Ward Sister Charge Nurse and
Team Leader Conference
Charlotte Mcardle
Chief Nursing Officer
DHSSPSNI
NI local issues
• Financial climate
• Demographics
Transforming your Care
• Public health
Fit and Well-changing
lives 2012-2022
• Media reports
• Francis Inquiry
Quality 2020
How will N+M Lead TYC
• It is a big challenge but also a great opportunity
• Our professions are best placed to lead this change
alongside others
• We must continue to be the advocate for the public
• We must be truly person centred supporting people to
make their decisions about care
• We must be open to change and create change for the
right reason
• New roles and opportunities to push the boundaries
• Must engage with technology
Q2020
• 10 year strategy to improve quality in health
and social care in NI
• Based on principles of safety, effectiveness
and patient & client focus
• Avoidable and preventable harm
• Right care in the right place at the right time
with the best outcome
• All patients and clients fully involved in their
care and treated with respect and dignity
Robert Francis Press Conference Statement 6/2/13
“We need a patient centred culture, no tolerance of non compliance with fundamental
standards, openness and transparency, candour to patients, strong cultural leadership
and caring, compassionate nursing, and useful and accurate information about
services”
“The Trust Board was weak. It did not listen sufficiently to its patients and staff or ensure
the correction of deficiencies brought to the Trust’s attention. It did not tackle the tolerance
of poor standards and the disengagement of senior clinical staff from managerial and
leadership responsibilities. These failures were in part due to a focus on reaching targets,
achieving financial balance and seeking foundation trust status at the cost of delivering
acceptable standards of care”
“Conventionally, some might say depressingly, when a disaster has occurred in the NHS the
usual approach has been to blame and sack individuals or to propose major reorganisations.
What has been found to be wrong here cannot be cured by finding scapegoats, and/ or
recommending major reorganisations yet again”
Key themes of the recommendations
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Putting the patient first
Common culture
Standards of service
Professional regulation of fitness to practice
Regulating healthcare systems
Complaints handling
Performance management
Medical training and education
Openness, transparency and candour
Nursing
Leadership
290 recommendations in total
Nursing
•
The Department of Health and NMC should introduce the concept of a
Responsible Officer for nursing, appointed by and accountable to, the NMC
•
Without introducing a revalidation scheme immediately, the NMC should
introduce common minimum standards for appraisal and support with
which responsible officers would be obliged to comply. They could be
required to report to the NMC on their performance on a regular basis
•
As part of a mandatory annual performance appraisal, each nurse,
regardless of workplace setting, should be required to demonstrate in their
annual learning portfolio an up-to-date knowledge of nursing practice and its
implementation
Nursing
• There should be an increased focus in nurse training, education and
professional development on the practical requirements of delivering
compassionate care in addition to the theory
• There should be a national entry-level requirement that student
nurses spend a minimum period of time, at least three months, working
on the direct care of patients under the supervision of a registered
nurse
• The NMC, working with universities, should consider the introduction
of an aptitude test to be undertaken by aspirant registered nurses at
entry into the profession, exploring, in particular, candidates’ attitudes
towards caring, compassion and other necessary professional values
What could it look like?
A system built on standards with Safety and
Quality the driver
.
…………….clear fundamental set
of standards, driven by the
interests of patients, and devised
by clinicians; a “bottom up” as
opposed to a “top down” system
Ensuring Safety
Improving Quality
Testing the patient/client Experience
))
)))))

130 mph
… Nearly will not do
The Person-centred Nursing Framework
(McCormack and McCance, 2006)
• Appropriate skill mix
•Professionally competent
• Shared decision making
•Developed interpersonal
skills
•Commitment to the job
systems
• Effective staff relationships
• Supportive organisational
•Clarity of beliefs & values
•Knowing ‘self’
systems
• Power sharing
• Potential for innovation &
risk taking
OUTCOMES
•Working with patient’s
beliefs and values
•Engagement
•Having sympathetic
presence
•Sharing decision making
•Providing Holistic Care
• The physical environment
•Satisfaction with Care
•Involvement with Care
•Feeling of Well-Being
•Creating a therapeutic Culture
McCormack & McCance,
How will N+M Lead Q2020
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We have a key role through SQE
Priority to deliver the regional KPIs
Priority to focus relentlessly on QI
Priority to be transparent about practice and the
standard of care with the public
• Priority to embed patient stories for learning
• Continue to do good work on 5 standards for
client experience
• Continue to embed the person centred nursing
framework
Key messages
• Be proud and stay true to the principles of the
profession
• Make a difference to peoples lives
• Be a flag bearer of compassionate care
• Work in partnership with patients and the public
• Ensure Safety. Improve Quality and test patient
Experience as you go.
• Nurses are never afraid of challenge
• Nursing is full of challenge