NHS leaders are being urged to support changes to clinical practice it is hoped will save more than £9bn a year.

The savings opportunities are explained in an NHS Institute for Innovation and Improvement document, setting out how organisations can implement the eight “high impact actions” unveiled by chief nursing officer Dame Christine Beasley last November.

The eight high impact actions include preventing pressure ulcers, falls, sickness absence and urinary tract infections, while encouraging better nutrition and end of life care, normal births and nurse led discharge.

Speaking to HSJ’s sister title Nursing Times, Dame Christine stressed the importance of good leadership.

She said: “We need to engage frontline staff and need leaders in all of their organisations to support this so it happens across whole hospitals and whole healthcare communities.

“We need leadership throughout the system to make that work.”

The Department of Health will continue to monitor progress and work with nursing directors to identify other possible high impact actions.

Dame Christine said this could include specialist areas such as mental health.

The guide, High Impact Action for Nursing and Midwifery - the essential collection, says: “A few nurses and midwives may still think that money is someone else’s business, but those that think this are, quite frankly, out of touch with reality - opting out isn’t an option.

“Addressing financial inefficiencies is a key personal, professional and moral responsibility.”

A major theme in the 260 page document is good communication and the need to disseminate good ideas for reducing waste. It also highlights the need to carefully analyse the costs and benefits of any changes, and draws on lessons learned from trial sites that have already started to see results.

One of the case studies is Kettering General Hospital Foundation Trust, which has reduced skin damage by 80 per cent.

Lead nurse for tissue viability Colin Iversen said the guidance helped to challenge the traditional “lack of commercial awareness” among some clinical staff.

He said: “Dressings cost £3 but a company like [clinical devices manufacturer] Smith and Nephew makes millions each year. Nurses might not see the bigger impact of the cost of what they do and that is now going to be made apparent.”

Clinical engagement is about more than GPs