Compassion In Practice - NHS England

Compassion in PracticeEvidencing the impactMay 2016

Compassion in PracticeCNO WelcomeIntroductionEvidencing the impactVersion number: 1Year 3 CommissionedProgrammesFirst published: May 2016Evidencing the impactof Compassion inPracticeClassification: OFFICIALPrepared by: Professor Laura SerrantNHS England gateway approval number: 05279What the review ofthe evidence is tellingus in relation to theimpact of Compassionin Practice, includingthe 6CsTowards LeadingChange, AddingValue: a frameworkfor nursing, midwiferyand care staffSummary StatementCompassion in Practice: Evidencing the impact - May 20162

1. ForewordJane CummingsCNO WelcomeIntroductionYear 3 CommissionedProgrammesEvidencing the impactof Compassion inPracticeWhat the review ofthe evidence is tellingus in relation to theimpact of Compassionin Practice, includingthe 6CsTowards LeadingChange, AddingValue: a frameworkfor nursing, midwiferyand care staffSummary StatementChief Nursing Officer, EnglandCompassion in Practice - Nursing Midwifery andCare Staff - Our Vision and Strategy was launched inDecember 2012. It’s hard to believe that over threeyears have passed since the strategy was publishedand addressed the issues relating to nursing andcare that were subsequently published in the FrancisReport in February 2013 and in ‘Hard Truths: TheJourney to Putting Patients First’ January 2014.Compassion in Practice was built on the values of the 6Cs (Care,Compassion, Communication, Courage, Competence, Commitment) anddelivered improvement programmes through six work streams calledAction Areas:1. Helping people to stay independent, maximising well-being andimproving health outcomes.2. Working with people to provide a positive experience of care.3. Delivering high quality care and measuring the impact of care.4. Building and strengthening leadership.5. Ensuring we have the right staff, with the right skills, in the right place.6. Supporting positive staff experience.There is no doubt that the world is different now to when we first launchedthe strategy. Over the last three years there have been many changes in thewider world as well as the health and care economy and this has influencedour understanding of health, wellbeing and the types of ‘care’ requiredby our diverse populations. Changes in health care demand, increasingglobal threats to civil liberties, the Ebola crisis, plus rising concerns aboutsafeguarding children and vulnerable adults are only a few examples of theissues that have impacted on the work of nurses, midwives and care staffsince 2012.The third and final year of the strategy provided a good opportunity for usto take stock of what we as nurses, midwives and care staff have achievedthrough the strategy and how we have contributed to ensuring high quality,compassionate care. This means not only thinking about this final year, butalso reflecting on the last three years as a whole.I have been privileged to spend time with nurses, midwives, and care staffacross the country and see for myself the opportunities, actions and effortsthey have employed to make sure that individuals and communities receiveCompassion in Practice: Evidencing the impact - May 20163

CNO WelcomeIntroductionYear 3 CommissionedProgrammesEvidencing the impactof Compassion inPracticeWhat the review ofthe evidence is tellingus in relation to theimpact of Compassionin Practice, includingthe 6CsTowards LeadingChange, AddingValue: a frameworkfor nursing, midwiferyand care staffSummary Statementthe best care possible. This report can only give a snapshot of the hundredsof activities that have taken place and the wide range of locations involved but it is important that we have a record of how the Compassion in Practicestrategy and the values of the 6Cs have impacted on how care has beenplanned, delivered and experienced over the last few years.A great strength of the Compassion in Practice strategy has been in itscommitment to coproduction and co-delivery that lay the heart of thestrategy from the outset. The wide-ranging requirements of a diverse careenvironment reflected in the Action Areas could not have been delivered byone organisation alone. Our successes were dependent on the way in whichwe devised and implemented the strategy in partnership across primary andsecondary care, public health, education, midwifery, social care, communityhealth, mental health, learning disability, children and young people.Indeed although originally driven by nurses, midwives and care staff, theCompassion in Practice strategy has been demonstrated over the years ashaving some relevance to all clinicians and professionals providing care.It was impossible for us to know way back in 2012, what the actualoutcomes or impact of the Compassion in Practice strategy would be.However, we recognised that by the end of the strategy, it was importantfor us to be able to not only evidence the contributions nurses, midwivesand care staff have made to improving health and care quality, but also toconsider the question“Has the Compassion in Practice Strategymade a difference?”This report, the third of three annual reports documenting our progressthrough the lifetime of the Compassion in Practice strategy addresses thisquestion. It also sets out what we have learned from the challenges of thepast in terms of both the experiences of people we care for; as well as thenurses, midwives and care staff delivering their care.I remain immensely proud of our professions and the way in which wecontinue to strive to improve care experiences, adapting our approach asneeded to ensure we do our very best in each situation. The Compassion inPractice Strategy provided a framework for our activities over the last threeyears, rebuilding public confidence and reaffirming pride in our profession.It also was important that during this final year we began to look to thefuture, and the direction of travel beyond the end of the strategy so thatnurses, midwives and care staff could begin to frame their own agendaproactively from April 2016. To that end we also asked you during thisyear to tell us what hadn’t worked so well during the last few years andhow we could improve in future? Your responses and recommendationsamounted to over 11,000 different types of data and information given atconferences, congress, online, social media, discussion groups, email andvia live academic debates. I thank you for taking the time to comment,reflect and to challenge and the positive way in which you engaged withthe future agenda for nursing, midwifery and care staff. Your contributionsCompassion in Practice: Evidencing the impact - May 201634

CNO WelcomeIntroductionYear 3 CommissionedProgrammesEvidencing the impactof Compassion inPracticeWhat the review ofthe evidence is tellingus in relation to theimpact of Compassionin Practice, includingthe 6Cswere invaluable in helping to create and shape the dialogue around whetherwe should have a follow-on strategy and what our approach should looklike beyond Compassion in Practice. However, what has been most evidentover the lifetime of the strategy, and is captured in this report, is how nurses,midwives and care staff continue to go above and beyond their dutiesto deliver high quality compassionate care and take very seriously theircontributions to shaping the care agenda.2016 sees the end of the Compassion in Practice strategy but with yourhelp, its legacy and the learning gained from it has already helped to shapethe new framework for nursing, midwifery and care staff in England whichis called Leading Change - Adding Value. I am excited about what the newframework will help us to achieve in the coming years.In the 21st century we live with constant change and challenge in healthas well as other aspects of our lives. I want to sincerely thank all of youfor your courage, strength and commitment to our profession throughchallenging times and the passion with which you continue to strive tomake the experiences of staff, individuals and communities the best it canbe. I look forward to facing the future together, one in which we can buildon the value and contributions our profession made as part of Compassionin Practice and through compassionate leadership continue our efforts toimprove the health and life chances of people and communities.Towards LeadingChange, AddingValue: a frameworkfor nursing, midwiferyand care staffSummary StatementCompassion in Practice: Evidencing the impact - May 201635

2. IntroductionCNO WelcomeIntroductionYear 3 CommissionedProgrammesEvidencing the impactof Compassion inPracticeWhat the review ofthe evidence is tellingus in relation to theimpact of Compassionin Practice, includingthe 6CsThe Compassion in Practice Strategy was first launched in 2012 by JaneCummings, Chief Nursing Officer for England and Viv Bennett, Director ofNursing at the Department of Health. The strategy was framed around sixaction areas, with implementation of each action area being led by a seniorresponsible owner with some NHS regions taking the lead in operationalisingthe Compassion in Practice strategy.Three years on, it is evident that a great deal of work has been completedto deliver the aims of the Compassion in Practice strategy and much of ithas received recognition and support across regions. There have been manychanges in healthcare practice and the wider health economy over the lastthree years and before we reach the end of the Compassion in Practicestrategy, it is a good time to: embrace the opportunity to take stock, evaluate the impact andcontributions that nurses, midwives and care staff have made to improvingcare quality and experience. share what we have learned in the process. think about future directions for the professions and ‘what happens next’.Towards LeadingChange, AddingValue: a frameworkfor nursing, midwiferyand care staffAt the beginning of year three of the strategy we began to think about whathad been achieved and started to consider the legacy of the Compassionin Practice strategy for nurses, midwives and care staff that we couldtake forward. In this final year of the Compassion in Practice strategy it isimportant that we can evidence not just WHAT we did but also the impactit has had on our workforce and the people we care for.Summary StatementTo achieve this an evaluation of the Compassion in Practice strategy wasundertaken during its final year. The aim was to address the question:‘Has Compassion in Practice made a difference to thepeople we care for and our workforce?’What counts as evidence?To answer this question and demonstrate the impact of the activities andcommissioned programmes undertaken as part of the Compassion in Practicestrategy, it was important that there was a shared understanding as to whatcounts as evidence. This was particularly important as the need to ‘evidence’work is not always a main influencing factor at the development stage ofaction planning for service improvement and delivery.In relation to the evaluation of Compassion in Practice, evidence wasidentified as information which may help us to identify what impact, if any,that projects have had on outcomes for both patients and staff. This is morethan simply information describing or reporting on all activities that may havetaken place during the three years of the Compassion in Practice strategy. Itreally focusses reporting of specific activities/projects that were carried out toachieve the strategic objectives of action plans.Compassion in Practice: Evidencing the impact - May 201636