Patient care must be priority
The challenges for 2014 can be summarised as needing to achieve care that delivers better outcomes and experiences for patients within available funding.
We must put patients and carers at the centre of care planning and decision making. We need to see a shift away from episodic care towards care focused on the whole person, across pathways that best suit patient needs. This is vital if we are to deliver integrated care for our vulnerable elderly and those suffering with dementia.
Clinicians should recognise and develop the assets of individuals, community groups and the voluntary sectors working as equal partners to build interventions such as health behaviour programmes.
We need development programmes that build generic and advanced skills to meet the needs of patients with multi-morbidity. We need more consultant skills in community settings, and hospital and community staff should work more closely together. The use of technology can be maximised to promote out-of-hospital supported care and integration.
Jane Cummings is chief nursing officer for England
Lisa Bayliss-Pratt
Investing in quality nurses
The nursing family - registered nurses and support workers - has been very much in the spotlight following the Francis, Cavendish and other reports published this year.
The publication of our National Workforce Plan highlights that we are going to invest in more nurses in 2014 - an additional 500 undergraduate places, increased numbers of health visitors and a focus on meaningful CPD to encourage nurses to return to practice. All this is excellent news for the profession.
The government made recruiting health visitors a priority, setting a target to increase the numbers by 4200 by 2015. This is an increase of 50 per cent in the workforce, and the job of HEE through 2014 is to maintain it at these historically high levels.
As well as making sure we have the right education and training in place, we need to ensure that we are recruiting the right people in the first place. Our strategy on recruiting for values is a very positive message for the profession. We want the public to be 100 per cent confident that the nursing profession as a whole embodies the right values so that they can care with kindness, intelligence and compassion.
An initiative like the pre-nursing experience pilot, although early days, is proving to be one of the meaningful ways in which aspiring student nurses can gain experience of caring, before committing to a career in nursing - checking nursing is right for them and that they are right for nursing. This, as well as the success we have had with our dementia awareness training, has put a further spotlight on kindness and caring: the core business of the nursing profession and those that support them, such as doctors, AHPs and support staff.
Nurses have key opportunities to enable the integration of health and social care, and promote wellness in addition to treating illness. The care support workforce will be key, and the development of the Cavendish Care Certificate across health and social care, along with other opportunities for this group to develop and progress, will be a step towards raising the profile and ability of this workforce.
We will do all this because it is essential that the nursing workforce takes centre-stage in the transformation of treatment and care for patients.
Lisa Bayliss-Pratt is director of nursing at Health Education England
Knowledge and compassion
In 2013 we started to make real progress in raising the profile of nurses' work in improving and protecting people's health - as well as providing high-quality care when people are ill. In 2014 I want us to achieve an even higher profile as we use our knowledge of health and illness, our clinical skills and our relationships with individual people/patients, families and communities to make a difference to health outcomes and inequalities.
In 2013 the 6Cs became embedded as values and behaviours for excellence in nursing. Alongside this I set out six areas for personalised care and population health. These are wider determinants of health, health improvement, health protection, healthcare and public health, including making every contact count, supporting wellbeing and independence, and lifetime approaches to health.
We will be working with nurses, key strategic partners and, through the national community nursing strategy prevention and population health workstream, maximising nurses' contribution to improving the nation's health.
Viv Bennett is director of nursing at Public Health England
Crystal Oldman
Community spirit
Community nursing has been high on the agenda in 2013 and for 2014 the activity and the debate will only increase. This is a great time to be a community nurse - our moment has arrived!
It will be no surprise that I believe that in 2014 the main issue will be supporting patients to be cared for in their own homes, thus avoiding hospital admissions, supporting safe early discharges and promoting self-managed care.
There will be a considerable focus on safe staffing levels in the community and this will result in more district nurses being employed to lead community nursing teams through the specialist practice programmes. The recent confirmation by Health Education England of a 7.2 per cent rise in commissioned places for the District Nurse Specialist Practitioner programme is welcomed, but the numbers will be insufficient to provide the growth needed. I predict that there will be a further increase in commissions announced in 2014.
With regard to the fabulous work and the critical role of general practice nurses, the preparation for their role will be scrutinised more closely by the Care Quality Commission (CQC) in its new inspections of general practice. This will result in a call for a recognised development programme for nurses new to general practice, to prepare them for their role.
Community nurses will be central to the implementation of the named GP for the frail older person in 2014. I can see that general practice nurses and district nurses will become the named nurse for some frail older people and there will be experiments with GP out-of-hours services, involving an expansion of community nursing services.
With regard to strategic developments in commissioning, I believe that the discussion on primary care services being commissioned by clinical commissioning groups (CCGs) will become louder in the run up to the 2015 election.
And finally…. Queen's Nurses will become very involved strategically and operationally in addressing the above predictions. Queen's Nurses have an excellent track record of supporting strategic developments at local, regional and national levels. They are leaders of practice, able to inform policy at all levels and hold the patient and carer firmly at the centre of all they do.
In 2014, the QNI expects to be swamped with demands for Queen's Nurses' time and expert advice….and even more applications for the cherished title of Queen's Nurse.
Crystal Oldman is chief executive at the Queen's Nursing Institute
Support for practice nurses
Nursing staff in primary care services play a vital role in treating patients in the most appropriate setting and helping them to manage their health. However, like the wider NHS, primary care will undoubtedly face many challenges in 2014, particularly over how services are adequately resourced.
A key concern is that practice nurse numbers have decreased while the number of patients they care for continues to rise. In addition, we hear from practice nurses that they are receiving less access to professional development, despite this being essential for maintaining and acquiring new clinical skills.
The Royal College of Nursing wants to see moves towards a more integrated and person-centred approach in all areas of the health service in 2014. Insufficient investment in practice nurses and primary care risks undermining this approach and is short-sighted because of the consequent pressures that will grow elsewhere in the NHS. Now is the time to support the staff who are equipped to deliver excellence in patient care.
Peter Carter is chief executive and general secretary of the Royal College of Nursing