interviews

'The 6 Cs in action'

Chief Nursing Officer for England, Jane Cummings, speaks to NHE about involving families in care.

The UK’s first conference on patient and family centred care was held in Liverpool on April 23, organised by Liverpool Heart and Chest Hospital (LHCH) and the US-based Institute for Patient and Family Centered Care, whose president and CEO Beverley H Johnson delivered a keynote address.

Jane Cummings, Chief Nursing Officer for England, also addressed the conference, discussing how the work done at LHCH on patient and family centred care fits in with the 6 Cs of Nursing.

She was very positive about the work done at the hospital, which has been rated the best in the country for overall patient care, with 100% recommending the hospital to their family and friends and 91% saying the care they received exceeded their expectations.

Speaking to NHE after the conference, Cummings said: “I particularly liked the work they’d done to set the vision to engage with so many of their staff, as well as their patients and families, and actually put it through the patients’ eyes. What was really helpful for me was their six-point plan where they set down what they wanted a really good patient experience to look like (see box out, bottom).

“The vision around patient and family centred care was a very strong one and a very positive one. They’d also thought very carefully about those patients who may not have family, or who may have slightly more complex family relationships. They’d thought that through really well.”

But it was walking the wards and talking to patients themselves at the hospital that really convinced Cummings of the value of the LHCH approach. She said: “The feeling you get in that organisation is one of staff who really do put patients and their families first – making small differences that have big impacts on people. They are really engaged with what they do, and I think that’s so clearly represented in the fact they get such good patient and staff feedback.

“It absolutely ties in well with the 6 Cs of Nursing. It was great to see that they’d badged the conference ‘6 Cs in Action’; I took a photograph of that! I thought it fitted very well.”

The feedback to the hospital’s experiments with family-centred care, explored in more detail over the following two pages, seem to suggest improved outcomes (though it is too early to say so with scientific certainty). Considering part of the point of the conference was to suggest the relevance and applicability of the LHCH method to other parts of the NHS, we asked Cummings who needed to be the driving force behind making such a change.

She said: “What we know from evidence is that things have a bigger impact when there’s an alignment between those who run an organisation and those on the front line. If you’re able to have a common purpose, and are able to have a clear vision that everyone signs up to, with a clear set of objectives – something that’s aligned throughout the organisation, we know it stands a better chance of success.

“Ideally, it would be good to have a board or senior manager or senior clinicians who support it, because they can often stop or unblock problems that might stop more junior staff doing it. But that doesn’t mean those who run wards can’t think about this or can’t start to look at implementing it locally. You need everybody to do it; it can’t just be top down.”

Does a greater focus on patient and family-centred care necessarily mean moving resources or focuses away from direct clinical services? Cummings says not: “I don’t see why people can’t prioritise both. If you look at what you need to do, it’s a fundamental part of the role of the job of providing care.

“If you look at quality in the round, and look at it in context, you’ve got the effectiveness of care, you’ve got the safety element, and you’ve got the experience element. You need to do all three of those together: you can’t just focus on one of those areas.”

The six steps of the Patient Experience Vision

Reputation – Why go anywhere else?
Arrival – They were expecting me.
Patient Contract – My care was planned with me and for me.
Stay – They made me feel special.
Treatment – They really knew what they were doing.
After Stay – Their support continued and my quality of life improved.

Compassion in Practice

The following is an extract from Jane Cummings’ speech at the conference: “Today we will hear about the achievements of LHCH, but we will also hear how this particular Trust’s work fits perfectly with Compassion in Practice, the three-year vision and strategy for nursing, midwifery and care staff launched at the end of last year.

“…During the coming months, we need to embed the 6Cs and the values and behaviours in everything we do. In order to achieve this, there will be a need for strong individual, local and national leadership, with support from local organisations and national bodies.

“By harnessing our collective energy and commitment, we, as the largest part of one of the largest workforces in the world, have unlimited potential to massively improve the quality of care.”