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Nursing and Midwifery Annual Report 2015-2016

2 Nursing and Midwifery Annual Report 2015-2016

Welcome and introduction

I am delighted to be able to share the huge progress our nursing and midwifery staff have made in 2015/16. The report forms our annual update against our previous strategy which ran from 2012 to 2016.

It has been another busy year and as usual our teams have risen to the challenge. There have been significant changes to our services, such as reconfiguration of our Tower, referred to as the ‘restack’, to accommodate the movement of our services to UCH at Westmoreland Street and the

creation of a new gynaecology ward, the on-going service changes in our Emergency Department, the transfer of Haematology and Head and Neck services from the Royal Free Hospital, The Heart Hospital services moving to the Barts Heart Centre, Jubilee ward at St Pancras closing and Sir William Gowers Assessment Unit at Chalfont St Peters transferring to us from the Epilepsy Society. Despite the distractions of such changes we have continued to deliver top-quality patient care, as agreed by our patients who voted us number one in London in the National Inpatient Survey.

Please enjoy reading this report which also marks the closure of our last strategy and the introduction to a very different approach over the next five years. Our new strategy ‘Stronger Together’ is the first joint strategy involving nurses, midwives, allied health professionals and pharmacists. I look forward to sharing this in more detail as we launch the Strategy in September.

Finally, I would like to take this opportunity to thank you for your hard work, dedication and professionalism which makes a difference every day to our patients and each other.

Flo Panel-Coates Chief Nurse

A message from Flo Panel-Coates, Chief Nurse

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As a governor I am delighted to be able to contribute to this year’s Nursing & Midwifery report. I was also very pleased earlier this year to be asked to join the Nursing & Midwifery Board. I believe that Nursing & Midwifery is a good example to other parts of the Trust, of how open and transparent it is possible to be.

Through the board I have learnt of the very impressive series of checks and balances which allow there be to detailed

monitoring of the quality of care being provided. Clearly not every ward can be the “best”, but there are impressive efforts being made, some of which are detailed in this report, for every ward to be focused on improving.

I hope that as a patient I also contribute to the work of the board. Sometimes it can be difficult for other people to understand how vulnerable you can feel as a patient, and the difficulty you can have in explaining any concerns. Much work has already been done on improving communication with patients, and I hope to see this continue in future years.

It has overall been a difficult year for Nursing & Midwifery as there continues to be significant financial pressures. But despite this it has been an impressive year with many achievements. It is difficult to single out any particular area, but clearly the lowering of the vacancy rate has brought benefits to staff and patients alike.

I would like to congratulate everyone for their efforts over the last year, and I would like to wish everyone further success in the future.

Annabel kanabus Patient Governor and member of Nursing & Midwifery Board

A message from Annabel Kanabus, Patient Governor and member of Nursing & Midwifery Board


Key facts and strategy summary

Key achievements: Patient safety

The N&M contribution to the UCLH’s patient safety agenda in 2015-16 was significant. Of note were the reduction in falls which result in moderate or severe harm, preventable dose omissions, consistently delivering 96% harm free care (Safety Thermometer), low number of cardiac arrests.

Key achievements: Patient experience

In 2015-16 UCLH achieved first place for the National Inpatient Survey in London, improved and was above the national score for Friends and Family Test for both inpatients and Emergency Department.

Key achievements: Research and workforce

2015-16 saw huge success in filling nursing and midwifery vacancies leading to a vacancy rate of 6.6%, reduction in use of temporary staff including agency, launch of the Chief Nurse Bulletin.

The N&M strategy was launched in summer 2012 and extended to 2016. It comprises of eight key strategic aims which link to UCLH’s vision statement to provide top-quality patient care, excellent education and world class research.

1 ‘We know that care and outcomes for patients are of a high quality’

2 ‘Nurses and midwives are always caring thoughtful and intelligent’

3 ‘Patients and their families feel confident in their care, and have the best experience possible throughout their whole pathway of care’

4 ‘Nurses and midwives are stewards of the NHS purse’

5 ‘Nurses and midwives have a structured, coherent clinical and/or academic post graduate pathway’

6 ‘Research is alive in practice’

7 ‘Matrons are influential and exemplify inspirational leadership at all levels’

8 ‘The sister and charge nurse is a high profile, valued and effective role’

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1. We know that care and outcomes for patients are of a high quality

Exemplar ward launchThe UCLH exemplar ward model, part of the ‘uclh future’ transformation strategy was developed and piloted on several wards during 2015/16. The diagram illustrates the key components with the associated weighting. It was launched in April 2016, starting with the National Hospital for Neurology and Neurosurgery, Queen’s Square. ‘Exemplar ward’ is a method for understanding ward performance from ‘ward to board’ and supporting quality improvement from a place of shared understanding and reducing variability.

UCLH Exemplar Ward Accreditation

UCLH Exemplar Ward Accreditation

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Quality & Safety

Efficiency PatientCentred

Staff Experience

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1 Patients always receive harm free care

2 Evidence based care

3 Ward safety

4 Patients receive the right care, at right time and place

5 Appropriate numbers of staff

6 Ward efficiency

7 All patients receive timely, holistic, individ-ualised care

8 Quality of the ward environment

9 Staff are engaged, empowered, and committed

10 Have the appropriate skills

11 The ward has an improvement culture and uses data to facilitate this

Safety thermometer: Harm free CareMeasurement of harm free care using the National Safety Thermometer demonstrates UCLH has consistently delivered 96% ‘harm free care’ during 2015/16 and that UCLH is achieving higher than the national expectation. The safety thermometer observes harms related to: falls, pressure ulcers, venous thromboembolism (VTE) and urinary tract infections using a ‘point prevalence methodology’.


A reduction in falls resulting in moderate or severe harm

The incidence of falls has increased over the last year which on investigation appears mainly due to increased awareness and reporting and a change of reporting criteria for falls. The number of falls with harm has not significantly changed over the last year; however, in 2015/16 a reduction of 35% in falls which resulted in moderate or severe harm has been achieved. See figure 1.

Training has been targeted to those areas with a higher incidence of falls and specialist areas; with bespoke training supported by falls sub groups such as at the NHNN have been formed. UCLH multidisciplinary falls steering group has continued and we received charitable funding for a Darzi Fellow, appointed mid-year for 12 months, to help implement and develop the falls strategy. All root cause analysis investigations (RCAs) are now signed off by the falls group and lessons learnt are communicated widely.

Hospital acquired pressure ulcer (HAPU)

Our work has continued over the last year to reduce HAPUs; our ability to do this has been affected by the introduction of new reporting categories. These changes initially led to an increase in reported HAPUs over quarter’s 3 and 4; but thanks to the efforts of our teams we have seen a dramatic reduction over the last three months.

Despite this increase 27% of our wards remained HAPU free for the year; this included a number of high risk areas. In addition an organisation wide pressure ulcer prevalence audit was conducted and pressure ulcer prevalence at UCLH was found to be 6%, with 1% hospital acquired; this is significantly lower than the national average. See figure 2.

Dose omissions Reducing preventable dose omissions has remained a priority and the improvements to achieve this objective have been led by the Medication Safety Committee. Figure 3 demonstrates the significant progress made over the last year. 7% of patients at UCLH experience a preventable dose omission which compares favourably with the national average of 9.3%. This success is the result of increased awareness, collaboration between nurses and pharmacists, adoption of the national medication safety thermometer, and more recently implementation of an electronic prescribing and medicines administration system.

In-hospital cardiac arrests

UCLH sustained its reduction of in-hospital cardiac arrests in 2015/16; with a consistent average of four cardiac arrests per month. This is half the national rate and UCLH remains the only large acute Trust to consistently be in the top four providers nationally for mortality indicators published from 2012 onwards.

2015/16 also saw a revision of the National Early Warning Score (NEWS) system to incorporate delirium, changes to Glasgow Coma Scale (GCS) and management of sepsis. This will continue to support low mortality and morbidity over the coming years.

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Figure 1

Figure 2

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Patient falls per 1,000 bed days and overall - all services

Pressure ulcers acquired at UCLH split by grade/category - all services

Proportion of patients with a preventable dose omission


Increasing trust and confidence in nurses and reducing attitude-related complaints has been a key focus over the last year. Targeted pieces of work have been conducted to address this; including a bespoke development programme for ward sisters and continued use of Schwartz Rounds to reflect on, and learn from, difficult situations.

2. ‘Nurses and midwives are always caring, thoughtful and intelligent’

The score for confidence and trust in nurses has improved from an average score of 93.5% to 94.0% when compared to 2014/15, see figure 4. In addition formal complaints highlighting concerns with the behaviours of nursing staff have decreased significantly over the last 6 months, see figure 5.

NB. Our variance in Quarter 2 data relates to the huge organisational changes which settled in Quarter 4.

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Midwifery values and behaviours

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Figure 5

Whole Trust confidence and Trust in nurses

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Midwifery supervision Despite the uncertainty nationally in relation to supervision of midwives; the profile of supervision at UCLH remains strong. Our supervisors continue to be available to women and midwives 24 hours per day, 7 days a week to provide advice and support on clinical matters, concerns that women are experiencing, or issues inside and out of work that may be impacting on a midwives working life. Breakfast clubs, supervisory surgeries, annual reviews and birth reflections clinic are used to support these activities for women and staff.

Dementia careEnsuring our team are confident and competent to care for our most vulnerable patients has continued. This year our dementia training programme saw the inclusion of simulation offering nurses the opportunity to practice new skills in a safe environment. In addition, the team have worked on a number of projects including improvements to the environment on the orthopaedic ward (T10S) identification and liaison with community colleagues for patients with complex needs and new approaches to support the recognition and prevention of delirium in those at high risk.

Strengths based recruitment

Recruiting great staff remains a key element of our strategy to increase public confidence in nursing and midwifery at UCLH. In 2015, we continued our work with Engaging Minds to roll out strengths-based recruitment across nursing and midwifery. 2015/16 saw the delivery of the much-awaited strengths profiles for staff nurses and nursing assistants. We have learnt that great nurses and great nursing assistants have the same core strengths, but it is the knowledge, skills and accountability that differentiates the two roles. During 2015/16 16 sisters/charge nurses and seven deputies were appointed using strengths-based recruitment. See figure.

We took a tactical decision to focus on national and international recruitment over the last 12 months, which has delayed the roll out of recruitment to these profiles. We have, however, still made progress by training an additional 35 staff at UCLH in how to conduct strengths based interviews which will help us to accelerate this work in 2016/17.

DeliveryThey love to be on top of things

They like to be ‘hands on’They thrive on having lots going on

They keep going when things are tough

RelatingThey get a buzz out of developing others

They pick up on other people’s needsThey are good at explaining things to others

IntegrityIt’s really important to them to do the right thing

They are honestIt’s very important to them to make

a difference

OwnershipThey love to be in chargeThey have a lot of drive

They have very high standards

Great Ward

Sisiters


Listening to patients

In the last year, listening to our patients has remained a priority with 15,559 surveys completed in inpatient and day case areas alone. The majority of these responses were to real-time surveys completed immediately prior to patient’s going home.

We have maintained our excellent overall Friends and Family Test (FFT) score in our inpatient areas, with an average score of 96.8% this year compared to 96.7% last year. Our average emergency department score has also improved from 90.2% to 94.7% meaning we are now significantly better than the national average. Maternity FFT results also maintained excellent results with a combined maternity score of 95.0% this year compared to 94.7% last year.

3. Patients and their families feel confident in their care, and have the best experience possible throughout their whole pathway of care

Figure 6

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Inpatient FFT scores 15/16 (% recommend) against National Average Score

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Outpatient Trust score

Inpatient FFT scores 2015/16 (% recommend) against national average score

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Outpatient FFT scores 2015/16 (% recommend)Maternity FFT scores 2015/16 (% recommend)

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National Inpatient Survey 2015

We did exceptionally well in last year’s inpatient survey, obtaining our best results since 2012. See figure 6. For overall experience we ranked number one in London and number two compared with Shelford Trusts.

Our best performing areas were providing information on condition and treatment -both in the emergency department and on the ward - explaining the purpose of medicines in a way patient’s could understand and providing information on how to complain. Our most improved areas included:

• ward cleanliness• hand hygiene• the number of nurses on duty• waiting list times • confidence in the decisions made about care and treatment

“Thank you … for making my day and visiting us on the John Young ward at The National Hospital for Neurology and Neurosurgery today - you have honestly made my day and I loved having cuddles with Charlie 💕 What you’re doing isabsolutely amazing and as a regular patient here I am so appreciative for the work you do & how you help all the patients, you really made a difference today for me“.

Patient feedback after they were visited by Katie and Charlie the dog.

Volunteers – adding value

Volunteers are an extremely important part of the team at UCLH – we now have 233 active volunteers. This year has seen a renewed energy in volunteering across the organisation and investment into many new and exciting roles.

Volunteering roles are now advertised and we have now moved to a system where volunteers give a regular commitment to one specific ward, enabling more integration into the team.

Bespoke training is now provided such as, learning disability, being a Dementia Friend, wheelchair training, meal-time assistance and anti-boredom training.

Our volunteers helped patients

109,952 times in 2015-16,

giving 12,824 hours of their time.


Revalidation

Our Nursing & Midwifery Revalidation Lead, Alison Finch, was appointed in July 2015 to support the organisation’s 2700 registered nurses and midwives to meet the new NMC revalidation requirements launched in 2016.

UCLH’s approach to revalidation goes beyond the Nursing and Midwifery Council’s (NMC) expectation of employers; it integrates staff development, retention, education, and workforce strategies. Over 650 nurses and midwives attended revalidation briefings in 2015/16. This included a joint RCN-UCLH conference on the 2 March, attended by 60 staff.

Over the year there were a wide range of revalidation activities including: team briefings, reflective writing workshops, drop-in sessions, study day presentations, and personalised support to individuals. 19 revalidation champions were also recruited and trained to support; embedding responsive feedback and the role of reflection in staff learning and development, equipping staff to guide reflective discussion and engage in coaching conversations and supporting leaders to consider revalidation as a tool to help guide professional, progressive practice.

Improving pain management Effective pain management is essential to our patients’ experience and also helps to reduce their time spent in hospital. In January 2016 the integrated complex pain team were established and introduced a unique approach to help educate and support the multidisciplinary team to manage patients experiencing difficult pain. The team is funded by the UCLH Charity and Camden Clinical Commissioning Group for two-years and consists of consultants, clinical practice facilitator, specialist nurse, psychologists and physiotherapist.

Flo Panel-Coates Chief Nurse

If you have any concerns about your care...Talk with your ward teamTalk with your MatronContact PALS on 020 344 73042If you still have concerns about care or safety, please call our dedicated 24 hour helpline to talk with a senior nurse: 07930 610108/07930 608238

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We aim to deliver top quality care

Call for concern bedside stickers ‘Call for concern’ bedside stickers were launched this year to give patients and visitors a quick step-by-step guide to raising concerns in the moment. The stickers are on the sides of bedside lockers, visible to patients in beds. The sticker is another way we can ensure our patients feel safe and always able to contact someone to raise a concern or issue when it arises. Evaluation of this initiative demonstrates that patients and their families benefit from this most out of hours and that concerns can be quickly resolved by site managers and on-call teams.

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Filling our vacancies – improving our careAt the beginning of 2015/16, UCLH had a nursing and midwifery vacancy rate of 16% and reliance on temporary staff was a risk to safety and quality. At the end of 2015/16, the vacancy rate was 6.6%; this was achieved by filling over 1,000 nursing and midwifery vacancies, see figure 8. This represents a 60% increase on the prior year and reflects the hard work of both clinical and non-clinical staff. In addition, our turnover is reducing and our staff are now choosing to stay at UCLH.

We have achieved this through a multifactorial approach including: • Refreshed marketing designed by our own staff • National and international recruitment campaign • Close collaboration between nursing and workforce teams• Innovative retention initiatives • Careers clinic – to encourage staff to stay at UCLH• New staff supports designed by our staff (e.g. staff lottery)• Proactive media engagement (e.g. with BBC re: immigration controls)• Sharing learning with the wider NHS

Filling these vacancies has also supported a reduction in agency nursing spend. A gradual month- -on-month reduction has been achieved since April 2015 yielding a better experience for patients and staff, and a financial reduction in spend of £3.2million a year, see figure 7.

4. Nurses and midwives are stewards of the NHS purse

Nursing and midwifery vacancy rate, vacancy projection and establishment3,600 -3,500 -3,400 -3,300 -3,200 -3,100 -3,000 - 2,900 -2,800 -

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Nursing and midwifery agency spend£800,000 -

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Figure 7


Exemplar roster In 2016, we launched the exemplar roster programme as part of the wider exemplar ward programme. This programme seeks to utilise the e-roster as a

control tool to enable sisters to live within their allocated ward budget. All ward establishments include capacity to deal with leave requirements including; annual, carers, special and study leave (commonly known as headroom).

Over the last year, April 2016 to March 2016 as seen in the figure 9, we have reduced our headroom usage from 25% to 23.4%; work will continue over the next year to bring this down to the allocated 22%. This work will support improved staff experience alongside financial sustainability.

Clinical Nurse Specialist Development Over the last year we have commenced a key piece of work to understand the Clinical Nurse Specialist (CNS) workforce and the contribution that they make to patient care and the organisation’s financial position. The CNS’s are a group of nurses and midwives working as part of multi-professional teams providing support to patients with both acute and long term conditions. They work collaboratively with the consultant teams and have taken over many tasks that used to be completed by junior doctors. The work conducted to date has included the establishment of a CNS forum, documenting job plans for the CNS’s workforce and understanding opportunities to increase nurse-led activity and improve efficiency.

In addition, we have secured funding, from UCLH charities, for a UCLH wide community of practice to be established. This will act as a vehicle to support the delivery of safe high quality patient care and a CNS workforce that is agile for the future. This is an innovative model that has been piloted with the Cancer CNS’s with excellent feedback.

Improving care and saving money - Dressing’s formulary In November 2015, the tissue viability team launched a new trust wide wound dressing’s formulary, which aims to provide staff with guidance on how to select appropriate dressings for different wound tissue types. This quality improvement initiative has already improved patient care and saved in excess of £50k this year. The quality and financial benefits are set to increase in 2016/17.

Wound Dressings FormularyVersion: November 2015

Approved by:UCLH Use of Medicines Committee August 2015Harm Free Care Committee November 2015Review Date: November 2016

The Tissue Viability Team wish to acknowledge the following departments for their contribution

to the creation of this document – UCH Pharmacy, Procurement, NHNN Lead Clinical Practice

Facilitator, Clinical Nurse Specialists – Dermatology, Continence, Andrology, Outpatients,

Head & Neck, Lymphoedema

100582 ConvaTec UCLH Formulary Guide A4 R07_Layout 1 04/11/2015 13:39 Page 1

Figure 9

Average total headroom by period - UCLH

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Careers clinic successAs part of our recruitment and retention strategy; two unique nurse-led initiatives were proposed, piloted and introduced initially for nurses as part of the retention strategy to stem the flow of leavers, improve job satisfaction and support personal development:

Careers Clinic – professional careers advice

Transfer process – lateral transfer to new specialty

The project was initially trialled for 3 months and permanently adopted following its success, see figure 10 for details of activity between April 2015 and March 2016.

The initiatives allow nurses to forecast their own career path and benefit from a wide range of in-house opportunities available; developing UCLH nurses as professionals in specialties chosen by them. Moreover the time-to-hire internally is reduced with little, or no, pre-employment clearances required.

Clinical Practice Facilitators (CPFs)

UCLH has a community of Clinical Practice Facilitators (CPFs) who lead education for pre-registration and post-registration staff in their clinical areas. The CPF community have been integral in seeking to ensure our nursing workforce have the right knowledge, understanding, skills and attitudes to care for our patients. This is achieved through; orientation, preceptorship, training, educating, assessing, one-to-one clinical support and contributing to Trust policies, procedures and guidelines.

In 2015-16 CPF’s played a vital role in a number of key areas that included:

• Welcoming 174 adult and child branch students from our higher education institute (HEI) partners; City University, King’s College London and London South Bank University. This is a credit to our undergraduate teams following changes to funding of pre-registration students

• Supporting the rollout of UCLH wide initiatives including

- End of life care and pain management

- Co-ordinating and delivering the successful band 6 development programme

- Developing and reviewing our clinical assessments in practice – directly observed practice skills

- Facilitating and delivering simulation training

• From a post-graduate perspective, the team supported commissioning of 517 academic modules for our staff

5. Nurses and midwives have a structured, coherent clinical and /or academic post-graduate pathway


Through innovation and staff engagement, nurses are reaching their maximum potential and prospering in their professional career at UCLH whilst continuing to deliver safe and professional care. The project is currently being trialled for nursing assistants and we intend on applying the model to AHP staff and are looking at the potential of partnering with other NHS organisations as a joint initiative to retain the public health nursing workforce.

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Preceptorship programme

UCLH preceptorship is one of the essential components to help new staff make the transition from student or internationally educated (overseas) nurse to Staff Nurse. Preceptorship activities have increased over the last year with 105 newly qualified nurses (NQNs) & 128 overseas nurses accessing the UCLH preceptorship programme. Our overseas nurses have joined us from the Philippines, Portugal, Spain, Italy and Romania.

The OSCE (Objective Structured Clinical Examination) is part 2 of the Test of Competence set by the NMC as a requirement for Non-EU overseas nurses wishing to join the register. We designed an OSCE Prep Course to help our overseas nurses get ready for their NMC OSCE test. We enjoyed a 100% pass rate during 2015/16.

In addition to supporting staff to achieve key competencies, the preceptorship programme has enabled staff to share experiences, problem solve, access peer support and educational expertise.

Figure 10

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A focus on our nursing and midwifery assistants:

During 2015/16, 127 people including nursing assistants & AHP’s have completed the ‘Care Certificate’ at UCLH. Staff who completed their certificate attended a presentation morning where their hard work was recognised and praised.

In addition, 20 staff attended a Nursing Assistant Careers study day with a view to commencing an apprenticeship or nursing training. UCLH and the RCN hosted their 4th joint Conference for nursing assistants with over 20 UCLH delegates and nursing assistants from all over England participating.

UCLH employs a number of nursing assistants who have qualified as nurses overseas. Before applying to the NMC and achieving registration these staff need to complete the International English Language Test (IELTS). In order to support these nurses UCLH piloted, in November 2015, the IELTS Intensive Course, in partnership with Hammersmith and West London College, allowing 26 nursing assistants to complete this course.

This initiative has been complemented by Health Education England’s campaign to encourage nurses to return to practice. UCLH has worked collaboratively with City University to support this programme. Across UCLH eight people working in different areas have been supported to complete the course and have now received their registration with the NMC.

Darzi fellows As in previous years, we were successful in securing a place and funding for a Darzi fellow to undertake a 12 month programme. This year our focus was falls reduction with the commencement of our falls practitioner; this has contributed to a significant decrease in falls with moderate or severe harm. We welcome two new fellows for 2016/17 in nutrition and specials.

Cancer Courses for Nurses and AHPs funded through Health Education North East LondonUCLH, along with other acute trusts in North and North East London, was allocated funding in 2015/2016 specifically to improve cancer patient experience across UCLH. This has been used to develop a number of different courses for all levels of staff, with a particular focus on communication skills training. UCLH is leading this programme of work across four Trusts in the sector. Working in this way will enable best use of resource and, for those attending the courses, learning from other staff in other trusts and understanding more clearly the pathway of care.


UCLH has continued to work collaboratively with the Centre for Nurse and Midwife-led Research (CNMR) and Higher Educational Institute (HEI) partners to support nurses and midwives who are interested in research and clinical academic careers. Over this year, stronger links with research-active allied health professionals at UCLH have been developed and some events are being held jointly.

UCLH staff have been able to attend a range of research skills workshops throughout

the year and leading light lectures on research in long-term care conditions, the culture of care, the chief nurse of England’s strategy and supportive cancer care. The CNMR has raised the visibility of nurse and midwife-led research through presenting on the preceptorship programme, at students’ induction and to clinical research nurses’ study days.

Research activity is included in the chief nurse’s bulletin monthly and an early career nurse researcher was covered in Insight and one of our consultant midwives with an NIHR PhD fellowship is now featured on the NIHR’s website.

The 11 nurses and midwives who are currently studying for PhDs on a range of clinical topics are making good progress and one was awarded her PhD in May 2016. Many nurses and midwives have published their research and have presented it nationally and internationally during this year.

The 2016 Research in Clinical Practice conference was very successful with workshops and a large poster display, and students’ reflections on evidence-based practice featured for the first time.

We will build on this next year by engaging with our clinical research nurses and launching a bespoke fellowship scheme for nurses, midwives and AHP’s.

UCLH has over a hundred non-medical clinical research staff who work in many different specialties across the organisation. During this year work has been underway to enhance the network for these staff; including a refreshing the clinical research forum, webpages, governance framework and standardising competencies.

6. Research is alive in practice

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The impact of the matron’s development programme remains evident across nursing and midwifery. Our matrons have led the way in 2015 /16 through visible leadership, change management and innovation in practice. The Matrons meeting has been reformatted to include a patient story, a ‘good catch’ and learning from serious incidents (SI’s)/incidents. The time-and-motion study was repeated during the year to support the matrons to spend 60% of their time in clinical leadership.

Samantha Philpott-Jones, integrated care matron, has been working with both Islington and UCLH teams to produce a seamless pathway-called the network model-for patients who receive care across multiple organisations. It aims to improve the standard and quality of care while also reducing the number of avoidable hospital attendances and admissions. Samantha said: “It’s so important to build on our relationships with GP’s and community colleagues in order to sustain NHS and social care

for our local population now and into the future. Learning about the resources available to us outside of UCLH has been a steep learning curve; there are just so many ways in which our patient’s can be supported outside of the ward.”

T7 shortlisted for Kate Granger Compassionate Care Award for “Mealtimes Matter” project lead by Matron, Josie Gladney

The matrons at the NHNN have developed ‘The Matron of the Week’ initiative; this enables them to work more closely with the clinical site managers and ward sisters / charge nurses to manage day-to-day clinical and operational issues which arise on site. The benefits of this have been that gaps in staffing are managed by ‘levelling’ staff across wards, staff who move feel better supported to do this and we are able to proactively manage capacity problems by working in collaboration with the general managers.

7. Matrons are influential and exemplify inspirational leadership at all levels


In 2016, the UCLH charity supported three cohorts of ward and departmental sisters to complete bespoke development programmes. These programmes complement the UCLH Institute leadership development programme and aim to equip all clinical leaders with service improvement and leadership skills.

The first programme was commissioned in partnership with Barking Havering & Redbridge University Hospital (BHR). Sixteen of our sisters / charge nurses were chosen to participate in this programme along with 16 staff from BHR. The main aim of this programme was to provide a space for band 7 sisters and charge nurses to learn together and draw on the collective wisdom, insights and experiences of the group.

The second programme ‘brings the development programme to the clinician’ - through a mixture of workshops and action learning sets, led by expert senior nurse leaders from outside the organisation.

The programmes consist of:

• An assessment of psychological preferences in each candidate to help them understand how they perceive the world and make decisions

• Delivery of a series of development workshops as a group (eight days in total)

• NHS clinical leadership competency assessment of each candidate individually and 360 feedback

• Support to deliver a work-based project as part of the programme

• Facilitation of action learning sets (five days in total)

By the end of 2016, more than 50 band 7 sisters will have completed the programmes and a full evaluation will be conducted throughout the autumn; although early feedback is excellent.

8. The sister and charge nurse is a high profile values and effective role

21

Leadership at all levels

In 2015/16 the UCH Collaborative, along with the Royal Marsden Partners and the Christie Cancer system, formed the National Cancer Vanguard. Vanguard Programmes are part of the NHS 5 Year Forward plan and endeavour to pilot new ways of working specifically across organisations. The UCLH Collaborative covers all acute trusts and primary care providers in North and East London. The Vanguard Programme is focussed on earlier diagnosis for patients, outcomes, and new innovative ways of working.

Within this framework, there are huge opportunities for nurses and AHP’s to influence the care and experience of cancer patients across a whole pathway from diagnosis onwards. This could be leadership at a system level, or at a tumour or pathway level. Nurses and AHPs often provide the glue that makes such complex patient pathways work and enable a better patient experience.

Sustainability and Transformation Plan (STP) As well as the specialist care we provide to patients from around the UK and beyond, we are working closely with partners from North Central London through our local STP to focus on improving the care we provide for our local population. Flo Panel-Coates has been appointed to the North Central London STP, Clinical Cabinet. Flo is one of two nurses who will ensure the nursing and midwifery voice is strong and well represented (Claire Johnson, Chief Nurse for Camden and Islington Mental Health Trust is the other nurse).


Over 300 people contributing to the overall production

of the NMAHPP strategy

over 100 people input into the draft strategy

document

Staff invited to roadshows and

open events at UCLH sites

with over 100, nurses, midwives, AHPs, pharmacists, managers, doctors and others

involved in developing the strategy themes and aims

Benefits of co-created strategyfor nurses, midwives, allied health professionals

and pharmacists

uclh

Journey of our co-created Nursing and Midwifery Allied Health Professionals and Pharmacists Strategy (NMAHPP Strategy)

NursesDay

Workshops

Over 300 people contributing to the overall production

of the NMAHPP strategy

over 100 people input into the draft strategy

document

Staff invited to roadshows and

open events at UCLH sites

with over 100, nurses, midwives, AHPs, pharmacists, managers, doctors and others

involved in developing the strategy themes and aims

Benefits of co-created strategyfor nurses, midwives, allied health professionals

and pharmacists

uclh


NursesDay

Workshops


23

Nursing, Midwifery, AHP & Pharmacy (NMAHPP) Strategy 2016-2021

The Nursing & Midwifery strategy 2012-16 has now come to an end and the successes have been illustrated through these annual reports. Going forward there is now the first joint strategy developed by nurses, midwives, AHPs and pharmacists across UCLH, which has been co-created during 2016 and will be launched in late summer of 2016. Please see page 24 for an overview of the Strategy. The strategy is aligned with UCLH’s objectives and with the national strategy, ‘Leading Change, Adding Value, A framework for nursing, midwifery and care staff, May 2016’. Progress will be monitored through the nursing, midwifery & AHPs/pharmacy leadership groups and Nursing & Midwifery Board.

The five strategic aims are over the five year period, 2016-21 and each year there are annual objectives. Below is a summary of 2016/17 NMAHPP objectives under each strategic aim.

Strategic aim 1 - NMAHPPs will provide the highest quality care within our resources

Accurately completed NEWS chart, with delirium assessment and appropriate escalations for all patients, reduction in avoidable harms to our patients, implement the exemplar ward programme, optimise medication efficacy and improve medication safety and women offered early access to maternity care.

Strategic aim 2: NMAHPPs will listen and respond to our patients and improve their pathways

Patients and their families feel confident in their care and have the best experience possible, increase the number of patients

involved in the design of services, focus on the experience of our patients as customers, utilise the experiences of patients, their carers and their families to drive change and to develop services and care, and to maximise patients to be and remain independent, active partners in their care.

Strategic aim 3: NMAHPPs will be valued and developed to deliver their potential

NMAHPPs have a clear framework that supports career progression, new clinical apprenticeship schemes are introduced, the careers clinic is embedded, clinical supervision is readily available, a reduction in lost hours from clinical duties through sickness and absence, a strategy for seven-day working for AHPs and Pharmacy and Nursing and midwifery leadership, and staff feedback is used to improve staff experience and welfare.

Strategic aim 4 - NMAHPPs will practice in ways which manage resources and achieve financial sustainability

To gain the resource and financial benefits from exemplar ward implementation, recruit to vacancies in hard to recruit to areas to eliminate agency use, for wards and services to live within their budget, develop plans to realise the benefits from Carter recommendations relevant to NMAHPPs.

Strategic aim 5 - NMAHPPs will inspire, innovate and generate world class research

Develop a revised research strategy for NMAHPP, plan evaluation of UCLH fellowships to support clinical academic careers, develop a UCLH research and innovation journal, develop leadership capabilities within the role of the ward deputy with a bespoke leadership programme and CNMR will maintain live website of activities.

Building on our successes


NMAHPPs will provide the

highest quality care within our

resources

NMAHPPs will inspire, innovate

and generate world class

research

NMAHPPs will be valued and developed to

deliver their potential

NMAHPPs will listen and respond to our patients & improve

their pathways

NMAHPPs will practice in ways which manage resources and achieve financial sustainability

UCLH’s five strategic aims are:1. Provide the

highest quality of care within our

resources

2. Improve patient pathways through collaboration with

partners

3. Support the development of

our staff to deliver their potential

4. Achieve financial

sustainability

5. Generate world-class

clinical research

Constructive conversations

Utilisin

g te

chn

olo

gy

Colla

borat

ive working

Stronger together

Nurses, midwives, AHPs and pharmacists unique contribution to UCLH strategic

themes are shown below

25

There are many successes that are celebrated as follows:

The 2015/16 awards Celebrating Excellence Awards

Nurses and midwives work as part of, or lead, multi-disciplinary teams. This leadership and teamwork was evident at the UCLH ‘Celebrating Excellence Awards’ in which nurses and midwives were amongst those honoured for their contribution to our success across a number of categories.

Celebrating success in the nursing and midwifery workforce

Georgina Fox, midwife, Women’s Health - Kindness Award

Susie Lagrata, clinical nurse specialist, Queen Square - Top Quality Patient care Award

Dean Morris, charge nurse, Queen Square - Chief Nurse Prize

Nikita Hill, clinical nurse specialist, Corporate Nursing - Chairman’s medal for excellence in education and training


International Nurses’ Day 2016

To celebrate the unique contribution that nurses make, over 100 nurses, midwives and other staff got together for International Nurses’ Day (IND) to acknowledge successes, pick up awards and share inspirational stories last week.

Awards were made to newly qualified, mentor and nursing assistant of the year, kindly supported by the UCH London Nurses’ Charity.

Mentor of the year - Faye Hickey Nursing Assistant of the year - Luke Phelps

Kindly supported by the UCH London Nurses’ Charity:

Newly Qualified Nurse of the year - Diana Aguiar

Shortlisted for HSJ & CIPD awards

UCLH has filled more than 1000 nursing, nursing assistant and midwifery vacancies and reduced agency pay by nearly £1 million – an achievement that has won our workforce and recruitment teams a place in the finals of the prestigious HSJ awards and CIPD People Management Awards.

The Florence Nightingale Foundation Annual Conference 2016 Poster competition

Careers Clinic & Transfer Process poster was a finalist at this conference.

Nursing and Midwifery Annual Report 2015-2016

Documents

Nursing and Midwifery Annual Report 2015-2016 › OurServices › ServiceA-Z › Nursing... · 8 Nursing and Midwifery Annual Report 2015-2016 Increasing trust and confidence in nurses