Let’s be open all hours for carers
The Chief Nursing Officer for England says the New Year resolution for the NHS as it goes into its 70th year should be an opportunity to review our hospital visiting restrictions:
John’s Campaign advocates the removal of all restrictions on family carers supporting their relatives in hospital who have dementia.
It also calls for a positive attitude of welcome and collaboration throughout the health and care system as was done in children’s services in the 1960s.
The campaign was founded by Nicci Gerrard and Julia Jones, after the publication of Nicci’s article about the death of her father Dr John Gerrard in 2014. Nicci also spoke on the Andrew Marr show about her father and her desire to see carers embraced as partners in care.
Chief Nurse Michelle McLoughlin, of Birmingham Women and Children’s NHS Foundation Trust shares the history of the campaign that places no duty on informal carers and imposes no specific actions on professionals, other than explicitly welcoming carers.
The campaign asks wards, hospital trusts, care homes and the ambulance service to pledge their welcome to carers and, wonderfully, to date more than 1,150 locations across the UK have already made this commitment.
However, this is not universal so I’m calling on all areas to make the same commitment in 2018.
The adoption of John’s Campaign has often come from individual nurses and patient experience staff who see this change as both compassionate and sensible. It’s been exciting to see that Mental Health Wards, building on the Triangle of Care work by the Carers Trust and the Royal College of Nursing which has supported areas to welcome carers’ contribution, are also embracing it.
Those organisations who have already removed restrictive visiting and have established this culture of openness and partnership-working, report the clear benefits this work has brought to patients and carers as well as to the participating organisations.
A flexible approach to embracing the presence of carers has led to improving the overall experience of care, changing the atmosphere in wards and services, and helping to make best use of current resources.
It has also led to better communication, fewer complaints, reduction in falls, violence, delirium, length of stay, improvement in hydration and nutrition, acceptance of therapy and medication, generally improved well-being and maintenance of function, complementing the work of the #endpjparalysis and the last 1000 days programme.
Flexible carer presence also facilitates the transition in and out of different areas of health and social care settings more easily and, of course, it’s particularly important in ensuring good end of life care.
By addressing holistic family needs, actively welcoming carers also provides the opportunity to identify and, if appropriate, offer support and signposting to carers themselves.
The explicit support of Commissioners, Trust Executive teams and senior managers has been integral and makes a significant difference in flexibly welcoming carers as partners in care universally. Senior leadership teams can help to give clinical staff confidence to progress this approach across services.
Experience shows there are many more positives to adopting the approach than challenges. To date, it’s often been individual ward managers who have taken a leading role in removing restrictions on visiting and the quality of their conversations with families and team members have made this shift to a more inclusive approach to caring achievable. Senior leaders can help expedite progress.
Sam Foster Chief Nurse at Oxford University Hospitals is passionate about the removal of restricted visiting and tweeted: “Our New Year resolution at our senior nurses meeting this week is to develop our visitors’ charter and pilot open visiting across the Trust in January.” Do follow their journey @SafetySamFoster @OUH.
Can we continue to grow this culture of open visiting in 2018? I know from personal experience when my Dad was an in-patient two years ago, that the adoption of John’s Campaign made a huge difference to me and my family.
Just as parents’ rights to be with their children in hospital became universally adopted in the1960s, in this, the NHS’s 70th birthday year, can we commit to make this cultural change of embracing and welcoming carers universal?
Professor Jane Cummings
Professor Jane Cummings is the Chief Nursing Officer for England and Executive Director at NHS England.
Jane specialised in emergency care and has held a wide variety of roles across the NHS including Director of Commissioning, Director of Nursing and Deputy Chief Executive.
In February 2004, she became the national lead for emergency care agreeing and implementing the 98% operational standard. She has also worked as the nursing advisor for emergency care. In January 2005, she was appointed as the National Implementation Director for ‘Choice’ and ‘Choose and Book’.
Jane moved to NHS North West in November 2007 where she held executive responsibility for the professional leadership of nursing, quality, performance as well as QIPP, commissioning and for a time Deputy Chief Executive Officer. In October 2011, she was appointed to the role of Chief Nurse for the North of England SHA Cluster.
She was appointed as Chief Nursing Officer for England in March 2012 and started full time in June 2012. Jane is the professional lead for all nurses and midwives in England (with the exception of public health) and published the ‘6Cs’ and ‘Compassion in Practice’ in December 2012, followed by publishing the ‘Leading Change, Adding Value’ framework in May 2016.
Jane has executive oversight of maternity, patient experience, learning disability and, in January 2016, became executive lead for Patient and Public Participation.
She was awarded Doctorates by Edge Hill University and by Bucks New University, and she is a visiting professor at Kingston University and St George’s University, London.
She is also Director and trustee for Macmillan Cancer Support and a clinical Ambassador for the Over the Wall Children’s Charity where she volunteers as a nurse providing care for children affected by serious illnesses.
Follow Jane on Twitter: @JaneMCummings.