Turning pledges and intentions into actions

A nurse visits a patient at home

NHS England’s Director of Nursing, Professional Development, and the UK Project Lead for Dementia Carers Voices, Health and Social Care Alliance Scotland, highlight how a new partnership using the Leading Change, Adding Value (LCAV) national framework can help improve care:

LCAV builds on the successful Compassion in Practice (2012) with the 6Cs remaining as the inherent core values. However, LCAV was developed to help nursing, midwifery and care staff to also apply an equal importance to ‘quantifying’ and ‘measuring’ the outcomes of their work as they do to demonstrating the quality and compassion that the professions are recognised for.

LCAV is about all nursing, midwifery and care staff, no matter what their role is or where they work, and how they can look at what needs to change or could be changed to improve services, experiences and outcomes for patients, individuals and populations. Of course, many colleagues already do this as part of their everyday practice. However, much of this essential work can often remain hidden or misunderstood, as some of it is not easily measured or captured, or shared.

Therefore, the framework specifically looks at reducing ‘unwarranted variation’, where standards of care are not equal and how we can make sure that by seeing where inequalities exist and changing them, that everyone can receive the same highest standards.

The telling of the distressing challenges that Tommy Whitelaw experienced when caring for his mum Joan, who had vascular dementia and sadly passed away in 2012, have highlighted how an inequity of service can have a devastating effect on families and carers.

However, Tommy also highlights the vast difference that great care can make too. The reassurance of a District Nurse, the support of a Speech and Language Therapist, a nurse taking the time to call in and help with care at the end of her day – all examples of people who change lives through their help, kindness and understanding.

Responses to Tommy’s story have resulted in thousands of staff across health and care organisations making pledges to think about what they could do to make a difference to others.

The pledges are compassionate, heartfelt and well-meaning. Pledge trees have sprung up around the country and are inspiring others to think about what they could do to make a difference too. These pledges have been tremendous and have reached staff working in a variety of roles and organisations, making them think about their own practice, services and what they can do personally to make that difference.

Nonetheless, there is still some work to do on turning many of the intentions of those pledges into clear and purposeful actions.

By using the LCAV framework these intentions can be identified, addressed, measured and then the success shared nationally for increased benefit. By doing so, pledges become much more than just an emotional reaction on a day to hearing a powerful story and turn in to a purposeful action which truly makes an ongoing difference.

Nursing, midwifery and care staff represent a significantly large proportion of the health and care workforce, and there is huge leadership ability to deliver change to improve quality of services, outcomes and experiences underpinned by the framework. No matter whether working in practice, academia or in policy, there is an opportunity to create and deliver the changes we need to see in practice, acting as role models for others to follow.

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

Susan Aitkenhead

Susan Aitkenhead is a Deputy Chief Nursing Officer to Ruth May, Chief Nursing Officer for England and supports CNO on matters linked to professional regulation, education, research, and collective leadership. This is in addition to the work with ministers, government officials, professional regulators, royal colleges, professional bodies and the Devolved Administrations to help shape policy and decision making.

Susan was previously a Director of Nursing at NHS England leading on a range of work aligned to system and service transformation at national, regional and local levels.

Susan is a registered nurse with extensive clinical, operational and strategic experience within healthcare across a variety of settings; and provider and commissioning executive and non-executive Board roles within both the UK and overseas.

She has also worked in a variety of other national 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 across the UK at the Nursing and Midwifery Council.

Twitter: @SAitke

Thomas Whitelaw

Thomas Whitelaw is the UK Project Engagement Lead – Dementia Carer Voices.

For five years he was a full-time carer for his late mother, Joan, who had Vascular Dementia, and in 2011 Tommy undertook a walk around Scotland’s towns and cities to collect hundreds of life story letters detailing the experiences of individuals caring for a loved one living with dementia.

Since then, he has engaged with thousands of carers through his ‘Tommy on Tour’ blog and as UK Project Engagement Lead with the Health and Social Care Alliance’s Dementia Carer Voices Project, conducting frequent talks to health and social care professionals and carer organisations across Scotland, to raise awareness of the impact of dementia on families and the importance of empowering carers in carrying out their difficult but vital role.

Tommy’s passion for his work and the Dementia Carer Voices Project has not gone unnoticed. He was the winner of the ‘Age Scotland Jess Barrow Award’ in 2013; Finalist Campaigner of the year 2013 for ‘The Herald Scottish Politician of the Year Awards’, won the NHSGGC Chairman’s Ambassador Award 2013 and in 2015, Tommy was awarded the ‘British Citizen’s Medal for Services to Healthcare’ in recognition of his work to raise awareness of dementia and promote a fuller understanding of the carer journey.

Tommy was shortlisted as a finalist for the Kate Granger awards 2016 and received an Honorary Master of the Open University for Health, Social Care, Education and Policy making influence.

Groups and boards Tommy represents the project and the ALLIANCE on are: Fair for all Board Member North Ayrshire Council, Girvan Community Hospital Dementia Friendly Steering Group Member, Member of Scottish Government Dementia Strategy 2016-2019 Expert Advisory Group and NHS Education Scotland Promoting Excellence Dementia Programme Board Member.

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One comment

  1. Kassander says:

    Much welcome ‘talk’about people ‘thinking’ and ‘Pledges’.
    Some examples of those ‘Pledges’ might have helped Patients and Public understand what’s going on in your ‘bubble’?

    It is OUR=NHS, after all.