PURPOSE OF THE PAPER To provide the committee with an overview of the Director of Nursing portfolio during quarter 1 of

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1 ENC 10 Meeting Date 30 th July 2015 Title of Paper Lead Director Author Director of Nursing Quarterly Report Kathryn Halford, Director of Nursing Kathryn Halford, Director of Nursing PURPOSE OF THE PAPER To provide the committee with an overview of the Director of Nursing portfolio during quarter 1 of SUMMARY OF THE KEY POINTS A positive infection control visit was completed by the TDA in July 2015 The delay in the deployment of VitalPac due to technical problems has resulted in a start date in September An update on the local and national revalidation process and plans to ensure the Trust is compliant A review is currently being completed within temporary staffing which includes the increased use of the new functionality of Rosterpro to provide real time data An briefing of proposed plans to develop and diversify the workforce to support patients care in the future by the use of advanced practitioners The paper provides an update on the preparation of for the CQC visit across the organisation An update is provided on the recruitment of both registered nurses and midwives and unregistered nurses with associated start dates The completion of the volunteering centre and planned formal opening date are detailed RECOMMENDATIONS 1. To note the content of the report 2. To agree the plans and revised for core projects including Vitalpac July 2015 For One and All Page 1 of 6

2 LINKS Strategic Objectives First class patient experience Integrated Care An effective NHS Foundation Trust Safe, high quality services Annual objectives Communicate and provide information to the patients their families and carers Sustain unconditional registration with the CQC Monitor / CQC / Regulatory Requirements Impacts on all CQC essential outcomes CQUINS including patient experience and family and friends test IMPACT Patient Experience To provide first class patient experience where patients feel safe in our hands Quality & Safety Patients experience and high quality care across the organisation whenever and wherever patients need and access it Financial Poor quality of patient care may result in patients choosing to seek care in other organisations Workforce Nursing staff are involved in monitoring the quality of patient experience and making improvements at a local level. Ensuring the right workforce is available to meet the needs of the patients Equality & Diversity All patients will expect to receive the same level of care irrespective of their special characteristics Estates Nil IM&T Nil Communications / Engagement Patients feel engaged and informed about the care they are receiving RISKS If patients receive a poor experience they may choose to seek care in another organisation PREVIOUS CONSIDERATION Nil July 2015 For One and All Page 2 of 6

3 REPORT TO THE TRUST BOARD THURSDAY 30 TH JULY 2015 DIRECTOR OF NURSING QUARTERLY REPORT 1. INTRODUCTION This report provides an overview of the work within the Director of Nursing s portfolio during quarter, which has not been detailed in other reports received by the Board. The first quarter, with the reduced pressure on capacity, has enabled the nursing and AHP teams to refocus on providing high quality care across both the hospital and community in the ward or teams that reflects the patients care that most clearly aligns with their care needs. In preparation for the CQC inspection the TDA have helpfully completed a number of visits. It was very pleasing that the infection control visit on the 14 th July resulted in a very good report. The TDA are no longer going to reinspect the organisation and felt that we had demonstrated a significant improvement which is reflected in our improved infection control rates. 2. VITALPAC The nursing and IT team have been working hard to support the implementation of VitalPac. This is the new system which will be used to record patient observations and other key parameters. The system is shown to improve patient safety and outcomes and was funded as part of the NHS Technology Fund. The initial implementation plan for VitalPacs had a go live date of 13 th July A number of unanticipated problems have arisen over the last weeks which has meant that the go live date has to be postponed. The new go live date will be decided at the project board on the 23 rd July. Clinical areas are ready and waiting to receive training and roll out as soon as the technical issues are resolved. The key issues have arisen are around the interfaces with the Lorenzo system in order to deliver a live working environment. Work continues with regular conference calls with the supplier to resolve these issues In order to introduce VitalPacs we have also changed from our local clinical trigger and escalation system (MEWS) to the national system (NEWS) which was July 2015 For One and All Page 3 of 6

4 developed by the Royal College of Physicians and is the main system in use across much of the country. A team have worked supporting all clinical areas to ensure a smooth switch over. The implementation has been very positively received on the wards. An audit will take place on to evaluate any impact. 3. REVALIDATION All nurses and midwives will be required to undergo revalidation from 2016 and the final plans will be released in September Revalidation will be a three year requirement for all nurses and midwives. Nurses will be required to 1. Demonstrate 450 hours of clinical practice plus 450 hours if a midwife 2. Five pieces of practice related feedback 3. Five reflections and discussion 4. Health and Character declaration 5. Professional indemnity 6. Third party confirmation A regional group led by NHS England meets monthly at St Chad s to plan implementation and share local learning. Internally a steering group has been set up under the Deputy Director of Nursing to develop our implementation plan. The first awareness raising event took place in July where over 60 nurses heard about the requirements and responsibilities in relation to revalidation. We will continue to develop our action plans and autumn campaign. This will also focus on key areas of risk such as bank staff, nurses in non-nursing roles and supporting staff in meeting the requirements. We also have an opportunity to lead on promotion and awareness raising for the local area and a decision will be made shortly on this. 4. TEMPORARY STAFFING The temporary staffing office now sits under the Director of Nursing. Work is continuing to develop the service provided. This will include a review of the structure required. Over the last two months we have undertaken a review to ensure all bank staff are compliant with DBS requirements and the very small number of staff who have not responded to information requests have been suspended from the system. From August 2015 we have developed a bespoke mandatory training programme for bank staff to ensure that they are complaint with mandatory training requirements The RosterPro system is key to supporting staffing and efficient deployment of staff. We have been participating in a national programme looking at maximising effective use of e-rostering. The new corporate matron that joined in mid July has extensive experience of Rosterpro and is supporting the introduction of the latest version across the Trust. As a result real time staffing data will be available, this will enable us to maximise the nursing resource. July 2015 For One and All Page 4 of 6

5 5. ADVANCED CLINICAL PRACTITIONERS During the last few years there has been an increase in the numbers and types of programmes to support a number of clinical professions to develop in terms of advanced practice. This has gained momentum over the last years in response to issues such as challenges in medical staffing recruitment, 7 day working, and changes to medical training and delivering compliant rota s. We face a number of internal challenges around difficulties in recruitment to medical posts in key areas such as Accident and Emergency and a significant reliance on agency and locum use for medical cover. In the past we have trained for example physician s assistants but they have left to work elsewhere as a structure and implementation plan on qualification was not in place. A number of local trusts are proactively working to train large numbers of Advanced Clinical Practitioners due to the success of earlier role introduction. We have an opportunity to look at the benefits and how we might implement this within the trust. We have secured funding is available from Health Education West Midlands to support training from September A number of staff are very interested in this career route. As we develop services such as the Frail Older Persons Pathway, Rapid Access and challenges in areas such as Accident and emergency there are clear opportunists to develop and introduce these roles. A wider paper will go to TMB in August 2015 for discussion. 6. PREPARATION FOR CQC The mock CQC inspections that were completed in the later part of 2014 and into 2015 have provided a benchmark to develop our local CQC action plans. the Heads of Nursing are leading the divisions in their preparation for the visit which is confirmed as the week commencing 7 th September The team have been provided with information, background to the visits and learning from other organisations. The teams are taking the preparation very seriously and are working together to ensure they are able to provide a true representation of the organisation. The TDA have completed a number a number of reviews including complaints, medicines management, infection control, safeguarding and A&E. two further visits are planned; 30 th July to review maternity and 5 th August to look at the Well Led domain across the whole organisation, bot hospital and community. To date the feedback has been helpful providing a balance of negative and positive. On every visit they have commented positively on the staff and their friendliness. The feedback has been shared with the clinical teams and they have included any improvements into their local action plans. July 2015 For One and All Page 5 of 6

6 The upload of the initial data to the CQC was completed in a timely fashion. The teams are now beginning to prepare the information required for the KLOE s (key lines of enquiry submission) which will be needed next. The initial meeting with the CQC took place on the 23 rd July which provided an overview of the planned visit. 7. WORKFORCE As a result of the investment in nursing and midwifery agreed by the Board 30 ward nurses and 21 midwives have been recruited from Italy to supplement the 50 nurses recruited from the UK. These numbers will ensure that all posts in the wards will be filled by the end of September. The first 3 Italian nurses have already started in the wards. the CSW (Care Support Workers) that were recruited as part of the same process are now in post and working on the wards. 8. VOLUNTEERING After some considerate time the volunteering centre has been completed. The area provides desks for volunteering. Membership, fundraising and PALS. In addition it has a separate area for private confidential discussions which can be used by all these teams. The formal opening will be on the 27 th August The Trust has been working with the Black Country Partnership and Wolverhampton University on the impact of supporting vulnerable patients when they return home by using the voluntary sector. To date 4 people have been successfully recruited into this research; one of whom has been supported to reintegrate into her community by being supported to attend day centres which would not have been possible prior to this scheme. The overall evaluation will be available in the Autumn. 9. CONCLUSION The focus in the next few weeks will clearly be on preparing for the CQC visit but alongside this there are some major projects that will require consistent and determined effort to ensure they are effectively deployed across the organisation for example real time staff data and Vitalpac. The Director of Nursing portfolio has continued to focus on providing safe, high quality care which has measurable outcomes delivered by highly competent professionals. It is pleasing to note that there is some demonstrable improvements recognised by external bodies for example the infection control audit and the friendliness of staff from external inspectors. July 2015 For One and All Page 6 of 6

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