Do ward staff need the encouragement and support of their executive team to get on and make changes to improve everyday processes?
It was an unexpected question at the launch of the NHS Institute's Releasing Time to Care: Productive Ward programme at the Royal College of Nursing annual congress this week (see news, page 5). Its aim is to help ward staff spend more time on direct patient care.
The answer is no and yes. No, because at the heart of the Productive Ward programme are nurses and therapists on wards being empowered to look at how processes such as drugs rounds, ward rounds and discharges work, strip out what is stopping those processes from being better and releasing themselves from activities that prevent them from spending time on direct patient care.
Yes, because if the trust culture is not open to empowering staff only pockets of committed nurses and therapists will fight the system to make the journey, and trust-wide efforts to improve ward processes simply won't happen.
And if senior executives fail to recognise that more efficient wards will unlock improvements in patient safety, reductions in length of stay and improve staff satisfaction, the resources and flexibility essential to supporting ward staff trying to improve will be lacking.
Chief nursing officer Christine Beasley was right to encourage nurses at the launch to get on with the things that are in their control rather than talking about what they cannot change.
But chief executives, directors and managers must play their part in engaging with ward staff and creating the environment (including financial support) where their energies and enthusiasm can be properly harnessed.