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Hi Sue, can you tell us a little about yourself? My background is in tissue viability and I retain the clinical and leadership role with tissue viability as part of this role. I have been in tissue viability for 17 years and developed and continue to lead the service at Ashford and St Peter's Hospital NHS Foundation Trust. During this time I was seconded into the post of Acting Assistant Chief Nurse 0.5WTE for 1 year. Previous to this, I worked as a Deputy Head of Practice Development and a Ward Sister. You are the first harms prevention nurse consultant in the UK. How did the role come about? The Trust Chief Nurse had the vision to look at hospital associated harms as a whole and how this needs to be managed in a strategic way across the Trust. The role ties in with the NHS Patient Safety Strategy 2019. Where does your role sit within the governance structure? The role sits within the corporate division and has close ties and associations with all of the divisions and their governance structures. The post reports into the Trust Safety and Quality Committee. How long have you been in post? This is the start of my fourth week. What are the main purposes of the role? My role includes: Leading and developing the Harms Free Care Service across the Trust. Developing the Trust Harm Free Care Strategy and monitor its effectiveness. Leading on the Harms Free Care Strategy within the Trust, working with the teams to deliver a sustained reduction in pressure damage, avoidable falls, the absence of a new venous thromboembolism (VTE), harm associated with poor nutrition and the absence of catheter associated urine infection. Being expected to develop and influence strategies and frameworks to ensure that all healthcare staff adhere to Trust policies relating to Harm Free Care, through developing practice linked to the clinical governance and performance frameworks and Trust corporate objectives. Supporting the Trust to develop and implement systems for performance monitoring and performance improvement programmes for pressure ulcers, VTE, falls, nutrition and catheter associated urinary tract infection. Talk us through a typical day. It's a little early to talk about a typical day yet. I still have a clinical role in tissue viability 2 days per week as part of my role and so these days are spent assessing and planning care for patients with complex wound needs, providing education and training. The rest of my time is filled with planning for the role of Harms Free Care, looking at our present data and analysis, meeting with the harms leads, such as the VTE prevention lead nurse and the nutrition lead. Have you had a chance to see what impact the role has had on patient safety? It’s too early to look at impacts, but feedback has been positive that harms must be seen together and not separately. Meaning that we should not concentrate on the reduction of one harm at the potential cost of a rise in another, the harms are interrelated and need to be focused on as such. One of the key parts of the role will be ensuring our metrics in relation to harm are relevant and meaningful to both staff and patients. How are you measuring the impact of the role? There will be multiple measures which will be benchmarked against improvement targets for the reduction of harms. This will include data such as numbers of harms as well as other data such as patient feedback. How do you engage staff and patients in patient safety? We engage staff via various means: education, bulletins, focus days such as Worldwide Stop the Pressure Day, focus weeks such as Nutrition and Hydration Week. We are working towards engagement strategies as part of the NHS Patient Safety Strategy. How do you see this role developing? I would like to see this role being adopted by other Trusts as we have a concerted focus across the NHS to reduce patient harms.

The NHS Improvement web page outlines the eligibility criteria and application form. Please note: The closing date for applications has now passed. The scheme is not currently considering any further applications. The application process is anticipated to reopen on April 1 2020.

Outstanding models of district nursing explores the elements that need to be in place to support an outstanding District Nursing service. It includes the views and experiences of a wide range of stakeholders including patients, carers, commissioners and GPs. It recommends that the Government and NHS: Urgently increase investment in the District Nursing service to give it the capacity and capability to meet the challenges of the 21st century Maintain the post-qualifying District Nurse Specialist Practice Qualification (DNSPQ), which develops DNs’ professional growth and enhances their clinical skills Develop a strategy to expand commissioners’, providers’ and the public’s understanding and knowledge of the District Nurse role, enabling them to recognise the added value they bring to the local health economy and particularly to the wider Health and Social Care system Develop a standardised data collection system and data set, collecting meaningful data that recognises value for money, promoting a strong economic case for investment in the District Nursing service Develop a standardised approach to the assessment of quality, to measure District Nurse effectiveness in England, providing reliable data, enabling innovation and cost-effective practice to be recognised and disseminated Explore the co-location of District Nursing teams within Primary Care Networks to provide personalised care, continuity of care and enhanced working relationships across primary and community care teams.

Key points: Staffing is the make-or-break issue for the NHS in England. Workforce shortages are already having a direct impact on patient care and staff experience. Urgent action is now required to avoid a vicious cycle of growing shortages and declining quality. The workforce implementation plan to be published later this year presents a pivotal opportunity to do this. This report sets out a series of policy actions that, evidence suggests, should be at the heart of the workforce implementation plan. They will require investment of an extra £900 million per year by 2023/24 into the budget of Health Education England. Recognising the close interrelationship between the NHS and social care, the report also recommends a series of policy changes to improve recruitment and retention in social care.

The growing global evidence that Anne Marie and academic colleagues have gathered shows we need more nurses, with the right skills and support, if we want to reduce patient mortality and improve nurses’ wellbeing. The RCN has used this research to create the aims of its safe staffing campaign and to tell all four UK governments what nurses and patients need now.