Your Care First Nursing and Midwifery Strategy 2013-2016

Our Vision Statement: We will work in partnership with patients, families and the wider healthcare community to deliver quality care with compassion in which our patients have confidence. We will promote an honest culture of learning and innovation, where all staff share our values and work in our organisation with pride.

Objective One: We will provide safe and effective patient care in all that we do by: Using Quality Evidence at the Point of Care Introducing and implementing accredited tools to support evidence based practice at the bedside; Embedding the use of national best practice guidelines; Taking every opportunity to apply local and national learning.

Ensuring an Effective Patient Journey with the Right Patient in the Right Place at the Right Time Establishing an effective care pathway for all patients accessing our services; Empowering nurses and midwives to improve the patient experience and be a strong patient advocate; Maximising enhanced quality and recovery programmes; Working with our partners to improve patient flow and access; Ensuring clear communication channels are in place; Assuring single sex accommodation is delivered; Using innovative technology.

Achieving Harm Free Care Valuing and supporting our Healthcare Assistants as part of the core nursing and midwifery team. Embedding care bundles and individualised care planning for all our patients; Implementing best practice for our patients in relation to: - Identifying the deteriorating patient; - Caring for our patients with dementia; - End of Life Care; - Preventing slips, trips and falls; - Managing and preventing pressure ulcers; - Supporting optimal nutrition and hydration; - Sustaining improvement in delivering reductions in infections; - Safe and effective Medicines Management; - Supporting good mental health; - Management of line care; - Reducing the risk of venous thromboembolism. (VTE); - Promoting normal birth; - Managing urinary catheters; - Developing electronic evidenced based clinical documentation; - Pain Management; - Surgical Safety checklists.

Undertaking intentional rounding; Safeguarding our vulnerable patients; Working closely with our multi-disciplinary colleagues; Eliminating ‘never’ events; Ensuring safe staffing levels and appropriate skill mix; Improving our recruitment processes.

Embedding Safety and Quality into Everyday Systems and Processes Developing quality metrics to produce significant real-time data that can be analysed to improve the patient experience and delivery of care; Allowing Trust-wide peer review by comparing and discussing any variations of care from that data; Eliminating variations of care and aligning best practice across the Trust by enabling sharing and adaptation, of that best practice; Displaying local Nursing and Midwifery Quality Dashboards demonstrating how well our wards and units are doing against our agreed quality indicators; Reporting our actions proactively to patients, colleagues and other partners. Developing and implementing our nursing and midwifery Friday initiative: Focus Reflect Inspire Discuss Analyse Your Care First

Shaping our Services from the Feedback about Care to Assure an Excellent Patient Experience Valuing, working with and responding to our local and national patient forums such as Healthwatch, PLACE, Maternity Service Liaison and peer reviews; Encouraging our patients to participate in Your Care Matters in innovative ways; Listening to our patients, families and carers; Empowering our patients, families and carers to escalate their concerns and worries. Excelling Within a Regulatory Framework Guaranteeing our standards of care will always excel when inspected; Working to the professional Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives; Developing our own SaSH Code of Conduct for Healthcare Support Workers; Assuring all nurses and midwives have active and relevant registrations, and are fit for practice and fit to practise; Ensuring quality and safety are the driving principles behind any decision making.

Objective Two: We will develop skills, behaviours and competence to deliver quality nursing and midwifery care by: Embedding a Culture of Lifelong Learning Making the education and training of staff a priority; Ensuring there is equity and fairness applied to staff being supported to undertake external courses; Aligning our education and training needs to Trust and Divisional objectives; Recognising individual learning styles.

Ensuring Our Education and Training Meets Our Needs to Enable the Best Delivery of Care Ensuring that all ward sisters/charge nurses undertake the bespoke SaSH Development programme to support them to be strong and competent ward leaders; Running the bespoke SaSH Healthcare Assistant Development Programme to enable our HCAs to deliver safe and compassionate patient care; Undertaking training needs analysis regularly in relation to service development or change in practices; Making sure that all staff have annual appraisals with clear development plans aligned to their objectives and personal career aims.

Supporting Safety by Providing Excellent Learning Environments Meeting the quality assurance and review procedures requirements of the Nursing and Midwifery Council; Identifying and raising the profile of excellent role models and leaders; Work with our higher education partners to create bespoke SaSH learning when specific local needs are identified; Identify potential early warning signs of deviation from quality practice by evaluating and acting upon student feedback; Strengthening our practice development by aligning it to our recruitment processes; Improving ward processes and environments to help nurses and midwives spend more time on patient care thereby improving safety and efficiency.

Supporting Our Students as the Workforce of Tomorrow Ensuring that students feel welcome as part of the nursing and midwifery team, and are prepared for placement; Strengthening nursing and midwifery mentorship by ensuring adequate numbers of mentors, that local mentor registers are in place and allocating protected time for signoff mentors to make robust final decisions; Providing a variety of approaches to mentor updates including face to face, classroom based backed up within the clinical area, E-learning and HEI related resources; Encouraging Trust-wide interprofessional learning; Talent spotting at an early opportunity to encourage students to come back and work with us when they qualify.

Being an Attractive Organisation to Work For Providing high quality Trust and local inductions and orientations for all staff within a maximum of two weeks from starting; Offering a range of opportunities such as rotational posts, shadowing and secondments; Clearly defining roles and responsibilities; Improving work/life balance.

Setting Clear Standards of Behaviour that Promote and Define the ‘Brand’ of being a SaSH Nurse or Midwife Celebrating our successes; Expecting and helping all nurses and midwives to challenge poor practice; Encouraging openness, transparency and candour; Using every patient contact as an opportunity to strengthen the confidence of patients in our care; Demonstrating compassion and empathy to all patients, their families and carers; Admitting if we get it wrong and putting measures in place to get it right; Promoting and assuring privacy and dignity for all patients; Recognising and supporting good leadership within all levels and roles; Respecting the contribution of all colleagues; Supporting staff in difficult situations; Embedding the NHS Constitution and highlighting the mutual responsibilities and rights of the nurses and midwives providing the care within SaSH.

Objective Three: We will build up the potential of our nursing and midwifery workforce by: Innovating Practice Roles and Structuring New Career Pathways Discussing with our staff their career aims and how we can support and develop them; Developing the role of non-medical prescribers; Introducing Nurse/Midwife Consultant and Advanced Nurse Practitioner roles; Considering joint posts with our external partners such as Lecturer/Practitioner positions; Developing nursing roles in out-of-hours care and the ‘Hospital at Night’.

Harnessing Expertise Strengthening the core of the nursing and midwifery workforce; Clarifying the roles of our matrons and senior nurses in driving safety and quality; Implementing ‘Grand Rounds’ by the clinical nurse specialists as a model of sharing expert knowledge; Encouraging our HCAs to consider becoming the registered nurses of the future; Using the workforce more effectively to challenge boundaries and raise the profile of nursing and midwifery; Embedding a culture to enable succession planning; Progressing a ‘personal mentor/coach model’; Developing clinical supervision; Introducing nurse-led discharge.

Encouraging Nurse and Midwifery Led Research Encouraging and supporting our nurses and midwives to undertake and then publish their research, audit and innovations; Encouraging and supporting our nurses and midwives to present at national and international conferences; Implementing journal clubs; Developing forums for sharing knowledge; Participate in the Academic Health Science Network to ensure a local multi-professional approach to health academia.

Our Next Steps This is our Surrey and Sussex Healthcare NHS Trust Nursing and Midwifery Strategy, and our commitment to deliver safety, quality and compassion to all our patients. This is our opportunity to set out as nurses and midwives, how we will take our practice to the next level and demonstrate the huge positive difference we can make to patient outcomes, care and experience. We would also like to share our aspirations as a professional workforce, in relation to being at the forefront of healthcare delivery in the 21st century. The objectives and sub-objectives within this strategy will be translated into an action plan, with detailed measures, enablers and associated timescales. Reporting on individual workstreams will be undertaken throughout the year at the relevant forums and an annual report will demonstrate the achievements and progression of this three year strategy.

We look forward to working with our patients, their families and carers, colleagues and other partners in delivering our vision.