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Leading Change, Adding Value: a framework for nursing, midwifery and care staff

A nurse stands with her arms folded

It is just over a year since Leading Change, Adding Value (LCAV) was launched as the national framework for nursing, midwifery and care staff with the aim of supporting colleagues whatever their role, wherever they work, to lead, influence and innovate – both individually and collectively. It enables staff to understand the importance of measuring the outcomes of their work ensuring quality through our work such as Compassion in Practice (2012) and the 6Cs.

It has been a very quick year and one of ongoing change, challenge and opportunity. Therefore it was helpful to take some time recently to consider how the framework has landed in this first year, and whether it is still offering the right support and direction that is relevant for the way we are delivering health and care across a variety of areas and sectors.

Academic colleagues at Edge Hill University undertook an independent evaluation of LCAV on our behalf and considered several areas aligned to the original aims and also to the update of the Five Year Forward View (October 2014) in the Next Steps (March 2017).

Findings were that some great work has taken place in the first year and that nursing, midwifery and care staff by using LCAV are identifying and addressing unwarranted variation in practice. By doing this they are delivering a positive impact, specifically relating to better outcomes, experiences and use of resources – the ‘Triple Aim’ outcome measures.

However, there is still much to do to address that cannot be justified by geography, demography, or infrastructure.

Change continues to move at pace and there is an opportunity to re-assess what we do but importantly without abandoning what we have already successfully achieved.

I was asked to consider leadership for this column and as is well documented, any change particularly at scale, takes effective leadership.

Nursing, midwifery and care staff represent a significantly large proportion of our workforce, and there is substantial leadership ability to deliver change to improve quality of services, outcomes and experiences.

Collective professional leadership is also strong and social media has been a revolution when it comes to connecting and keeping in touch, particularly with international colleagues. With the benefits of social media the professions can now see easily how a lot of the pressures and issues that we face globally are the same. Whether it be workforce, an ageing population, the increase of long-term conditions, or dementia, there are more similarities than there are differences and we can gain important insight across the board.

As we know the world is changing, and our workforce is responding by developing new roles and routes into the professions to ensure the delivery of care is supported by an adaptable, contemporary and professional workforce. This also offers us a variety of leadership opportunities at all levels with LCAV proving an effective tool to support these. Year one has clearly shown this with fantastic work led by both Health Care Assistants and system leaders.

With this in mind, we continue to share knowledge and information and learn from each other – and importantly support and encourage each other too. This is the only way that we can respond as leaders to global health challenges and also measure and demonstrate the impact that we achieve.

Leading Change, Adding Value can be accessed via the NHS England website and follow the framework on twitter via #Lead2Add

Susan Aitkenhead

Susan Aitkenhead is Director of Nursing, Professional Development at NHS England.

Susan is a registered nurse with extensive clinical, operational and strategic experience in delivering healthcare across a variety of settings, with previous Director of Nursing roles at board level both within the UK and overseas.

She has also worked in a variety of national policy roles such as at the Department of Health providing advice and support to ministers and policy officials across central government departments, and in professional regulation at the Nursing and Midwifery Council.

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