Learning from excellence.

Abstract

The mass media as well as professional press seem to delight in the dissemination of ‘bad’ news. We hear unending stories of poor Care Quality Commission (CQC) ratings, struggling health professionals who feel insufficiently rewarded for their efforts, and appalling accounts of neglectful care or worse. To buck this trend, this column will celebrate success and highlight what may be learnt from an organisation and individuals who are role models for community nurses aspiring to offer the highest quality of care possible. Some community nurses have an ambivalence about GPs because they view them as individualistic and focused on goals related to the success of their general practice rather than the wider community. However, it is important not to make assumptions. That said, the nurse-led Cuckoo Lane Practice in Hanwell, West London, achieved haloed status this year — they were awarded outstanding CQC ratings after a visit in January. The CQC (2015) report explains in detail how, as an organisation, Cuckoo Lane Practice is distinctive and deserving of its outstanding ratings. The practice is particularly commended for its contribution to helping its patients stay out of acute and mental health secondary care, and its innovative practice involving an Age UK support worker, transport to the practice, and engagement in a borough-wide diabetes care redesign. Importantly, every activity is wholly focused upon the patient and achieving the best possible outcomes from a holistic perspective. Thus, there is an emphasis on open communication and good care coordination and linkage across sectors underpinned by care decision making, based on a coaching model and mutual participation with patients and a readiness to ‘think outside the box’. As a visitor, you are struck by the quest for constant improvement and the open culture that is nurtured by short daily meetings, regular multidisciplinary team (MDT) and clinical meetings, and the engagement with and alignment of all practice staff members in the aims of the practice. The district nursing staff are not embedded in the practice but come from the local community provider, which has its challenges in terms of good communication and personal contact. Community nurses can learn much from Julie Belton and Carol Sears and their practice colleagues. The Queen’s Nursing Institute’s (QNI) Annual Conference in late September, with its theme ‘Inspire, Innovate, Implement’, provided a forum to hear about initiatives involving community nurses and for the exchange of ideas. Tommy Whitelaw, Project Engagement Lead, Health and Social Care Alliance Scotland, gave a powerful and moving speech, reminding the delegates that good nursing practice delivered in the home can make an immeasurable difference to both their client and the client’s carer; few of those present will forget his message, couched as it was within his personal experience of caring for his mother. The conference’s parallel seminars and posters showcased a broad range of initiatives, including the new QNI and QNI Scotland’s (2015) District Nurse Education Standards. The creative ideas that community nurses employed to improve the local services to meet the needs of their patients, families, and carers were impressive, as was evidence of the difference that the initiatives had made in terms of health outcomes, health-care usage, and care experience. A recording of the conference is available on the QNI website (www.qni.org.uk). Autumn can be a time when the enthusiasm of health professionals dissipates after the summer, in anticipation of the challenges that come with an increase in workload associated with winter influenza and other triggers to exacerbations of existing health problems. The Cuckoo Lane Practice provides an exemplar of a highly professional problem-solving organisation that is determined to deliver the very best to its patients holistically and to excel. The Practice is ‘special’, but there is no reason why organisations delivering community nursing services could not be ‘special’ too.