Opinion

Time to market nursing

The new nursing framework is a chance to promote the cost-effectiveness of nursing and empower communities 
Time to market nursing

For too long, nursing has been seen as a cost rather than a way of providing efficient and cost-effective care. My hope is that the nursing framework, Leading Change, Adding Value, will help nurses re-establish their place in the system.

Gone is the language of top-down strategy, replaced with a notion of a framework to guide local teams and a triple aim focus on health and wellbeing, care and quality, and funding and efficiency.

Framework

I recently witnessed advanced community intravenous therapy nurses in one clinical commissioning group (CCG) celebrate their success in reducing hospital admissions and enabling people to remain in education and in jobs, only to hear that the CCG next door had disinvested in the same IV therapy services. That is what I would call unwarranted variation (addressing variation is one of the frameworks ten commitments).

Commissioning nurses and directors of nursing have a

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For too long, nursing has been seen as a cost rather than a way of providing efficient and cost-effective care. My hope is that the nursing framework, Leading Change, Adding Value, will help nurses re-establish their place in the system. 

Gone is the language of top-down strategy, replaced with a notion of a framework to guide local teams and a ‘triple aim’ focus on health and wellbeing, care and quality, and funding and efficiency. 

Framework

I recently witnessed advanced community intravenous therapy nurses in one clinical commissioning group (CCG) celebrate their success in reducing hospital admissions and enabling people to remain in education and in jobs, only to hear that the CCG next door had disinvested in the same IV therapy services. That is what I would call unwarranted variation (addressing variation is one of the framework’s ten commitments). 

Commissioning nurses and directors of nursing have a big part to play in this framework, by discussing variation in nursing care and services across CCGs as part of sustainability and transformation plans. 

Care and efficiency

Nurses contribute to care and efficiency, but we are bad at measuring and publicising it to those that matter; Leading Change will ensure that we do.  


Nurses contribute to care and efficiency, but we are bad at measuring and publicising it to those that matter

Other professions have shown the way. The Chartered Society of Physiotherapists has a web page showing the cost effectiveness of each service it provides, and it publishes articles in journals read by commissioners explaining why they should invest in therapy services. Basically, we need to market nursing as if it was a new drug or treatment. 

Nurses must engage not just employers, educators, families and communities, but also the police, local authorities, the care sector, and housing, schools and fire services. We need to be valued as part of ‘place’ (as Leading Change describes) and part of the system.

21st-century nursing

We are being taken advantage of by those who view nurses as a cheap way to plug gaps in services. I hope Leading Change will help us say what a 21st-century nurse is and what she or he is not. Nursing must remain distinct from medicine: ‘maxi nurse, not mini medic’.

At New NHS Alliance, our executive has more than 20 years’ experience of ‘asset-based community development’: moving beyond health promotion, prevention and protection to the idea of harnessing what is strong, not what is wrong, in communities. It is a glass half full approach, familiar to many community nurses who have a history of working with neighbourhoods to help residents find their own solutions. 

Forming friendships

My own work with disadvantaged fathers in Salford demonstrates they can improve their own, as well as their children’s, wellbeing by forming friendships and helping each other. 

We need to use Leading Change to enable nurses to move from providing yet more services we can no longer afford to enabling communities to help themselves.  

Compassionate care can mean asset-based, not just needs-based, approaches. Nursing needs to build community resilience to address intransigent health inequalities and, in doing so, stem demand.

Heather Henry is an independent Queen's Nurse and co-chair of the New NHS Alliance

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