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Primary Care Trust
Improving Darlington’s health and well-being

6 November 2008 Item No 08/11/09

Nursing and AHP Strategy Performance Update October 2008
1. Introduction/ Summary of Scheme/Report In July 2008 Darlington PCT Board approved the Nursing and Allied Health Professionals Strategy 2008-2011 performance framework. This update relates to the progress made in achieving the specific actions with target dates up to December 2008.

2. Implications and Risks Will there be a significant impact on patients or patient care? Are there any financial implications to implementing this item? Will there be an impact on Equality, Diversity or Human Rights? Does this item form an essential part of quality or performance standards e.g. Healthcare Commission, NHS Litigation Authority? If yes, detail which standard. 3. Recommendation The Board is requested to receive this feedback. 4. Submitted by Author: Title: Sponsoring Director: Date: 5. Purpose of the Paper Information sharing x Development/discussion Decision/action Pat Wilkinson Clinical Development Lead Linda Templey, Director of Nursing and Patient Safety October 2008 Yes Yes Yes Yes Standards for Better Health Use of Resources Theme NHSLA Risk Management Standards for PCT’s


Primary Care Trust
Improving Darlington’s health and well-being

Nursing and AHP Strategy Performance Update October 2008
1. Introduction
In July 2008 Darlington PCT Board approved the Nursing and Allied Health Professionals Strategy 2008-2011 performance framework. This update relates to the progress made in achieving the specific actions outlined in the framework. A group consisting of the leaders responsible for the various process targets has been established and will continue to meet on a quarterly basis to provide assurance that the target outcomes have been achieved within the identified timescale. The performance framework has been updated and specific action targets that have planned completion dates by December 2008 have been colour coded using a traffic light system. Green – target achieved, amber – target on course to being achieved, red – target unlikely to be achieved within time period.

2. Implications and Risks
The implementation of this strategy has a direct impact on patient care and provides assurance that the workforce has the necessary training and governance to deliver services that are fit for purpose. The Nursing and Allied Health Professionals Strategy 2008- 2011 is divided into seven themes and the achievements made to date are outlined below. Further details are provided in the updated performance framework, (appendix 1) Theme 1: Safety, Quality and the Patient Experience A mapping exercise of existing clinical policies has been carried out and the top twenty clinical policies have been identified. These policies have been updated where necessary to ensure they address patient safety and risk. This work around clinical policy developments is a major factor in ensuring the PCT meet their quality assurance targets set out in CNST and Standards for Better Health indicators. The current patient management recording system has been reviewed and the “Safeguard” patient management system has been purchased. Service managers are working with integrated governance colleagues to ensure the system is implemented. This will ensure a just and fair incident reporting system becomes operational in all service areas.


There are a number of service reviews underway, Muscular Skeletal services is an example. As part of these reviews the services and commissioners are aiming to engage with service users to ensure their experiences and expectations are a key component in the process. Theme 2: Essence of Care In July 2008 a conference was delivered which re-launched and raised the awareness of Essence of Care in County Durham and Darlington. The Directorate was delighted to play host to Dame Christina Beasley Chief Nursing Officer and Maureen Morgan Doha Lead for Essence of Care. The PCT have appointed an Essence of Care lead who is expected to join the trust in January 2009. This will be a significant addition to the organisation, which was reflective of the amount of interest the post attracted. In the meantime an audit implementation programme has been developed and implementation of the 11 patient-focused benchmarks is planned. Progress in relation to two of the benchmarks has been good beginning with a baseline audit of record keeping. This resulted in the adoption of a new clinical record keeping policy and refresher training for all clinical staff. Early evaluation of this training appears to suggest that staff are finding this training to be very valuable. The second benchmark that has made good progress is food and nutrition. The PCT have led the implementation of Focus on Food and Nutrition Now campaigns. Theme 3: New ways of working TPP/ SystmOne is the preferred system for community staff across County Durham and Darlington and is currently being deployed to all District Nurses and Health Visitors - this rollout is likely to be completed by end of December 2008/mid January 2009. There are plans to deploy to Allied Health Professionals, Tier 2 services and School Nurses during 2009. Fourteen clinical champions have been appointed by NHS County Durham and where appropriate, will be utilised to provide clinical input as part of service reviews and the development of multi-disciplinary clinical pathways.

Theme 4: Future Career development A robust appraisal system with measurable objectives has been developed and a gap analysis completed to ensure all posts have a KSF outline. A partnership with the University of Teesside (Learning in the Workplace) has been developed to deliver a wide range of developmental and academic programmes. The added value of this exciting initiative is that learning will mainly take place in the place of work rather than expecting staff to travel to the university. A new clinical supervision policy has been developed and training to support the policy has been implemented. The next steps will be to audit the process to ensure staff are undertaking this beneficial activity.


Theme 5: Education, Training and Development An electronic training management system has been developed and a mandatory and essential training matrix to determine the workforce training needs has been implemented. Training needs are now identified and additional courses have been commissioned to meet the demands. Theme 6: Public health and health improvement The key aim of this theme is to improve health outcomes by ensuring all professionals contribute to providing the solutions to public health and health improvement. Within the developing role of the clinical champions there is an expectation that some individuals will target Lord Darzi’s Staying Healthy work stream. The Directorate will co-ordinate public health activities with assistance of the Public Health Lead Nurse to ensure key documents and drivers are being utilised to initiate public health and health improvement initiatives. Theme 7: Healthcare Associated Infection All infection control policies have been reviewed and mandatory infection control training is being provided for all nurses and allied health professionals. A data base has been developed to monitor and ensure all staff attends infection control training. Audit mechanisms have been implemented to monitor performance standards in accordance with “Essential Steps to Safe Clean Care.” Project management support for community staff has been identified as a priority and resources have been secured. These posts are currently out to advert and will be a welcome addition to the frontline teams. In conclusion this paper and the attached action/implementation plan demonstrate that excellent progress has been made in implementing the Nursing & Allied Heath Professionals strategy. There is a positive correlation between the progress made against the targets in relation to improving patient safety and experience.

3. Recommendations
The Board is asked to receive this feedback and provide comments.

4. Sponsor Director
Linda Templey, Director of Nursing and Patient Safety Purpose of the Paper Information sharing Version 1 Date Development/discussion Summary Decision/action Approved

Owners Name


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