Service improvement and transformation

Service improvement and transformation include empowering staff to take on a wider range of clinical tasks. Here the matron should:

  • gain support from the senior management team for staff to take on a wider range of clinical tasks
  • allocate protected management time to Band 7 leaders and hold regular one-to-one meetings with them
  • carry out talent mapping and training needs analysis (TNA) relevant to the personalised and department development plan, checking that all staff are ready and committed to life-long learning
  • provide development opportunities to all, ensuring all staff are given equitable access to development that meets their specific needs and requirements
  • ensure the TNA and education programme cover the development of nurse consultants, advanced nurse practitioners, emergency nurse practitioners, midwives, all levels of clinical nurse specialists, Band 7 leaders who empower the Band 5 and 6 staff to support and develop the Band 2 to 4 staff
  • encourage continuous quality improvement and be a change agent
  • share learning and knowledge with other organisations
  • motivate others to give the highest quality care
  • engage with primary care partners and community services.

Quality improvement

Quality improvement (QI) is ‘a systematic approach to improving service quality, efficiency and morale – not just a mechanism to solve problems in failing parts of the organisation. It is a way of expanding improvement beyond organisational or functional boundaries, so that impact is possible across the wider health and social care system’.45 Various QI programmes and accreditation schemes are available; trusts should choose the most appropriate for their circumstances. QI programmes are a means of achieving clinical effectiveness and encouraging collaboration in clinical areas.

What are the benefits of QI?

The literature about nurse involvement in QI highlights benefits to patients and to staff. Patient harm is reduced, operational performance improves, and financial savings can be made. Staff satisfaction increases, and staff sickness absence reduces. Trusts taking part in NHS Improvement collaboratives have benefited in many ways: the table below contains links to examples.

QI topic Benefits Resources
Criteria-led discharge Increased weekend discharges Criteria-led discharge
End-of-life care Improves the outcomes for end of life care for patients
Frailty Identifying and managing frailty for early intervention Rapid improvement guide: Identifying and managing frailty

Matrons have a pivotal role in QI as they are the link between the executive nurse and frontline staff. They can help in measuring current practice against best practice and monitoring improvement. They can encourage staff to suggest ideas for improving services, allocate resources to improvement projects and support staff to test change on a small scale before rolling it out. This may include administrative support and providing an objective view of everyday practice.

Matron’s Handbook – next sections