Sharon Blackburn and Stacey McCann: Leading Change, Adding Value releases the potential of care workers

The Leading Change, Adding Value framework is supporting care staff as well as nurses and midwives to tackle unwanted variation and transform services

The Leading Change, Adding Value framework is supporting care staff as well as nurses and midwives to tackle unwanted variation and transform services

Picture: iStock

The Leading Change, Adding Value (LCAV) framework for all nursing, midwifery and care staff was launched in May 2016 by England’s chief nursing officer Jane Cummings. The framework not only supports staff, it also benefits people who use services.

Social care colleagues developed a set of ‘I statements’ for people they support, related to the ten commitments of LCAV and the 6Cs, nursing’s value base.

The aim is that people using services feel informed and supported, and have a voice, choice and control. LCAV – What it means for social care covers how to support people to stay connected to their local communities, and encourage families to participate in shared decision making.

Narrowing the gaps

By using the LCAV framework, care staff can demonstrate the provision of competent, compassionate care.

This was apparent at the LCAV care worker conference held in October 2017. Care workers across all services and client groups, inside and outside the NHS, demonstrated how the framework had enabled them to take the lead and introduce innovative ways of working, with a positive impact on people, their families, staff and services.

The care workers also demonstrated their contribution to narrowing the three gaps described in the Five Year Forward View: health and well-being, care and quality, and funding and efficiency.

Improved understanding

More than 80% of attendees felt the conference had improved their understanding of their capacity to lead change, and 99% thought the conference had improved their understanding of how to identify and lead change on unwarranted variation.

Experiences shared at the conference showed health and well-being needs were being met in tangible ways, as care workers used their initiative in different settings such as primary care. The care and quality delivered in acute settings, and the savings that were evident as staff worked collaboratively and efficiently, showed how they were transforming lives and services.

Care workers in multidisciplinary teams were accepting responsibility and undertaking activities delegated by registered staff, who continued to retain accountability and use their skills and expertise in more focused ways.

Greater satisfaction

Team members complemented each other and clear protocols were in place. Staff reported higher levels of satisfaction in their roles, and their stories provided inspiration and clear examples of how leading change benefited people receiving care.

The LCAV framework allows people the scope to contribute to and measure the impact of high quality care. It is not restrictive – rather it enables innovation and supports staff to demonstrate the value of the work they are undertaking.

It does so by measuring and quantifying improved outcomes, rather than outputs, as experienced by people using services. This is complemented by effective use of resources and amounts to the ‘added value’ in practice provided by care staff.

More can be done

Much has been achieved since the implementation of LCAV, but more can be done. The framework provides ongoing support for staff to identify and reduce unwarranted variation in practice, changing what they know needs to be changed and doing what they do every day.

As conversations and collaborations develop to shape future integrated care systems, it is important to recognise the crucial role social care plays in new ways of working and will play in the future.

The LCAV framework is being used both within and outside of the NHS, which means it is reaching into adult social care. This is the enduring legacy of the framework. It is an enabler and a starting point, not just an end in itself.

Sharon Blackburn CBE is a member of the national Leading Change, Adding Value governance board, and policy and communications director of the National Care Forum



Stacey McCann is head of nursing strategy and commissioning, NHS England, and lead for implementation of Leading Change, Adding Value


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