Nursing and midwifery care: event report

A report of Scotland's first assuring nursing and midwifery event.

Excellence in Care: Introduction

Excellence In Care To Be Rolled Out Nationally

The Cabinet Secretary for Health, Wellbeing and Sport has asked the Chief Nursing Officer (CNO) and executive nurse directors to roll out Excellence in Care across Scotland.

Excellence in Care, which forms part of the government's response to the Vale of Leven Hospital Inquiry Report, focuses on four key deliverables (see boxed text below). It covers nursing and midwifery in all hospitals and community services, from A&E to mental health, and care of older people to children's services.

The aim is that all NHS boards and integrated joint boards will have consistent and robust processes and systems for measuring, assuring and reporting on the quality of nursing and midwifery care and practice in place by April 2017. The systems will inform quality of care reviews at national and local level and drive continuous improvements in nursing and midwifery care quality.

Excellence in Care Deliverables

Excellence in Care aims to deliver:

  • a nationally agreed (small) set of clearly defined key measures/indicators of high-quality nursing and midwifery
  • a design of local and national infrastructure, including an agreed national framework and "dashboard"
  • a framework document that outlines key principles/guidance to NHS boards and integrated joint boards on development and implementation of local care assurance systems/processes
  • a set of NHSScotland record-keeping standards.

"This will make a real contribution to improving care," CNO Professor Fiona McQueen told participants at the event. "Systems of assurance help to ensure consistency of standards across Scotland without losing the essence of individualised person-centred care. They will reignite in nurses and midwives the passion for excellence that brought them into these professions in the first place. Each of us has a contribution to make - whether it is developing policy, or advocating for excellence and seeking to solve problems at NHS board level, or nurturing the next generation of nurse and midwife leaders."

Professor McQueen acknowledged that ensuring excellence is not something that can be done by nurses and midwives alone. "We need to connect with patients, families and healthcare colleagues, sharing our vision so we can truly make a difference for all patients, all of the time," she said.

She also warned of the risks of making care assurance systems so bureaucratic that they stifle innovation and impede care delivery. "We mustn't squeeze the life out of people by imposing impossible bureaucratic burdens," she said. "I'm confident that with the support of IT colleagues, we can develop a system that is light-touch and which supports improvements in care."

The work will only succeed, Professor McQueen suggested, if a genuine co-production approach is adopted. "We all have an equal voice in this," she told participants. "We come to this event without preconceived ideas - we need your contributions to help us define how we can assure the kind of care for patients we all want."

Phase 1 of Excellence in Care will cover acute adult in-patient, in-patient maternity and in-patient specialist dementia care (see boxed text), with all other areas of nursing and midwifery practice, including community services and mental health and learning disabilities, being addressed in Phase 2.

Why choose these three areas for Phase 1?
Work is starting in these three areas to begin the process of ensuring widespread testing and feasibility. Assuring nursing and midwifery care was a key action arising from the Vale of Leven Hospital Inquiry, so acute adult in-patient care was selected as one of the initial areas for Phase 1 of the work. Work is also currently underway in in-patient specialist dementia care under the auspices of Commitment 11 of Scotland's Dementia Strategy and the Quality and Excellence in Specialist Dementia Care programme, offering an opportunity for integration and alignment with the assurance work. And because it is key that assurance applies to all nursing and midwifery specialties, in‑patient maternity care was identified as being crucial to Phase 1.


Email: Jan Liddle

Back to top