PM UNVEILS HOSPITAL CARE REVAMP

Nurses will be told to undertake hourly ward rounds while members of the public will be allowed to inspect hospitals, under plans announced by the Prime Minister.

David Cameron said most patients were happy with NHS care but there was a "real problem" in some hospitals with people not getting food and drink or being treated with respect.

He said the Government was going to "put right" the problem after the Care Quality Commission (CQC) found issues with dignity and respect in hospitals up and down the country.

The PM wants hourly rounds by nurses.

Mr Cameron is pledging to strip away "stifling bureaucracy" and allow nurses to focus on what they do best, adding that the whole approach to caring in this country needs to be reset.

He also emphasised the need for leadership on wards, saying people wanted to see a figure of authority, whether they were called matron, ward sister or team leader.

In October, the CQC found a fifth of NHS hospitals are breaking the law on care of the elderly.

Its study also found half of hospitals are failing to provide all-round good nutrition to elderly patients while 40% do not offer dignified care.

Of 100 hospitals investigated in England, 49 were found to generate minor, moderate or major concerns about nutritional standards for elderly people.

Today's announcement is intended to mean nurses can focus on "patients not paperwork" while all hospitals will be expected to implement regular ward rounds "to systematically and routinely check that patients are comfortable, are properly fed and hydrated".

Strong leadership on wards will is also expected become common practice.

A new Nursing Quality Forum of frontline nurses and nursing leaders will be tasked with promoting excellent care and ensuring good practice across the NHS.

Patients will also lead inspections of hospital wards, with local people becoming part of teams assessing cleanliness, dignity and nutrition.

A new "friends and family test" will also ask whether patients, carers and staff would recommend their hospital to friends and family.

The results will be published and hospital leaders who fail the test will be held to account.

Mr Cameron said: "If we want dignity and respect, we need to focus on nurses and the care they deliver.

"Somewhere in the last decade the health system has conspired to undermine one of this country's greatest professions.

"It's not one problem in particular. It's the stifling bureaucracy. The lack of consequence for failing to treat people with dignity.

"Even, at times - as we saw with Mid Staffordshire - the pursuit of cost-cutting or management targets without sufficient regard for quality of care.

"Nursing needs to be about patients not paperwork.

"So we are going to get rid of a whole load of bureaucracy that stops nurses from doing what they do best.

"And in return patients should expect nurses to undertake regular nursing rounds - systematically and routinely checking that each of their patients is comfortable, properly fed and hydrated, and treated with the dignity and respect they deserve.

"This happens in the best hospitals. In some it has never stopped happening. "Now it needs to happen in every hospital. And the Royal College of Nursing support us on this and we'll be working with them to make it happen."

Under the plans, an NHS Institute Time to Care initiative will be rolled out with the aim of cutting paperwork.

More than 60% of NHS acute trusts are currently implementing the programme, which has helped nurses to spend an extra 500,000 hours with patients in one year, according to information from Downing Street.

The aim is to have all hospitals implementing the programme from April 2013.

Evidence also shows that regular nurse rounds enable patients to talk to a nurse at least every hour and a ward sister at least twice a day.

The aim is not for the rounds to replace usual nursing care, such as dressing wounds, but to run alongside them.

Where regular rounds have been implemented, evaluation suggests they improve patient safety by cutting the number of falls and patients suffering pressure ulcers, improve patient satisfaction and reduce anxiety and make the shifts less stressful for the nurses.

In another development, hospitals could receive bonus payments of up to 0.5% of their contract income if they use a new NHS Safety Thermometer to improve quality on basic care, including with regard to pressure ulcers, falls, blood clots and hospital infections.

Dr Peter Carver - Nurses care for people.

Dr Peter Carter, Royal College of Nursing chief executive and general secretary, said: "Nurses working in every field have one thing in common - they chose the profession because they want to care for people.

"The profession will welcome the moves to free up nurses to put care first, and to focus all their energies on the needs of their patients.

"In particular, nurses themselves have emphasised the enormous burden of the paperwork they have to complete, day in and day out."

Katherine Murphy, chief executive of the Patients Association, said: "This is a significant step forward in meeting the demands of our Care Campaign, launched in November last year.

"But we are disappointed that it has taken intervention at this level to bring about the change that is desperately needed.

"We have consistently said that nurses need time to care, and we have called for an end to the bureaucracy that stops effective nursing."

Shadow health secretary Andy Burnham said: "If David Cameron really wants to help nurses focus on patient care, he should listen to what they are saying and drop his unnecessary Health Bill."

Jo Webber, deputy policy director at the NHS Confederation, told BBC Radio 4's Today programme that the amount of paperwork required from nurses varied from hospital to hospital.

She said: "I think the first thing hospitals will do in any case is to do an audit of what nurses are actually doing and to try and pare away those tasks which are mundane and routine and can be done by, say, ward clerks.

"I am not saying they don't need to be done. They need to be done by somebody, things like ordering supplies etc, but maybe it is not the best use of nurses' time."

Speaking on BBC Radio 4's Today programme, Mr Cameron said: "There is clearly a problem in some hospitals in some settings where we are not getting the standards of care that the nation expects.

"And I think politicians frankly have done nurses a disservice by not talking about this. Such is our respect for nurses that we have almost hidden away concerns about this."


PA 2012