Essence of Care

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Essence of Care Moving Forward Maureen
MorganDepartment of Health 11th June 2008
London
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Themes

• Reforming and transforming healthcare creating
  world class services
• What we are getting right what must we do
  better?
• Focus on quality and on fundamental aspects of
  care
• Role of EoC

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Ambition World Class Services

• Now in year 8 of NHS 10yr plan to reform health
  care so we can respond to major societal changes
  and technical advances
• demography ageing population
• major causes of mortality and morbidity impact
  of life-style
• consumerism
• escalating costs associated with new treatments
  and medicines
• Underpinned by unprecedented levels of investment
  - 40 billion approx in 1997 nearly 100
  billion today to deliver tangible results
• Three phases of reform

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Improving the system
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So far So Good

• Achieved national targets on reducing mortality
  from cancer and cardio-vascular disease
• On track to reduce MRSA by 50
• Reducing waiting to 18 weeks
• HCC survey 90 of patients rated their care as
  good or excellent

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BUT..

• Wide regional variation SMRs in some parts of
  UK among best in EU others among the worst
• If 90 of patients rated care as good or
  excellent 10 did not! 110 or 3 patients in
  30-bedded ward
• High profile cases eg Maidstone contributing to
  loss of confidence that the NHS cares
• Patients feel at risk in our care

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New Approach to Managing Performance

• From central targets to self-improving systems
• Emphasis on qualitative data
• Clinically focused and evidence based
• Stronger accountability
• Responsive to patients, public and staff
• Overseen by Care Quality Commission

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Patients tell us they wantmore care
closer to hometo be treated as a personto be a
partner in careto have choice .fit into my
life to be safe! Next Stage Review focus
on quality patient voice
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In spite of all this change, what patients want
and need from nurses has changed very little.
Patients want their contact with nurses to make
them feel safe, cared for, respected and
involved. They want to know that the nurse is
there unconditionally for them, especially when
faced with fear, pain or loss. They want to
know that nurses actions will be in their best
interests and will help them get better, keep
well, live life to the full, or help towards a
better death. This may sound obvious, almost
simple, after all it is what nursing is and has
always been about.
Modernising Nursing Careers Sept 2006
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Responding to Patients role of EoC

• Essence of Care
• unique in building quality indicators from
  patients / users perspective
• addresses issues patients / users say matter to
  them and which they experience and judge for
  themselves
• applicable to all settings and for all health
  professionals
• generates comparable data
• powerful mechanism for change
• external validity, source of evidence of
  continual improvement
• Are we capturing this as well as we could?
• Importance of clinical metrics

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EoC Developments

• 11th benchmark Environment of Care Nov 07
• access
• cared for environment
• cleanliness
• infection control precautions
• ethos
• personal space
• leadership and competence of staff
• supplies equipment
• This year refresh toolkit - ? Benchmark on pain

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Summary

• Focus of reform now on quality patient
  experience service transformation
• Reputation of organisations rests on actions /
  omissions of staff
• Strong performance management systems will
  require evidence of continual improvement
• EoC can provide mechanism to improve fundamental
  aspects of care
• harnesses enthusiasm of front-line staff
• combines efforts of nurses, AHPs, doctors and
  others helps to create effective health care
  teams that meet expectations of patients, users
  and the public
• help re-new trust and confidence in the NHS