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Care staff can be the agents of change

The second Care Worker conference in Leeds last month attracted 130 care staff from around the country, across the health and care sector, with delegates coming to find out more about ‘Leading Change, Adding Value: a framework for nursing, midwifery and care staff’ (LCAV).

The framework positions nursing, midwifery and care staff as leaders, wherever they work, whatever their role and highlights the need to apply the same importance on how we measure the outcomes of our work, as we do to demonstrate quality.

It highlights how all staff can lead in reducing the three gaps of health and well-being, care and quality, and funding and efficiency as set out in the Five Year Forward View.

The framework encourages staff to focus on” unwarranted variation”, a new way of working for many. Put simply, it’s about looking at differences in health outcomes of people, individuals and populations and what we can do to identify and reduce variation in practice.

Having set out the outline of the framework, delegates heard from five inspirational sets of speakers, all care staff themselves, who had in one way or another led change that has made a difference to patients and individuals by improving outcomes, experiences and making better use of resources.

I was moved by the dedication and commitment of the care staff that represented just a small proportion of people that do amazing things every day and often don’t realise the differences they are making.

They showed how to lead change and add value often without additional resources but through their passion and tenacity, starting small and persevering to make change happen. Care staff work with individuals at the bedside, in waiting rooms, in care homes and other varying settings – they can often see what can be changed and when supported they can be the agents of change.

So, take the Primary Care Navigators from a GP practice in Gateshead, who help people access appropriate services more quickly and effectively to improve outcomes, experiences and reliance on GP appointments. Then, midwifery support workers delivering practical parenting sessions supporting the most vulnerable mothers, and the midwifery support workers providing one-to-one ante natal and post-natal emotional support; I was humbled by the success story they told that brought me close to tears.

Another great example of leading change was from health care assistants who work with the ‘Portrait of a life’ reminiscing tool in Care Homes, communicating with individuals to find out and understand who they truly are and the stories they have to tell. Conversations really matter and this work supports staff to communicate with, and understand about, the person they are caring for, not the condition they may have. A success story we were told about was the reuniting of two people who had been old school friends but who hadn’t realised they were living in the same care home, until their individual reminiscing stories had been told; what a fantastic outcome for those two people.

And, finally, we heard from a health care assistant who worked to improve mouth care on the stroke ward where she worked. She now delivers training on mouth care throughout her hospital and has with support from her ward manager designed posters, leaflets, badges and resources to support her campaign.

Her tenacity has made her in to a leader in her own right, championing good quality mouth care for patients across the hospital trust. The results are impacting on the incidence of pneumonia and better nutrition and overall use of resources in relation to staff time.  The chief nurse and chief executive have recognised and supported this initiative wholeheartedly.

The conference demonstrated the vital role that care staff have and crucially, the importance of their role in the implementation of the framework.

Four workshops helped care staff understand how they could lead change by being champions for change, using the support of managers and recognising variations in practice. This helped them think about their own areas of work where change might be needed.

I was particularly struck with the value of networking and the importance care staff placed on coming together with other colleagues to hear about how others have started to make a difference for people they care for. Leading Change, Adding Value is a framework that can support staff to do this. I made a promise at this event that we would organise another one next year, where even more people can come and share their inspirational stories and bring what they do to life.

It was a real pleasure to meet everyone in Leeds and we heard some great stories. I’m now asking you to give us your story. I’m sure there are lots more out there so please do send them to us and we’ll tell your story on our Leading Change, Adding Value web pages – who knows you might be presenting at the next conference!

Hilary Garratt

Hilary Garratt CBE, BSc, MSc, RGN, SCPHN (RHV), PGCE is the Deputy Chief Nursing Officer NHS England/Improvement.

Hilary leads the implementation of a range of national programmes that focus on safeguarding vulnerable people and programmes that support the professional development and leadership of the nursing profession.

Hilary is a registered Nurse and Health Visitor, with 36 years’ experience of working in clinical, public health and Executive leadership roles in the NHS. Hilary has held a number of Executive Director posts across both commissioning and provider organisations in addition to holding and Deputy Chief Executive post for both. Hilary has been working at National Director level for the last 7 years.

In addition to her professional life, Hilary enjoys volunteering at the front line and also for the third sector. From 2013 – 2017 Hilary worked for BBC Children in Need as a committee member that undertook grant making for the North of England. Hilary also engages in hands on volunteering, working with the homeless and other vulnerable groups in her home city.

Hilary received a CBE in the 2017 New Years Honours for services to Nursing and her national work to safeguard some of the most vulnerable people in society. In 2018 Hilary was nominated as one of the country’s 400 Women of Achievement and Inspiration.

Follow Hilary on Twitter: @HilaryGarratt.

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