The greatest
challenge was in modifying the RCN’s ways of working in
order to work with external agencies, and particularly
with older people.
The Professional Nursing Department (PND) gives
support to implementing the NOP Strategy. A forum
organiser is employed full time to provide support to
the forums. The Professional Nursing Department’s
Gerontological Nursing Adviser provides support to the
forums and leads on some elements of strategy work.
Importantly, all the RCN strategies focus on the
‘business’ of nursing.
Figure 1: The RCN Older People Strategy: supporting structures and inter-relationship with other elements of
RCN work
RCN Nursing Directorate
Operational Plan Themes
Also five year plan, but updated
annually
RCN Strategic Plan
A five year strategy guiding
RCN work. Available as hard
copy or on website
RCN Nursing Older People Strategy
Developed at the time that the RCN
was developing its Strategic Plan
Forum Action Plans*
RCN Governance Standards
and RCN Policies**
Staff and Governance group
ensures that these are
adhered to
Professional Nursing
Department Adviser and Forum
Organiser
Governance Sub-Group of the
Professional Membership
Structure Action Group)***
Support the work of the forums
Oversees forum work from
member perspective
*Forum action plans are determined by the forum committees,
and state their priorities for the year ahead.
responsibilities and financial management.
*** The Governance Sub-Group of the Professional Membership
Structure Action Group overseas forum work from RCN members’
perspective.
** The RCN Governance Standards and RCN Policy responsibilities
concern codes of behaviour; for example, corporate
3
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
1.4 Evaluating progress
The RCN undertook to carry out an annual review of
progress achieved against the work identified in the
action plan. Reviews so far (Waddington, 2005, 2006)
have identified a range of achievements and challenges.
Implementation strategies have included:
✦
Dissemination of the NOP Strategy through a range
of conferences and workshops, including the
National Pensioners’ Convention, local and national
meetings
✦
The development of more effective partnerships
with older people, so that they could be more
involved in helping to promote the strategy and the
achievements within it
✦
The development and dissemination of practical
tools and material to support nurses, including
publications on outcome indicators in continuing
care, rights risks and the use of restraint, and an
updated version of the RCN Assessment Tool
✦
Promoting a positive image of nursing older people
through increased training opportunities
✦
Involving older people directly in all aspects of
strategy work - for example conference planning
and delivery.
4
ROYAL COLLEGE OF N URSI NG
2
The developing policy context
Pressures currently experienced across health and social
care not only impact on crucial services, they also
impact on the members and staff of the RCN who are
trying to implement the Nursing Older People Strategy.
2.1 Policy trends, 2006-07
Older people continue to be a focus of health and social
care policy and, around the UK, a range of new services
and new roles are developing which offer opportunities
to work with older people in new ways.
Broad policy trends are consistent around the UK:
Nursing remains central to the delivery of care for older
people and effective clinical leadership is at the heart of
creating high quality, modern, patient focused services.
RCN leadership programmes run around the UK have
been positively evaluated in contributing to leadership
development.
There are, however, fundamental challenges which inhibit
the delivery of person-centred services for older people.
As the RCN (RCN, 2007) observes, the NHS deficits crisis
is real and entrenched. Deficits are leading to a serious
reduction in the NHS workforce. Crucial health services
are being cut, access to care is being restricted, treatments
are being delayed or cancelled and patient care is suffering
as a consequence. At the same time as cuts in jobs, there is
an underlying shortage of nurses and nursing workloads
are increasing. The RCN’s General Secretary (RCN, 2007)
warns: ‘Almost 60 years on from its creation – and in spite
of record and welcome levels of investment – our NHS is
caught up in a rip-tide of deficit-led cuts, rushed reforms
and poor workforce planning that is hitting services,
hurting patients, undermining staff morale and
threatening the hard-won progress made over recent years
in raising health outputs, improving clinical outcomes and
modernizing the delivery of care’. The RCN concludes that
if NHS spending falls after 2008, the progress made in
improving clinical outcomes and increasing NHS outputs
over recent years could be lost.
The independent sector, and in particular care homes,
also faces challenges with rising costs, extensive
regulation and levels of state funding which providers
claim are inadequate to achieve desired standards of
service (RNHA, 2007). Despite the challenges, however,
new service models are evolving - such as communities
where people can live and receive care when the need
arises. Services which use the skills of both NHS and
independent sector staff are also being developed
around the UK, for example in offering palliative care
for people with dementia.
5
✦
a drive to combat age discrimination. Age
discrimination legislation has been implemented
✦
health service operations increasingly shifting from
acute, hospital-driven models to more communitybased models, with an emphasis on services as close
as possible to people’s homes
✦
more widespread working across organisational and
professional boundaries, in partnership with people
and communities, to deliver integrated services
✦
new nursing roles developing
✦
an increased focus on long-term conditions,
particularly for older people
✦
an increased emphasis on promoting health, on
preventative health strategies and on anticipatory
care
✦
new services developing specifically to reduce
unscheduled hospital admissions
✦
resources increasingly targeted at those with
greatest risk of ill health, with an emphasis on
targets and fiscal prioritisation
✦
more support for self-care and a growing emphasis
on individuals’ responsibility for their own health
✦
a reducing number of care homes. Care homes are
developing new models of service (such as
intermediate and rehabilitative care) for a more
diverse range of residents (for example, people with
severe disabilities). Some care homes have been redesignated as housing support services
✦
continuing priority on policies and schemes to
support carers
✦
an increasing emphasis on adult support and
protection, along with zero tolerance of abuse of
vulnerable adults. Policy and guidance about this is
growing
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
✦
targets for this. It also sets out an intention to increase
numbers of nurse consultants, with emphasis on acute
in-patient care and older people.
dignity has become a focus of government
campaigns.
Within these broad policy trends, policies within the
four countries of the UK are distinct.
‘Free’ personal care: An independent evaluation of
Scotland’s ‘free’ personal care policy was published in
February 2007 (Scottish Executive, 2007b). It finds that
the majority of recipients receive their payments or
personal care services without undue delay or
complication. It also makes recommendations to
improve implementation.
2.2 Scotland
Strategy for an ageing population: In March 2007, All
our futures: planning for a Scotland with an ageing
population (Scottish Executive, 2007a) was published.
This is a long-term strategy outlining the opportunities
and choice available to people as they get older. It
emphasises improving the quality of life for older
people and ensuring that services are in place so that
people can live a full life as they grow older.
Supporting carers: The Future of Unpaid Care in
Scotland, published in April 2006 (Scottish Executive,
2006c), set out a ten year vision with four immediate
priorities for action: young carers, carers’ breaks, carers’
health and carers’ training. NHS Carer Information
Strategies Guidance has been issued.
Developing Community Hospitals: December 2006 saw
the launch of a new strategy to enhance the vital role
community hospitals play in Scotland’s changing NHS.
Developing Community Hospitals (Scottish Executive,
2006a) sets out a blueprint for re-organisation of
community hospitals and their services, in order to
meet recommendations made in Delivering for Health
(Scottish Executive, 2005a).
Care home standards: A new initiative to ensure that
older people receive the highest quality of care from
care homes was launched in March 2007 (Scottish
Executive, 2007c). From April 2007, new measures will
be introduced, including staff training requirements
and clearer information for service users and families.
Adult support and protection: A new Bill aiming to offer
greater protection to adults at risk of abuse was
approved by MSPs in February 2007 (Scottish Executive,
2005b). The Adult Support and Protection (Scotland)
Act 2007 will give new powers and a statutory
responsibility to local agencies to investigate any risk of
harm or abuse to adults living in care homes or in the
community.
Mental health nursing: In April 2006 a national review
of mental health nursing in Scotland and a five-year
action plan on developing this workforce were
published. Rights, Relationships and Recovery (Scottish
Executive, 2006b) aims to improve future mental health
services for patients and their families. The main aims
are to:
✦
support the role of mental health nurses in the
recovery of patients’ mental health and enhance
their role in areas such as health improvement,
therapy and preventative care
✦
strengthen the leadership in mental health nursing
✦
improve support to newly qualified staff nurses
✦
involve people who have experienced mental health
problems in service planning
✦
redesign education programmes to prepare people
to be mental health nurses
✦
increase the number of nurse consultants.
Local health checks: A new wave of preventative care
programmes, to be implemented later this year, was
announced in February 2007 (Scottish Executive,
2007d). These ‘Keep Well’ services illustrate the
movement from treating ill-health to preventing it, as
locally as possible. Resources are targeted where most
needed.
2.3 Northern Ireland
Restructuring Health and Social Services: Between 2006
and April 2008, Health and Social Services in Northern
Ireland will be restructured.
Developing Better Services (DBS) (DHSSPS, 2006a): this
strategy is changing the way in which health care
services are provided throughout Northern Ireland. The
More emphasis will be placed on supporting mental
health nurses in the workplace and the development of
training opportunities for nurses, and the plan sets
6
ROYAL COLLEGE OF N URSI NG
gather all the information necessary to plan home care
services for people with complex needs. This will enable
them to continue living at home, with appropriate home
care support, or to make a decision regarding the need
for nursing or residential home care.
DBS vision is for high quality, safe services which are
accessible for all and provided by well trained,
motivated staff in modern settings.
Priorities for Action Targets 2006-2008: The Planning
Framework for Health, Social and Public Safety Services
in 2006-2008 (DHSSPS, 2006b) sets out detailed targets
and objectives that should be reflected in board and
trust plans. The framework outlines ten key priorities
for health, social and public safety services for 2006
2008.
✦
Dementia: A new dementia services centre, based on the
model of the Stirling Centre in Scotland, has recently
opened in Northern Ireland.
2.4 Wales
improving health and well-being; helping people to
live healthier lifestyles, to be actively involved in
their own care, promoting their own health and
wellbeing and that of their communities
✦
safer, better quality services
National Service Framework for Older People in Wales:
The National Service Framework (NSF) was published
in March 2006 (Welsh Assembly Government, 2006a). It
aims to improve:
✦
reductions in hospital waiting times
✦
the health and well being of older people
✦
significant improvements in emergency care
✦
✦
fully integrated care and support in the community
✦
improvements in children’s services
access to primary and community based services
designed to promote older people’s independence
and support them to stay living in their own homes;
access to and quality of specialist health services.
✦
better mental health and learning disability services
✦
effective financial control and improved efficiency
✦
reforming the workforce
✦
infrastructure improvements.
The NSF addresses health and social care services
across primary, community and secondary care, and
focuses on the prevention and treatment of stroke and
falls and fractures, services for older people with mental
health problems, and the effective management of
medicines. The NSF is the main policy drive for dignity
in care, and any initiatives in older people’s care will be
driven through the NSF.
The key priorities are supplemented by 40 targets and
actions. Two examples relevant to older people are:
✦
by 31 March 2008, boards and trusts should
contribute to a reduction in the gap in life
expectancy between those living in the fifth most
deprived electoral wards and the Northern Ireland
average from 3.1 to 2.5 years for men and from 2.5
to 1.5 years for women
✦
by March 2008, older people with continuing care
needs should wait no longer than eight weeks for
assessment to be completed and should have the
main components of their care needs met within a
further 12 weeks.
The Strategy for Older People in Wales (Welsh Assembly
Government, 2007a): Launched in January 2007, this is
set in a ten-year framework and provides an action plan
with more detailed objectives and programmes. The five
key aims are:
✦
reflecting the United Nations principles for older
people, to tackle discrimination against older people
wherever it occurs, promote positive images of
ageing and give older people a stronger voice in
society
✦
to promote and develop older peoples’ capacity to
continue to work and learn for as long as they want,
and to make an active contribution once they retire
✦
to promote and improve the health and well-being of
older people through integrated planning and
service delivery frameworks and more responsive
diagnostic and support services
Achievement of the priorities, targets and actions will be
closely monitored.
Single Assessment Tool: The DHSSPS has
commissioned the development of a Single Assessment
Tool (DHSSPS, 2005b), to be developed in association
with the University of Ulster, which will be used to
7
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
✦
to promote the provision of high quality services
and support which enable older people to live as
independently as possible in a suitable and safe
environment and ensure services are organised
around and responsive to their needs
✦
to implement the Strategy for Older People in Wales
with support funding to ensure that it is a catalyst
for change and innovation across all sectors,
improves services for older people and provides the
basis for effective planning for an ageing population.
Consultation on revised carers strategy: In December
2006 the refocused strategy for carers in Wales was
published for consultation. The focus includes health
and social care, information on a range of issues to help
people provide care, including rights and benefits and
medicines management and support. A Carer’s
Champion has been appointed.
2.5 England
Strategy for social services: Fulfilled Lives, Supportive
Communities (Welsh Assembly Government, 2007b)
sets out the direction for social services between 2008
and 2018. Modern, accessible, high quality and
personalised care is at the heart of a ten year vision for
social services launched in February 2007. The strategy
outlines a vision of social services centred on the needs
of citizens and communities. The focus is on ensuring
that people are supported earlier and are helped to
retain their independence for longer.
A new ambition for old age: Next steps in implementing
the National Service Framework for Older People (DH,
2006a), was published in April 2006. This sets out the
priorities for the second phase of the Government’s 10year National Service Framework (NSF) for Older
People in terms of dignity in care, joined-up care and
healthy ageing. It consists of ten programmes driven
nationally and covers the second half of the ten year
NSF Older People:
Commissioner for Older People: The Welsh Assembly
has pledged to appoint a Commissioner for Older People
in Wales. The Commissioner will be able to:
✦
act as a source of information, advocacy and
support for older people
✦
encourage best practice in their treatment
✦
publish reports and make recommendations
✦
issue guidance
✦
examine individual cases where wider issues of
principle are involved
✦
assist an older person to make a complaint or to take
a case to court
✦
✦
dignity in care
✦
dignity at the end of life
✦
stroke services
✦
falls and bone health
✦
mental health in old age
✦
complex needs
✦
urgent care
✦
care records
✦
healthy ageing
✦
independence, wellbeing and choice.
Also published was A new ambition for old age: Next
steps in implementing the National Service Framework
for Older People: A resource document (DH, 2006b),
which provides supporting information for the next
steps in implementing the NSF.
review the effect on older people of the way in which
public bodies, such as the Wales Assembly
Government and local authorities, carry out their
functions.
Continuing care: A proposed new National Framework
for NHS Continuing Healthcare and NHS funded
Nursing Care in England (DH, 2006c) was issued by the
Department of Health for consultation in 2006. This had
two main purposes:
Care package for disabled and older people: The Health
and Social Services Minister announced in February
2007 that thousands of disabled and older people on
low incomes will benefit from the introduction of extra
assistance from the Welsh Government. New safeguards
are also being introduced from 9 April 2007 for disabled
and older people who are charged for non-residential
services by their local authority.
8
✦
it sets out a single policy on who should receive NHS
funding
✦
it proposes a standard process for assessing
ROYAL COLLEGE OF N URSI NG
eligibility for these services, including national tools
to support decision-making.
✦
long-term conditions managed in the community,
integrated with social care and specialist services
The National Framework planned to remove the
banding system for NHS-funded registered nursing and
the requirement for a separate determination to decide
the band. In its place, the NHS will continue to fund
registered nursing care via a weekly rate which takes
account of a national average. Primary care trusts will
continue to be responsible for assessing a person’s
nursing needs and for deciding what nursing should be
provided. In January 2007 the Department of Health
issued a Referral Tool (RT) and a second draft of a
Decision Support Tool (DST) and in June 2007 the new
National Framework for NHS Continuing Healthcare
and NHS funded Nursing Care was published (DH,
2007a) followed by Directions.
✦
early supported discharge, whenever possible
delivering care closer to home
✦
general acute hospital care whenever you need it,
combined with quick access to new specialist
centres
✦
partnership built around the needs and wishes of
older people and their families.
Safeguarding Vulnerable Groups Act 2006: Planned for
implementation in 2008, this legislation instigates a
centralised vetting and barring system which enables
employers to make ‘real time’ checks of employees
through secure access to electronic databases. This aims
to provide a comprehensive and consistent measure of
protection for vulnerable people in a wider ranges of
settings, including the NHS.
Dignity in care: A Department of Health national
campaign to place dignity and respect at the heart of
caring for older people featured:
✦ the Dignity Challenge – a ten point plan that lays out
the national expectations for what constitutes a
service that respects dignity
✦ a new network of local champions of dignity –
volunteers working to raise the profile of dignity in
care locally
✦ the Dignity in Care Practice Guide to help people
take up the dignity challenge.
National policies are being reviewed, including
safeguarding vulnerable adults, complaint reforms,
training /registration of the workforce and improving
care environments.
A Recipe for Care: In this document (DH, 2007b),
Professor Ian Philp, National Director for Older People
highlighted that new services for older people are
helping them to maintain their independence and avoid
unnecessary hospital admission. A Recipe for Care
identified five key elements of older people’s care:
✦
early intervention and assessment of old age
conditions
9
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
3
Internal review of progress
3.1 Review of progress during
2006/2007
3.2 Evaluating the strategy:
strengths
In February 2007, RCN forum committee members met
for a review of progress on implementing the Nursing
Older People Strategy during 2006, from the forum
committees’ perspective. The workshop also agreed a
work programme for 2007/2008 and secured
commitment to working together on these priorities.
Attendees of the workshop are listed in Appendix 2.
The Nursing Older People Strategy:
The workshop aimed to:
✦
is an important tool for developing opportunities to
influence nursing practice (such as improving older
people’s nutrition or preventing abuse). In
particular, it sets out ways of influencing practice
through listening to older people’s experiences of
nursing and what is important to them.
✦
gives a framework, focus and direction which the
forums lacked before it was developed, and helps
work cohesively
✦
clarify background, context and purpose of the RCN
Nursing Older People strategy
✦
record individual contributions to the five core
principles
✦
helps forums work meaningfully with other
stakeholders, particularly older people
✦
explore the strategy’s impact on individual forum
committee members
✦
recognises the achievements of RCN work in
improving nursing for older people
✦
identify current and effective ways of working and
how these may be developed in future
✦
✦
plan the work of 2007-2008 using the strategy and
forum action plans.
offers opportunities to further raise the profile of
older people’s nursing, in terms of past
achievements and future potential, with the RCN
and its members, including through events at RCN
Congress
The meeting also highlighted the achievements of the
strategy so far, and ways in which the RCN had
continued to work in partnership with older people,
through a range of initiatives such as the Education
Think Tank, planning the 2007 conference, and
developing principles for RCN publications.
3.3 Evaluating the strategy:
ways of working
Discussions identified particularly helpful ways of
working and considered changes to help the forum
committees become more effective in implementing the
Nursing Older People strategy.
Forum members acknowledged the efforts of all their
RCN colleagues who champion the needs of older
people, and the older people, carers and others who are
active partners in this process.
Clarifying the strategy:
The document is too wordy to be easy to use, and its
purpose is not clearly defined. The document’s structure
can be restrictive and inflexible, which could reduce
creativity if activities were not recorded and developed
within the strategy. Ways of improving the document’s
usability:
The rest of Section 3 looks at the conclusions drawn by
the workshop through its analysis of the strengths and
weaknesses of the Strategy, of the opportunities for the
future, and at the ideas it developed for increasing the
efficacy of the strategy.
✦
10
a user-friendly, short document (possibly an A4
sheet) containing the core principles of the strategy
ROYAL COLLEGE OF N URSI NG
✦
and summarising its outcomes will make the
strategy more widely available
✦
a laminated card containing outcomes of the
strategy would also improve dissemination
✦
aims could be clarified by developing a mission
statement/ vision for the future
✦
a more tangible action plan for users and
practitioners would increase understanding and
implementation.
Building links
Representation on national groups is working well. For
the future, it will be important to:
Improving dissemination of the strategy:
The Congress 2006 fringe event was highly successful,
and the profile of the work has been raised in the RCN.
To build on this in the future:
✦
the document should be more widely marketed
through RCN Bulletin, Ageing Matters and on the
forum webpage.
✦
forum members need more support in
disseminating the strategy
✦
the summary of achievements could be published in
Nursing Standard and Nursing Older People
✦
the core principles could be relaunched through the
website and Ageing Matters
✦
more could be done to show how the document
could be used to support activities outside the RCN
✦
the strategy could be promoted through another
Congress fringe event, and an event organised to
celebrate achievements to date
✦
the document must be used to be successful.
Ongoing evaluation will be important in monitoring
its use and the achievement of objectives.
when the Nursing Older People website is running,
communication opportunities will increase
✦
the development of a forum email address would
help communication with RCN members
✦
engage with other RCN forums and regional groups
around the UK, and in particular to build links with
other groups such as the RCN Rehabilitation Forum
✦
build further links with external organisations such
as the British Geriatric Society
✦
engage a wider range of older people partnerships
regarding mental health issues
✦
bring a nursing student representative onto the
forum’s committees
✦
build international links.
Training and direction
Forum committee members have gained confidence
through their work, as a result of the Nursing Older
People Strategy. It was noted that:
Improving communication
Communication improved during 2006, particularly via
email, and there is much better partnership working
with older people. Committee members are now clearer
about the role of the RCN Adviser and about the
expertise that each member brings to the committee.
Further improvements:
✦
a communication template in the form of a standard
questionnaire on the website could ask specific
questions about RCN nursing older people work and
this would help to target responses to ensure that
RCN work is responsive to expressed membership
requirements.
✦
greater understanding of, and preparation for,
working on forum committee would be helpful, as
would additional training on specific aspects such as
public speaking
✦
forum chairs should be more directive about
expectations of the work and about deadlines
✦
training will be needed for website development.
Resources
The issue of forum resources, particularly time, is
ongoing. Resources available to work on the plan are
small – there are a limited number of RCN advisory
staff , and forum members have full time jobs as well as
their forum work.
11
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
The workshop agreed to:
3.4 Aims for 2007-2008
The workshop clarified the role of activists and staff in
taking work forward, and identified priorities for 20072008:
✦
making the strategy as user-friendly as possible, in
order to maximise everyone’s opportunity to
participate
✦
identifying ways the strategy can be disseminated,
and helping forum committee members feel
empowered to do so
✦
keeping up the momentum of implementing the
strategy
✦
continuing to raise awareness of older people’s
issues within the RCN membership.
12
✦
build links with other forums and further external
groups
✦
produce a user-friendly document outlining the
principles of the strategy
✦
produce a laminated card containing areas already
achieved from the Strategy
✦
plan a celebration event with external partners
✦
publish a summary of achievements in Nursing
Standard and Nursing Older People.
ROYAL COLLEGE OF N URSI NG
4
Overall summary: Older people
strategy objectives
For example, at University College London Hospital
NHS Trust where RCN Associate Fellow Jonathan
Webster is Consultant Nurse Older People, the strategy’s
five core principles have been used to underpin how
staff aim to work with older people and their carers,
particularly in clinical practice and service
development. A ‘principle’ document being developed by
the trust will link in and be part of strategies for
working with older people created by the London
boroughs that work with the trust.
Progress to date
This section shows the objectives set out when the
strategy was established in 2004. It shows an outline of
work to date towards these objectives.
As well as the specific objectives achieved, the strategy
also provides a focus for developing the key enabling
principles underpinning nursing older people; it can be
used effectively to develop the way people and
organisations work.
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 1: To ensure older people are valued
OBJECTIVE A: The RCN will actively root out age discrimination in its own organisation.
A1: To review the RCN human
resources strategy to
ensure it is not age
discriminatory
To ensure that the RCN does
not discriminate on the basis
of age
• Issues highlighted with Human
Resources Department and
equality officer of the RCN (June
2005)
• Achieved. No further action
required
A2: To work with older
people to examine RCN
publicity material for
negative stereotypes of
older people
Feedback and views from
older people will inform all
publications for nursing older
people
A3: To examine the language
and internal workings of
the RCN to ensure no
stereotypes of older
people are explicit or
implied
Language and images are
positive and promote the
value of older people
Lead forum member for any
new publication will ensure
older people have the
opportunity to comment on
penultimate drafts prior to
publication
• Meeting held with publications
team, Better Government Older
People and National Pensioners’
Convention (2005)
• Language is challenged as
necessary
• Publications: images and
language addressed in a
workshop with publications
team and older people
• Image commissioning
works to criteria
developed in partnership
with older people
• RCN and Help the Aged
exploring some joint work
on language as part of the
dignity project
13
• Publication developed
highlighting this intention for
Nursing Older People journal
(June 2005)
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 1: To ensure older people are valued
OBJECTIVE B: The RCN will work with other key stakeholders to portray positive images of ageing
B1: To work with older
people and others
to disseminate
positive images of
ageing
• Printed material
associated with
BSc uses positive
images of ageing
• Actions agreed publication developed for
Nursing Older People journal (June 2005)
• Positive images of older people and
ageing in content of BSc(Hons) in
Gerontological Nursing and all
associated marketing
• Positive images of
ageing are
promoted at every
opportunity
• Contributed to poster project ‘See the
Person’
OBJECTIVE C: RCN will raise the profile of older person abuse. The RCN will seek to ensure members are alert to its detection
and respond appropriately
C1: To review existing
RCN older person
abuse guidance
with other
interested parties,
to identify gaps and
priorities for nursing
practice
Better informed
public and nursing
workforce, more able
to recognise and
respond to elder
abuse
C2: To build on the
review to develop a
framework for good
practice for wider
dissemination
• Ongoing collaboration with
partners (Action on Elder
Abuse, Help the Aged, Age
Concern) and older people’s
organisations. RCN is a
member of Elder Abuse
Strategic Alliance (England)
• Selected topic for RCN political
leadership programme
• Participating in campaigns e.g.
with Help the Aged
• Presentation at Congress 2006 event
• Ensuring that the topic of elder
abuse is fed into other RCN
projects, e.g. RCN/Age
Concern Think Tank
• Lobbying to ensure mandatory
training on elder abuse is
incorporated in nurse
orientation/induction
programmes
• Awareness-raising activities,
conferences, publications
• T-shirt and badge campaign at RCN
Congress 2005
• Question to political party
representatives at Congress 2005
• Two-page guidance produced and
disseminated at Congress 2006 and
2007
• Presentation at Congress Students’ Day
• Conference presentations February,
October and November 2006
• RCN Direct fact sheet updated
• Article published in Nursing Standard
• On behalf of RCN, gave evidence to
Health Select Committee on Protection
and Support of Adults Bill (Scotland)
• Working locally and nationally
to raise awareness of elder
abuse and educational needs
of nursing students
OBJECTIVE D: RCN will work with older people to develop its range of services for nurses working with older people
D1: To work in
partnership with
older people to
review the RCN
nursing older
people strategy and
progress reports
RCN and older people
work in partnership
on the RCN Nursing
Older People Strategy
National Pensioners’ Convention
and Better Government Older
People members actively
engaged in developing and
reviewing strategy
• External stakeholders contributed to the
development of the strategy – 2004
• Better Government Older People and
National Pensioners’ Convention
attended review meeting 2005 and 2006
PF and Forums
• Age Concern members attended review
meeting in 2006
14
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 1: To ensure older people are valued
OBJECTIVE D: RCN will work with older people to develop its range of services for nurses working with older people
D2: To involve older people in
the development of
conferences
To establish a system to
involve older people
Older People are
actively involved in all
aspects of RCN older
people conference.
Forums and older people worked in
partnership to plan and run conference
in 2005
D3: To work with older people in
the development of RCN
publications
• Publications will appear
in different formats
depending on the topic,
e.g. executive summary
or bullet points
• Forums working in
partnership with
older people
• Images in publications have been
adjusted to show more positive
images of older people
• Forums will
encourage working in
partnership with
older people around
the UK
• New documents have an
endorsement from older people, e.g.
‘This document has been produced
in collaboration with …’
• All future RCN
publications for nursing
older people will have a
nominated lead who will
determine how to engage
older people as
stakeholders
• Documents have been produced in
appropriate fonts, colours and styles
AIM 2: To maximise the potential of older people and nurses
OBJECTIVE E: The RCN will support nurses in developing person-centred assessment processes that recognise the need to
develop a holistic view of older people’s needs
E1: To develop a new edition of
the RCN Nursing Older
People Assessment Tool to
reflect the contemporary
policy on assessment and
ensure it is linked into the
single/unified assessment
process
New edition of publication
E2: To develop paper and
electronic versions of the
tool for wide dissemination
New versions of the tool
E3: To provide guidance, advice
and training on the use of
the RCN Nursing Older
People Assessment Tool
To support nurses and
organisations in their use
of the tool
• Nursing assessment and older
people: A Royal College of Nursing
toolkit published in May 2004. RCN
Publication code 002 310
• No further action planned
• Paper and electronic versions of tool
produced in 2004
• No further action planned
As requested by
organisations
15
Nurses and organisations supported in
their use of the tool as requested and
upon demand
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 2: To maximise the potential of older people and nurses
OBJECTIVE F: The RCN will work with its forums and older people to develop a more positive approach to risk management
F1: In partnership with
older people the
RCN’s older
people’s forums
will explore ways
in which they can
promote practice
that maximises
potential
RCN is seen to
contribute and
influence policy
development and
practice
Ongoing through
forums, adviser,
associate fellows
and activists
The RCN contributed to (2005-2006):
• NHS Estates consultation on inpatient facilities for older
people
• Department of Health work on information for choice
• Department of Health consultation on advocacy
• Vulnerable Adults England Forums
• Vulnerable Adults Scotland
• National Institute for Clinical Excellence and Health
(NICE) work on falls
• National Institute for Clinical Excellence specialist
adviser
• Setting up local groups for Nurses working with Older
People in Eastern Region (CR) and with RCN Scotland in
Scotland
• Founder member of Dementia Care Network in local
area
• Elder restraint project with National Patient Safety
Agency
• Contributing to Ask the Experts, Nursing Older People
journal
• Contributed to the consultation for the Mayor of
London’s ‘Towards an older people’s strategy’ for
London aimed at challenging negative perceptions and
promoting the contribution older people make to
London 2005/2006
• Following consultation with members, made
presentation at the Mayor of London’s Capital Woman
event 2006
• Contributed to the original project Let’s Respect Toolkit
and currently involved in follow up work
• Member of the working group of the British Geriatrics
Society to produce guidelines on Advanced Planning
• Member of Department of Health working group on
Information prescriptions Jane Bleach
F2: To prepare new
material on rights,
risks and the use of
restraint
New materials
• Restraint revisited – rights, risks and responsibility:
Guidance for nursing staff published January 2004.
Publication code 002 167
16
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 2: To maximise the potential of older people and nurses
OBJECTIVE G: The RCN will influence the learning and practice development of nurses so that they can maximise the potential
of older people
G1: To promote the RCN
BSc(Hons) in
Gerontological Nursing
to increase its take up
Increased
focus on RCN
work to
promote the
educational
needs of
nurses
working with
older people
Increased numbers of nurses
working with older people
undertaking this programme
• Marketing strategy
continues to be
implemented
• Innovative work on
developing methodology to
evaluate impact on practice
• Recruitment now increased Help the Aged
bursaries (2004-2005)
• Education think tank for external stakeholders
with Age Concern
• Age Care Awards evaluation research project
• Help the Aged have agreed to continue to
sponsor
• Support of nurses on the
political leadership
programme wishing to
influence the development
of pre-registration curricula
across the sector
G2: To develop a new edition
of outcome indicators for
nursing in continuing
care
New
publication
G3: In partnership with
Government nurses and
RCN leadership
programme, explore the
potential for providing
older people-specific
clinical and political
leadership programmes
The potential
of leaders in
older people’s
care is
maximised
• New edition of What a difference a nurse
makes published in 2004. Publication code
000 632
• No further action planned
Forums participating in
political leadership programme
• Department of Health commissioned Clinical
Leadership for Nurses Working with Older People
Programme sponsored by Department of Health
in England. Completed and well evaluated
• Network established
• Political leadership programme mentorship
undertaken (2004-2005)
• Forums participating in political leadership
programme
• Leadership programme in Dublin commissioned
for Directors of Nursing
• Campaign for equal access to mental health
services based on need, not age. Measured
outcomes in influencing/changing the national
agenda
• Two forum members are undertaking RCN
Political Leadership Programme in 2006
• Sponsorship for two forum members to the
Political Leadership Programme. Completion of
course and feedback to forum members.
G4: To work with
representatives of NHS
and primary care trusts
and the Independent
Sector to develop a
programme for rotational
opportunities for nurses
to move between acute
and community settings,
to broaden experience
and understanding
Evidence of
best practice
is
disseminated
Forums ongoing action
• Local initiatives, for example possible area for
collaboration in Ellesmere Port and Neston
PCT where two rotational posts between acute
and community settings were quite
successful. Experience may add to RCN
learning
• Information collected on current opportunities
being offered to staff and impact evaluated
• Results fed into the Education Think Tank
• No further action planned
17
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 2: To maximise the potential of older people and nurses
OBJECTIVE G: The RCN will influence the learning and practice development of nurses so that they can maximise the potential
of older people
G5:To collaborate with
Help the Aged to
promote the newlyestablished
Bursaries and
Awards (RCN BSc
in Gerontological
Nursing) for
person-centred
practice.
To maintain
bursaries for
students
studying on the
BSc (Hons) in
Gerontological
Nursing and BSc
(Hons) in Nursing
Practice (Older
People)
• Ongoing
collaboration with
Help the Aged
G6:To develop the
Dementia Nursing
Bursary for personcentred practice in
community care
To support
nurses develop
their knowledge
and practice
• Awards continue to
be given in
partnership with
Alzheimer’s Society
• 8 nurses have received awards
G7: Work in
partnership with
other agencies to
continue
lobbying and
influencing UK
policies on the
funding of
nursing and
long-term care
Older people
receive
appropriate
assessment and
funding. Nurses
are empowered
to support older
people in
achieving this.
• RCN leading
external
stakeholders group
(e.g. Age Concern,
Help the Aged,
Alzheimer’s Society)
to share information
and maximise
influencing
opportunities. Close
liaison continues.
• RCN submitted evidence to courts for Grogan case (2004-2005)
The RCN is seen
as a key
influence in the
development of
continuing
health care and
funded nursing
policy
• Number of bursaries awarded in total is 142.
• Article published in Nursing Older People highlighting Help
the Aged bursaries
• Negotiations re
continuing bursaries
and prizes
• RCN hosting
meetings with ADSS
and Social Services
leaders, along with
continuing care
solicitors and
practitioners in
order to identify
legal implications of
consultation
framework.
• RCN submitted evidence to Department of Health consultation on
continuing health care and funded nursing following extensive
stakeholder involvement
• RCN provided evidence of funded continuing care for AS so that
they could support a member who was seeking funded continuing
care (2004-2005)
• RCN contributed to Department of Health consultations on
Continuing Care directives
• RCN contributed to Department of Health work on national
(England) eligibility criteria and assessment
• Internal stakeholder meeting was held to inform RCN policy
Forums
• Congress resolution action plan produced and implemented UK
perspective
• RCN worked with Department of Health and Embrace Learning to
develop a learning course on continuing health care
• Commissioned research disseminated widely
• Lobbying and media work undertaken to inform election manifesto.
• Further internal stakeholder work undertaken
• Responding to
Department of
Health policy
initiatives.
• Sharing of concerns and information with the RCN RNCC nurses
and the discharge and liaison nurses, along with evidence from a
group of mental health nurses, was used to inform discussions
with representatives from the Department of Health
• RCN Scotland, Wales
and Northern
Ireland continue to
influence policies as
opportunities arise.
Sharing information
and learning from
each country
• Lobbying for access to PCT/NHS education to support delivery of
NHS funded nursing care homes by independent sector nurses in
care homes
• Joint publication giving guidance to public and nurses post Grogan
judgement - 2006
• Presentations at RCN Congress Fringe Events on Continuing Care
2005, 2006
• Following consultation with members and staff (via web-based
questionnaire, written submissions and focus group) RCN
submitted detailed response to Department of Health proposed
National Framework for Continuing Care and NHS-funded Nursing
– 2006
18
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 3: To ensure the delivery of good quality physical, mental and emotional care
OBJECTIVE H: The RCN will encourage its members to contribute to the development of high quality models of nursing
H1: To contribute to the
regeneration of the local
community teaching
nursing home project in
North East London with
City University
Project
completion
H2: To contribute actively to
developing creative ways
of anticipating and
responding to needs of
older people through the
promotion of good
practice
Nursing is
contributing to
this important
project.
Profile of forum
work increases in
Nursing Older
People and
Nursing Standard
• Research project completed
• RCN is a member of
the Age
Concern/Mental
Health Foundation
board of Inquiry into
Mental Health and
Wellbeing PF
• Regular page in
Nursing Older
People (NOP) for
forum news
• Regular publications
in Nursing Older
People and Nursing
Standard
H3: To support work on
Dignity in Care
The RCN is a key
stakeholder in
Dignity in Care
work
• Review of core competencies Skills for Health
• RCN contributed to the Department of Health
(England) consultation on commissioning
• RCN contributed to the Department of Health
(England) consultation on Social Care Green paper
• Supporting the Age Concern/Mental Health
Foundation board of enquiry
• Attended national rally re dementia drugs and
lobbied MP in commons
• Design and dementia care. IAHSA Malta
Presentation. New Village
• Hypothermia, older people and community care.
Keynote presentation on behalf of the RCN. Radio 4
interview
• RCN actively takes
opportunities to
promote and shape
good practice
• Member on emergency care operational group. Led
to workshop and development of liaison team
• Conference
presentations
• Reviewed Dignity on the ward, Age Concern
publication
• Working with
stakeholder
organisations – Age
Concern, Help the
Aged, National
Pensioners’
Convention, Better
Government Older
People
• Represent the RCN at Vulnerable Adult Association
Scotland (VAAS) which were previously Elder Abuse
Group. Associated with strategy and action plans
Discussions with Help
the Aged and British
Geriatrics Society
regarding
collaboration on
Dignity in Care
• Supporting RCN Executive Director for Nursing in her
membership of Department of Health England
working group.
• RCN endorsement of awareness-raising document
Suicide and older people
• Represent the RCN with Age Concern Scotland (and
Mental Health and Wellbeing in Older People)
• Local initiatives, e.g. study day in Eastern Region on
Dementia Care in general settings
• Individual projects, e.g. to raise the status and
profile of nurses working with older people
• Establishing effective two-way communication with
RCN Executive Director for Nursing to ensure forums
are kept up to date on progress
• Letter to RCN Executive Director for Nursing
• Briefings prepared in full
• Contributed to Department of Health Let’s Respect
project 2006
19
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 3: To ensure the delivery of good quality physical, mental and emotional care
OBJECTIVE H: The RCN will encourage its members to contribute to the development of high quality models of nursing.
H4: To support
initiatives to
prevent
malnutrition among
older people
Raised public
awareness;
accredited training
developed in
partnership with
Royal Colleges;
screening practice
developed;
standards defined
Continuing to support
initiatives
• Attended workshop on Malnutrition among Older
People in the Community: New Mechanisms for
Prevention and Improvement, organised by the
European Nutrition for Health Alliance, Internal
Longevity Centre UK and British Association for
Parenteral and Enteral Nutrition in association with
the Parliamentary Food and Health Forum
• Attended the House of Commons launch of the paper
Malnutrition among Older People in the Community,
produced with key stakeholders 2006
• Produced Marvellous Mealtimes strategy for
organisers
• Published article in Ageing Matters
• Involved in RCN stakeholder day on improving
nutrition
• Working with Anglian Water. RCN Hydration /
Nutrition. Developing nutritional assessment tool
locally to use across the country
H5: To contribute to
the National
Patient Safety
Agency Elder
Restraint project
RCN contribution
Tracy Paine sat on the
project group with
National Patient Safety
Agency which
produced the Bed rails
guidance document.
Partnership with
National Patient Safety
Agency formed to work
on Let’s talk about
Restraint
20
• Contributing to working party reviewing the use of bed
rails, physical and chemical restraint in hospitals and
the community 2006
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 3: To ensure the delivery of good quality physical, mental and emotional care
OBJECTIVE I: The RCN will develop and promote the concept of person-centred practice
I1: To utilise
opportunities such
as conference
presentations,
guidance and
advice to promote
person-centred
ways of working
Person-centred ways
of working are
promoted through all
opportunities
• RCN is a member of
the Alliance to resist
National Institute for
Clinical Excellence
proposals re antidementia drugs
• RCN is a member of
the elder abuse
strategic alliance
(England)
• Involvement of
forums at regional
level, e.g. proposed
north west network
for nurses working
with older people
• RCN took part in press conference and met with minister
• RCN contributed to the National Institute for Clinical
Excellence consultations on social values (2004-2006)
• RCN contributed to National Institute for Clinical
Excellence consultation on anti-dementia drugs
• Evidence submitted for National Institute for Clinical
Excellence review
• Campaign lobby
• Evidence submitted for appeal with alliance
• Evidence given at hearing
• Congress resolution work on anti-dementia drugs
• Theme at Congress Fringe
• Media interview
• Conference presentation in Dublin (Sept 2005)
• Presentations well-evaluated which led to commissioned
work on leadership
• RCN website to publish presentations from 2005
conference
• Established terms of reference for joint work on elder
abuse
I2: To influence the
educational
curriculum and
practice
placements for
student nurses
working with older
people
Raised awareness.
All modules in BSc
focus on personcentred practice
• Person-centred
practice is at the
core of the
BSc(Hons) in
Gerontological
Nursing Practice
• Local influence with
regard to principles
of Single
Assessment process
as part of both prereg and post-reg
study in HEIs
• RCN contributed to planned Nursing and Midwifery
Council work in 2005
• Education think tank established with Age Concern in
November 2005
• Four work streams taken forward with Age Concern. Each
work stream planned to result in specific products
• Nursing and Midwifery Council attended Education Think
Tank. Shared early work on mentorship with Think Tank.
Age Concern addressed their meeting
• Letter written to Nursing and Midwifery Council about
role of mentors and practice teachers
• Letter written to Council of Deans
• Council of Deans had long and constructive discusses
based on letter received from CN and Age Concern
• General Secretary discussed concerns and planned work
with Jonathan Asbridge and four country Chief Nursing
Officers between Feb and April 2006
• Fit for Practice meeting attended
• Abstract submitted for ICN 2007 on pre-registration
education
• Worked with care homes locally in the provision of
learning and development
21
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 3: To ensure the delivery of good quality physical, mental and emotional care
OBJECTIVE I: The RCN will develop and promote the concept of person-centred practice
I3: To gather evidence of
the impact of
contemporary policies
that influence the
delivery of personcentred care
Evidence informs
RCN work
Evidence gathering ongoing
• Discussions in terms of
identifying a research resource
for gerontology within the RCN
• Deidre Wild appointed as
Associate Fellow for Gerontology
Team (Research)
• Collaborative research with
Warwick University, University of
the West of England and RCN on
implementation of the
Registered Nurse Contribution
Calculation completed with
Department of Health England
its commissioners DW
• Research findings presented at
conferences and used as
evidence to inform continuing
care work
I4: To work with the
Health and Social
Care Advisory Service
in its Acute Care for
Older People project
Not progressed
HASCAS project
ceased
• No further action
I5: To explore with
Government how the
RCN can promote best
practice in work with
older people
RCN works closely
with Department
of Health to
actively seek
opportunities
• Regular meetings with Deborah Sturdy
(Government Nurses for Older People
(England))
• RCN is member of Ian Philp’s professional
forum (Clinical Director for Department of
Health (England))
• Meeting with Patient and Public Director
Department of Health to explore opportunities
• RCN is member of Department of Health
Dignity reference group
• RCN Wales, Northern Ireland, Scotland works
with Government Departments and invites
Older People Advisor/Forum as appropriate
22
• Contributed to Daily Times
article (2004-2005)
• Identifying the future source of
nursing advice to the Chief
Nurse and develop a lobbying
strategy to ensure that such
advice is contemporary, credible,
evidence based and reflects best
practice
• Establish who is the Government
lead for Northern Ireland, Wales
and Scotland
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 3: To ensure the delivery of good quality physical, mental and emotional care
OBJECTIVE J: The RCN will promote the role of nurses in securing health and wellbeing in older age
J1: To develop an
information toolkit for
nurses and older
people on sex and
sexuality
Materials to be
developed which
will support nurses
in care homes to
assist them in
identifying and
working effectively
with older people’s
needs
J2: To develop an RCN
position statement on
the nurse’s role in
promoting health and
wellbeing in older age
by working with older
people and partner
nursing organisations
Nurses’ role in
promoting health
and wellbeing is
highlighted in
Education Think
Tank work
• Project delayed to 2007/08
Ensuring role is covered within Education
Think Tank work
• Promote mental health and
wellbeing in old age by
contributing to delirium
guidelines, National Institute
for Clinical Excellence
guidelines, CR69 review,
women’s issue group (Mental
Health and Older People Forum
Action Plan 2006-7)
AIM 4: To empower older people through the provision of good quality information
OBJECTIVE K: The RCN will ensure that its own information is made available to patients, carers and advocates in an
appropriate way
K1:To produce material in
a range of formats
that can be accessed
by older people
Introduce greater
clarity concerning
the role, purpose
and audience for
documents
Ongoing monitoring
23
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 5: To promote effective partnership working
OBJECTIVE L: The RCN will work in partnership with older people to develop its policies and priorities
L1: To develop
arrangements to
involve older people
in RCN forums to
contribute to shaping
priorities
RCN work will be
shaped, informed
and influenced by
older people as
consumers of
health and social
care
• RCN engaging in greater
communication with pensioners
• Better Government Older People and
National Pensioners’ Convention
representatives actively involved in
strategy work
• Better Government Older People and
National Pensioners’ Convention
representatives participate in
conference planning and delivery
• Speaking at National Pensioners’
Convention meetings
Better Government Older People and
National Pensioners’ Convention
representatives participated in
conference planning, chairing and key
note speeches at conference (2005), in
the strategy review and the images work.
• Speaking at All London National
Pensioners’ Convention rally
• Addressed National Pensioners’
Convention Pensioners Parliament
May 2006
• Attending National Pensioners’
Convention meetings and conferences
• Publications team has a working brief
of criteria which informs their images
work
OBJECTIVE M: The RCN will develop confident practitioners who can work in partnership with older people
M1: To review modules on
the RCN BSc
Gerontological
Nursing course in
collaboration with
older people
When modules are
designated for
review, older
people will be
involved as critical
readers
M2:To encourage
providers of
education to develop
their material in
partnership with
older people.
Older people
become
increasingly
involved in
planning
education
provision for
nurses
Ongoing
• BSc GN revalidated with the University
of Manchester
• Education providers as key
stakeholders of education think tank.
• Raised at Education Think Tank
November 2005
OBJECTIVE N: The RCN will develop confident practitioners who can work as members of multi-agency and
multi-professional teams
N1: To promote the roles
of consultant nurses
and older people
specialist nurses
N2: To promote support
and networking
opportunities for
consultant nurses
and older people
specialist nurses
RCN is influenced
by Consultant and
Specialist nurses.
Nursing roles with
work in isolated
situations are
supported
Enhanced
networking
between
practitioners.
More effective
ways of informing
policy through
practice are
established
• Consultant and specialist nurses are
involved in influencing opportunities
• Older People Specialist Nurse working
group established
• RCN gerontology has two associate
fellows who are consultant nurses
• Older People Specialist Nurse Network
established
• Member of Glasgow Caledonian Virtual
College advisory Group
• Project on Older People Specialist
Nurse hosted workshop October 2005
• Older People Specialist Nurse network
• Older People Specialist Nurse Annual
event planned
• Networks established for Older People
Specialist Nurses, leaders and forum
members
• Older People Specialist Nurse project
as in N1
• Practice dilemmas and information
sharing is met through networks
24
• Mentoring commenced with aspiring
consultant nurse
• Workshop on 18 October
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Outcomes achieved 2004-07
AIM 5: To promote effective partnership working
OBJECTIVE N: The RCN will develop confident practitioners who can work as members of multi-agency and
multi-professional teams
N3: In partnership with
Help the Aged and
local providers, the
RCN will seek
funding to undertake
an evaluative study
on the outcomes of
the older people
specialist nurse roles
An evaluation study
on the outcomes of
older people
specialist nurse
roles
• Help the Aged is a partner in this work
• Ongoing discussions to explore funding
options
• See N1 and in discussion with big
lottery fund for funding
• Further discussions planned to
explore way forward
• Older People Specialist Nurse
postholders will participate in a
scoping study.
• Funding not secured. Project close
OBJECTIVE O: : The RCN will promote the role of older people as active partners in the single or unified assessment process
O1: The RCN older
people’s forums will
disseminate
examples of good
practice
Greater coverage
and enhanced
communication of
forum work
• Forums working to highlight best
practice via Ageing Matters (RCN
newsletter)
• Regular submissions of forum work to
Nursing Older People (RCN Publishing
journal)
25
• Nursing Older People the journal has
regular RCN forum submission
• Ageing Matters RCN newsletter
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
5
Overall summary: Older people
strategy objectives
Plans for 2007/2008
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 1: To ensure older people are valued
OBJECTIVE A: The RCN will actively root out age discrimination in its own organisation
A2: To work with older
people to examine
our publicity
material for
negative
stereotypes of older
people
Feedback and
views from older
people will be fed
into all
publications for
nursing older
people
Lead forum member for any new
publication will ensure older people have
the opportunity to comment on
penultimate drafts prior to publication
• Involvement of older people for
rehabilitation document
A3: To examine the
language and
internal workings of
the RCN to ensure
no stereotypes of
older people are
explicit or implied
Language and
Images are
positive and
promote the
value of older
people
• Language is challenged as necessary
• RCN working with Help the Aged
regarding work on language in the
media and its relationship to dignity
• Image commissioning works to criteria
developed in partnership with older
people
• Involvement of older people for
restraint document
• RCN and Help the Aged exploring some
joint work on language as part of the
dignity project
OBJECTIVE B: The RCN will work with other key stakeholders to portray positive images of ageing
B1:To work with older
people and others
to disseminate
positive images of
ageing
Printed material
associated with
BSc uses
positive images
of ageing
• Nursing Older People Strategy
principles will be produced in a
laminated format for use at Congress
and at conferences as a way of
informing practice in a positive way
Positive images
of ageing are
promoted at
every
opportunity
• Involvement in ‘The Poster Project
revisited’ looking at producing
materials specifically aimed at
working in end of life and dementia
care
26
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 1: To ensure older people are valued
OBJECTIVE C: RCN will raise the profile of older person abuse. The RCN will seek to ensure members are alert to its detection
and respond appropriately
C1: To review existing
RCN older person
abuse guidance
with other
interested parties
to identify gaps and
priorities for
nursing practice
Better informed public
and nursing workforce,
more able to recognise
and respond to elder
abuse
• Ongoing collaboration with partners (Action on
Elder Abuse, Help the Aged, Age Concern) and
older people’s organisations
• RCN is a member of Elder Abuse Strategic
Alliance (England)
• Participating in campaigns e.g. with Help the
Aged
• Ensuring that the topic of elder abuse is fed into
other RCN projects, e.g. RCN/Age Concern Think
Tank
C2: To build on the
review to develop a
framework for good
practice for wider
dissemination
• Lobbying to ensure mandatory training on elder
abuse is incorporated in nurse
orientation/induction programmes
• Awareness-raising activities, conferences,
publications
• Working locally and nationally to raise
awareness of elder abuse and educational
needs of nursing students
• Continue partnership
with other agencies
and RCN
representation for
Elder Abuse Strategic
Alliance England
• Prepare new edition of
RCN guidance on elder
abuse
• Nursing Standard
article/booklet
• Continue with keynote
presentations
• Local work on the
protection of
vulnerable adults
OBJECTIVE D: RCN will work with older people to develop its range of services for nurses working with older people
D1: To work in
partnership with
older people to
review the RCN
nursing older
people strategy and
progress reports
RCN and older people
work in partnership on
the RCN Nursing Older
People Strategy
National Pensioners’ Convention and Better
Government Older People members actively
engaged in developing and reviewing strategy
• Future older people
work will be embedded
within the RCN
Professional
Development
Framework (PDF) –
ways of future working
to be explored
• Draft strategy
evaluation report will
be sent to stakeholders
for comment and
feedback incorporated
• Local initiatives in
partnership with older
people
D2: To involve older
people in the
development of
conferences
To establish a system to
involve older people
Older people are actively involved in all aspects
of RCN older people conference
• Working in partnership
to plan conference in
2007
D3: To work with older
people in the
development of RCN
publications
Publications will appear
in different formats
depending on the topic,
e.g. executive summary
or bullet points.
• Forums working in partnership with older
people
• To work with older
people in developing
publications, e.g.
rehabilitation and
restraint documents
• Forums will encourage working in partnership
with older people around the UK
All future RCN
publications for nursing
older people will have a
nominated lead who will
determine how to engage
older people as
stakeholders
27
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 2: To maximise the potential of older people and nurses
OBJECTIVE E: The RCN will support nurses in developing person-centred assessment processes that recognise the need to
develop a holistic view of older people’s needs
E3: To provide guidance,
advice and training on
the use of the RCN
Nursing Older People
Assessment Tool
OBJECTIVE F:
To support nurses and
organisations in their
use of the tool
Available as requested
A major provider of nursing
home care is planning to
introduce RCN assessment tool
across the UK
The RCN will work with its forums and older people to develop a more positive approach to risk management
F1: In partnership with
older people the
RCN’s older people’s
forums will explore
ways in which they
can promote practice
that maximises
potential
RCN is seen to
contribute and influence
policy development and
practice
F2: To prepare new
material on rights,
risks and the use of
restraint.
New materials
Ongoing through forums, advisor,
associate fellows and activists
• Local networks for Nurses
working with Older People
and Mental Health and Older
People forums, e.g. in the
North West
• Local Network for East of
England being explored
• Local network in Belfast
Review and rewrite Rights, risks
and responsibilities publication.
Being produced in collaboration
with the National Patient Safety
Agency and partnership
agreement on definitions with
Commission for Social Care
Inspection
OBJECTIVE G: The RCN will influence the learning and practice development of nurses so that they can maximise the potential
of older people
G1: To promote the RCN
BSc (Hons) in
Gerontological
Nursing to increase its
take up
G3: In partnership with
Government nurses
and RCN leadership
programme, explore
the potential for
providing older
people-specific
clinical and political
leadership
programmes
Increased focus on RCN
work to promote the
educational needs of
nurses working with older
people.
• Marketing strategy continues to be
implemented
Increased numbers of
nurses working with older
people undertaking this
programme
• Support of nurses on the political
leadership programme wishing to
influence the development of preregistration curricula across the
sector
The potential of leaders in
older people’s care is
maximised
Forums participating in political
leadership programme
• Innovative work on developing
methodology to evaluate impact on
practice
• Following the RCN’s strategic
decision made in early 2007
to relinquish its status as a
Higher Education Institution,
to work with the Distance
Learning team to try and
secure the future delivery of
the BSc (Hons) in
Gerontological Nursing, and
its successor the BSc (Hons)
in Nursing Practice (Older
People)
• 18 directors of nursing
services are currently
undertaking the Dublin
leadership programme
• Leadership and development
programme being developed
for independent sector
provider
• Supporting development and
leadership for Dignity at a
hospital trust in North West
28
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 2: To maximise the potential of older people and nurses
OBJECTIVE G: The RCN will influence the learning and practice development of nurses so that they can maximise the potential
of older people
G4: To work with
representatives of NHS and
primary care trusts and the
Independent Sector to
develop a programme for
rotational opportunities for
nurses to move between
acute and community
settings to broaden
experience and
understanding
Evidence of best practice
is disseminated
Forums ongoing action
• None planned
G5: To collaborate with Help
the Aged to promote the
newly-established
Bursaries and Awards (RCN
BSc in Gerontological
Nursing) for personcentred practice.
To maintain bursaries for
students studying on the
BSc (Hons) in
Gerontological Nursing
and BSc (Hons) in
Nursing Practice (Older
People)
• Ongoing collaboration with
Help the Aged
• To negotiate with Help the Aged
the potential to continue
sponsorship of the bursaries and
prizes in collaboration with any
strategic partner identified for
the future delivery of the BSc
(Hons) in Nursing Practice (Older
People)
G6: To develop the Dementia
Nursing Bursary for
person-centred practice in
community care
To support nurses
develop their knowledge
and practice
• Awards continue to be given
in partnership with
Alzheimer’s Society
• Awards continue to be made in
partnership with AS
G7: Work in partnership with
other agencies to continue
lobbying and influencing
UK policies on the funding
of nursing and long-term
care
Older people receive
appropriate assessment
and funding. Nurses are
empowered to support
older people in achieving
this.
• RCN leading external
stakeholders group (e.g. Age
Concern, Help the Aged,
Alzheimer Society) to share
information and maximise
influencing opportunities.
Close liaison continues
• Review latest versions of
Department of Health Referral
Tool (previously called Screening
Tool) and Version 2 of Decision
Support Tool for continuing care.
Respond to Department of
Health as appropriate
• RCN hosting meetings with
Association of Directors of
Social Services and Social
Services leaders, along with
continuing care solicitors and
practitioners in order to
identify legal implications of
consultation framework
• Continue to influence the current
work in England by the
Department of Health on the
pending National Framework for
NHS Continuing Care
RCN is seen as a key
influence in the
development of
continuing health care
and funded nursing policy
• Negotiations regarding
continuing bursaries and
prizes
• Responding to Department of
Health policy initiatives
• RCN Scotland, Wales and
Northern Ireland continue to
influence policies as
opportunities arise. Sharing
information and learning from
each country
29
• Support Kings Fund Caring
Choices and identify the care
issues within the funding debate
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 3: To ensure the delivery of good quality physical, mental and emotional care
OBJECTIVE H: The RCN will encourage its members to contribute to the development of high quality models of nursing
H1: To contribute to the
regeneration of the local
community teaching
nursing home project in
North East London with
City University
Project
completion
H2: To contribute actively to
developing creative ways
of anticipating and
responding to needs of
older people through the
promotion of good practice
Nursing is
contributing to
this important
project.
• RCN is a member of the Age
Concern/Mental Health Foundation
board of Inquiry into Mental Health and
Wellbeing
Profile of forum
work increases in
Nursing Older
People and
Nursing Standard
• Regular page in Nursing Older People
for forum news – RCN and others
• RCN is member of
Department of Health
specialist forum
• RCN is establishing a UK, all
sector Dignity project
• September 2007 publication
of book Mental Health and
Older People’s Nursing
• Regular publications in Nursing Older
People and Nursing Standard
• RCN actively takes opportunities to
promote and shape good practice
• Conference presentations
• Working with stakeholder organisationsAge Concern, Help the Aged, National
Pensioners’ Convention, Better
Government Older People
H3: To support work on Dignity
in Care
The RCN is a key
stakeholder in
Dignity in Care
work
Discussions with Help the Aged and British
Geriatrics Society regarding collaboration
on Dignity in Care
• Supporting HTA Dignity
publications
• Dignity to be a central
component of RCN
conference 2007
• to lead on RCN’s work on
Dignity
• Identify blocks and barriers,
agree best practice and
develop learning and
practice support material
• Fringe event held at congress
• RCN supported BGS in its
Dignity in Continence work
• Written and oral evidence
given to House of Lords
enquiry on Human rights
H4: To support initiatives to
prevent malnutrition
among older people
Raised public
awareness;
accredited training
developed in
partnership with
Royal Colleges;
screening practice
developed;
standards defined
Continuing to support initiatives
• Continue to contribute to
RCN work on malnutrition in
older people
• Define standards for best
practice
• Local initiatives to prevent
and screen for potential
malnutrition
30
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 3: To ensure the delivery of good quality physical, mental and emotional care
OBJECTIVE H: The RCN will encourage its members to contribute to the development of high quality models of nursing
H5: To contribute to the
National Patient Safety
Agency Elder Restraint
project
OBJECTIVE I:
To contribute RCN
perspective to the
work
Tracy Paine sat on the project group with
National Patient Safety Agency which
produced the Bed rails guidance document.
Partnership with National Patient Safety
Agency formed to work on Let’s talk about
Restraint
• Develop the RCN guidance
on the use and abuse of
restraint in partnership with
the National Patient Safety
Agency for publication in
Autumn 2007
The RCN will develop and promote the concept of person-centred practice
I1: To utilise opportunities
such as conference
presentations, guidance
and advice to promote
person-centred ways of
working
Person-centred
ways of working
are promoted
through all
opportunities
I2: To influence the
educational curriculum and
practice placements for
student nurses working
with older people
Raised awareness
I3: To gather evidence of the
impact of contemporary
policies that influence the
delivery of person-centred
care
Evidence informs
RCN work
Evidence gathering ongoing
• No research resource
available to continue this
I5: To explore with
Government how the RCN
can promote best practice
in work with older people.
RCN works closely
with Department
of Health to
actively seek
opportunities
• Regular meetings with Deborah Sturdy
(Government Nurse Department of
Health)
• Identify the current leads for
2007/2008 and how the RCN
might work with them
• RCN is member of Ian Philp’s
professional forum (Director
Department of Health)
• RCN is member of Ian Philp’s
professional forum
• Meeting with Patient and Public Director
Department of Health to explore
opportunities
• Opportunistic work across
the UK
All modules in
BSc focus on
person-centred
practice
• RCN is a member of the Alliance to resist
National Institute for Clinical Excellence
proposals re anti-dementia drugs
• RCN is a member of the elder abuse
strategic alliance (England)
• Two day conference in Cardiff
to be held in November 2007
• Continue to promote personcentred work through Ageing
Matters. All forum members
• Involvement of forums at regional level,
e.g. proposed north west network for
nurses working with older people
• Local initiatives including
monthly e-updates on
national policy documents to
which members contribute
through North West Network
for NWWOP and MHOP
• Person-centred practice is at the core of
the BSc(Hons) in Gerontological Nursing
Practice
• Resource pack and
influencing strategy to be
developed in partnership
with Age Concern
• Local influence with regard to principles
of Single Assessment process as part of
both pre-reg and post-reg study in
higher education institutions
• RCN is member of Department of Health
Dignity reference group
• RCN Wales, Northern Ireland, Scotland
works with Government Departments
and invites Older People advisor/forum
as appropriate
31
• Laminated card on positive
mentorship to be issued
• Dignity reference group
• Linking with deputy Chief
Nursing Officer and
colleagues
• Linking with CSIP
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 5: To promote effective partnership working
OBJECTIVE L: The RCN will work in partnership with older people to develop its policies and priorities.
L1: To develop arrangements to
involve older people in RCN
forums to contribute to
shaping priorities
RCN work will be
shaped, informed and
influenced by older
people as consumers
of health and social
care
• RCN engaging in greater
communication with pensioners PF
• Better Government Older People
and National Pensioners’
Convention representatives actively
involved in strategy work
• Better Government Older People
and National Pensioners’
Convention representatives
participate in conference planning
and delivery
• Speaking at National Pensioners’
Convention meetings
RCN nursing older people work
• Conference planning for 2007
conference
• Strategy review
• Forums attend National
Pensioners’ Convention
meetings
• Explore how to further
involve older people in forum
work
• Addressing Pensioners’
Parliament
OBJECTIVE M: The RCN will develop confident practitioners who can work in partnership with older people
M1: To review modules on the
RCN BSc Gerontological
Nursing course in
collaboration with older
people
When modules are
designated for review,
older people will be
involved as critical
readers
M2:To encourage providers of
education to develop their
material in partnership
with older people
Older people become
increasingly involved
in planning education
provision for nurses
Ongoing
• An outcome of the Education
Think Tank
OBJECTIVE N: The RCN will develop confident practitioners who can work as members of multi-agency and multi-professional teams
N1: To promote the roles of
consultant nurses and
older people specialist
nurses
RCN is influenced by
consultant and
specialist nurses.
• Consultant and specialist nurses
are involved in influencing
opportunities
• Two leadership programmes
being developed for nurses
working with older people
Nursing roles with
work isolated
situations are
supported
• RCN gerontology has two associate
fellows who are consultant nurses
• RCN members have
opportunities to represent
RCN in a variety of working
groups
• Member of Glasgow Caledonian
Virtual College advisory Group
• Older People Specialist Nurse
network
N2: To promote support and
networking opportunities
for consultant nurses and
older people specialist
nurses
Enhanced networking
between practitioners.
More effective ways of
informing policy
through practice are
established
• Networks established for Older
People Specialist Nurses, leaders
and forum members
• Practice dilemmas and information
sharing is met through networks
• Networks in place,
information disseminated via
these, support provided via
the networks
• Supporting individual
consultant and specialist
nurses
• Identifying opportunities to
promote the establishment
of these roles
• Meeting with Nursing Older
People consultant nurses
32
ROYAL COLLEGE OF N URSI NG
Milestones
Desired outcome
Ongoing action
Activities for 2007-2008
AIM 5: To promote effective partnership working
OBJECTIVE N: The RCN will develop confident practitioners who can work as members of multi-agency and multi-professional teams
N3: In partnership with Help
the Aged and local
providers, the RCN will
seek funding to undertake
an evaluative study on the
outcomes of the older
people specialist nurse
roles
An evaluation study on
the outcomes of older
people specialist
nurse roles
• Help the Aged is a partner in this
work
• Funding not secured, project
closed
• Ongoing discussions to explore
funding options
OBJECTIVE O: The RCN will promote the role of older people as active partners in the single or unified assessment process
O1: The RCN older people’s
forums will disseminate
examples of good practice.
Greater coverage and
enhanced
communication of
forum work
• Forums working to highlight best
practice via Ageing Matters (RCN
newsletter)
• Regular submissions of forum work
to Nursing older people (RCN
Publishing journal)
33
• To continue regular coverage
in Nursing older people, and
Ageing Matters
C A R I NG I N PA RTN E RS H I P – 3 YE A RS ON
6
Conclusions
✦
This RCN Nursing Older People Strategy report
represents work completed between May 2004 and April
2007. It also includes the objectives identified for taking
forward between April 2007 to March 2008. It covers the
sponsored period of work and is therefore the final
report and evaluation of the RCN Nursing Older People
Strategy.
In less than 20 years from now, the number of people
aged over 85 will have increased by two thirds.
Extending lifespan is something to be celebrated. As
Scotland’s First Minister, Jack McConnell, stated when
launching the new strategy for older people (Scottish
Executive, 2007a): “We must stop seeing our ageing
population as a burden. We need to think about the
opportunities it can offer”.
The policy agenda has been and will continue to be
significant and the agenda for nursing continues to be a
demanding one. Demographics alone highlight why
improving health and social care for older people must
remain at the heart of government agendas, and why
older people must remain a priority in nursing
throughout the UK.
Wales has a higher concentration of older people than
the rest of the UK. 22% of Wales’s population is aged
over 60, and over the next 20 years, that number of
people will increase to almost one third of the
population. The number of people over 85 will also
increase significantly (Welsh Assembly Government,
2007a).
By 2031 the number of people aged over 50 in Scotland
is projected to rise by 28% and the number aged over 75
is projected to increase by 75% (Scottish Executive,
2007a)
In Northern Ireland it is projected that the over-65
population will, by 2023, total about 350,000, compared
to 266,000 in 2002 (DHSSPS, 2005a).
In England, the National Director for Older People, Ian
Philp, (DH, 2007b) reports that, while people over the
age of 65 make up around 16% of the population:
✦
people aged over 65 occupy 65 per cent of acute
hospital beds
✦
in 2004/2005 they accounted for 63 per cent of all
finished consultant episodes in acute hospitals
✦
older people are three times more likely to be
admitted to hospital as a result of attending Accident
and Emergency
✦
in 2003/2004 they accounted for 43% of the total
NHS budget - £16.47 billion
in 2005/2006 older people accounted for 58% of
social services budgets and in 2004/2005 received
71% of social care packages.
34
ROYAL COLLEGE OF N URSI NG
References
Publications
Scottish Executive (2005a) Delivering for Health.
Edinburgh: Scottish Executive.
Department of Health (2001) The National Service
Framework for Older People. London: DH.
Scottish Executive (2005b) Adult Support and
Protection (Scotland) Act 2007. Edinburgh: Scottish
Executive.
Department of Health (2006a) New Ambition for Old
Age. London: Department of Health.
Scottish Executive (2006a) Developing Community
Hospitals: A strategy for Scotland. Edinburgh: Scottish
Executive.
Department of Health (2006b) New Ambition for Old
Age: next steps in implementing the National Service
Framework for Older People. A resource document.
London: DH.
Scottish Executive (2006b) Rights, Relationships and
Recovery. Edinburgh: Scottish Executive.
Department of Health (2006c) Proposed new National
Framework for NHS Continuing Healthcare and NHS
funded Nursing Care in England. London: Department
of Health.
Scottish Executive (2006c) The future of unpaid care in
Scotland. Edinburgh: Scottish Executive.
Scottish Executive (2007a) All Our Futures: Planning for
a Scotland with an Ageing Population. Edinburgh:
Scottish Executive.
Department of Health (26 June 2007a) The National
Framework for NHS Continuing Healthcare and NHSfunded Nursing Care. London: DH.
Scottish Executive (2007b) Evaluation of the operation
and impact of free personal care. Edinburgh: Scottish
Executive.
Department of Health (2007b) A Recipe for Care – Not a
Single Ingredient: Clinical case for change: report by
Professor Ian Philp, National Director for Older People.
London: Stationery Office.
Scottish Executive (2997c) Keeping Well. Edinburgh:
Scottish Executive.
Welsh Assembly Government (2007) Strategy for Older
people in Wales. Cardiff: WAG.
Department of Health, Social Services and Personal
Safety (2007) Priorities for Action 2006-2008. Belfast:
DHSSPS.
Waddington E (2005) One year on – caring in
partnership: older people and nursing staff working
towards the future. London: RCN.
Ford P, Waddington E (2004) Caring in partnership:
older people and nursing staff working towards the
future. London: RCN.
Waddington E (2006) Two years on – caring in
partnership: older people and nursing staff working
towards the future. London: RCN.
Royal College of Nursing (2007) Our NHS – today and
tomorrow. A Royal College of Nursing commentary on
the current state of the National Health Service and the
steps needed to secure its future. London: RCN.
Government websites
Registered Nursing Homes Association (2007) NHS
Contribution too little too late. Press release from the
Registered Nursing Homes Association. March 19th
2007.
Welsh Assembly Government: www.wales.gov.uk
Scottish Executive Health Department:
www.scotland.gov.uk
Northern Ireland Department of Health, Social Services
and Public Safety: www.dhsspsni.gov.uk
Department of Health England: www.dh.gov.uk
35
November 2007
Published by the Royal College of Nursing
20 Cavendish Square
London
W1G 0RN
020 7409 3333
The RCN represents nurses and nursing,
promotes excellence in practice and shapes
health policies
Publication code 003 195
ISBN 978-1-904114-83-3