Friday 06 November 2015
- Independent professional standards body impressed by HSSD's significant and continuing progress in improving maternity services over the past 12 months - but further progress is needed in governance
- Progress driven by staff 'passionate about and committed to patient care' and effective leadership and management
- HSSD confirms its commitment to continue working to action plan recommendations
- Progress on revalidation of nurses and midwives puts Guernsey ahead of the UK
HSSD has welcomed the monitoring review that the Nursing and Midwifery Council (NMC) has undertaken on-site in Guernsey from 2-5 November 2015 - and its overall finding that the improvements to maternity services have brought 'tremendous progress' across all areas. The NMC's view is that HSSD has come a long way in just 12 months, and that the department and its partners should 'keep their foot on the pedal' in making continuing improvements.
Dr Jackie Smith, Chief Executive of the NMC said:
"HSSD has made tremendous progress in the past 12 months, right across the board. Staff are clearly passionate about and committed to patient care, and that has been a very visible part of the review we have done. Nurses and midwives have done a phenomenal job and we are impressed.
"Significant progress has also been made, for example, on the very important issue of the revalidation of nurses and midwives, and Guernsey is now leading the way when compared to the UK.
"Further progress is needed in the areas of governance, including multi-disciplinary approaches to governance, and the organisation's culture, which will always take more than 12 months to achieve."
"The difference in the organisation from 12 months ago is significant and positive. The NMC is reassured by what it has seen in this monitoring review - but HSSD must keep its foot on the pedal now, and continue to drive forward improvements."
Deputy Paul Luxon, the Minister for HSSD said:
"The staff and the Board have been determined to continue to make significant progress against the findings and recommendations of the NMC's Extraordinary Review, which was published 12 months ago. The issues that underpinned the NMC's Extraordinary Review were of the utmost seriousness and the NMC's findings revealed widespread failures across a number of areas of the maternity service. One year on, it is of huge importance that the community has been provided with assurance from this independent expert body that HSSD had made significant and effective progress against its October 2014 findings and recommendations."
"I am delighted that the NMC has taken this long, hard look at us again and not found us wanting. The positive feedback we have received today is the product of many people's tireless work over the last year and I wish to thank and congratulate them, especially our nurses and midwives. We have come a long way in a short time. We now have the systems and processes in place to ensure that our staff and patients feel supported to speak up when they have concerns, and are confident that those concerns will be embraced by management and looked into properly, and reported to my Board. We know that we have more progress to make - but for today, I hope that nurses and midwives throughout HSSD can take genuine pride in the positive outcomes their hard work has produced."
Dr Carol Tozer, Chief Officer of HSSD said:
"HSSD has undertaken a considerable programme of work over the past year and we are delighted that the impact of our work has been evaluated so positively by the NMC. Staff from across the whole of the department have been engaged in this programme of change and improvement - as well as partners such as the Medical Specialist Group (MSG) and the Maternity Services Liaison Committee (MSLC). Staff can be proud of what they have achieved, and the community can be reassured by what is now in place.
"Over this past year, we have never forgotten that what always matters most are the people we serve. The messages we received from the NMC this time last year were very difficult for many of us, including those patients who were directly involved. So over this past year, our moral compass and professional focus has been patient safety, clinical effectiveness and leadership. We need confident, competent, critical thinking nurses and midwives - and they in turn need an organisation that supports the delivery of effective health care services. That is what the NMC has been examining this week.
"As Chief Officer, it has been a privilege and inspiration to work alongside so many colleagues who have worked incredibly hard to deliver the necessary improvements including the senior nurse and midwifery forum; the Institute, the governance team; colleagues in housekeeping; the facilities and estates department; our IT team; and our HR team. Their hard work has paid off and I am incredibly proud of, and grateful to, all of them. Our nurses and midwives deserve real credit for the improvements that they have driven. We have the foundations and structures in place to make continuing improvement."
Supported by additional resources from the States of Guernsey, over the past year HSSD has many positive steps including the following ten significant improvements:
Strengthened clinical leadership through investment in additional senior nurses, midwives and recruitment to the Chief Nurse and Medical Director posts;
Strengthened performance management through the introduction of the Vital Signs our performance framework, the use of a 'safety thermometer' and the implementation of the Nursing Assessment and Accreditation System (which are internal reviews of nursing and midwifery care standards);
Improved communications across the Department through events such as routine Big Conversations for staff, fortnightly Ward to Board events and engagement with patients and their representatives through vehicles such as the Listening Post - this has enabled HSSD to seek out and act on feedback from frontline staff and patients;
Tripled the level of essential training provided to staff across the Department;
Successfully restarted the pre-registration nursing degree programmes for second and third year students (the latter of whom have just graduated) - with all 41 mentors now fully "in date" and adequately prepared to support students nurses in practice the first year students who are about to restart their degree programme towards the end of this month;
Completed more capital projects between January and June 2015 than had been done for the whole of 2014 - including improvements to maternity facilities;
Increased the size of the nursing and midwifery workforce - so that staffing levels are more robust and better able to meet the needs of patients;
Ensured that the statutory rules and standards governing the supervision of midwives are met in full;
Reviewed the majority of HSSD policies and procedures; and
Prepared all of nurses and midwives for successful revalidation which starts in 2016 - putting Guernsey ahead of the UK.
The review has been an extensive examination of the rules and standards relating to the supervision of midwives, the maternity services, and adult and mental health pre-registration nursing degree programmes (and associated nursing services).
The NMC's methodology has involved:
an in-depth review of a range of information and reports;
the observation of clinical practice; interviews with nurses, midwives and other staff (including nurse students, senior managers and the HSSD Board);
meetings with patients, women and their representatives; and
visits to over 23 different clinical areas based in the community and at the Princess Elizabeth Hospital.