Posted by: ayrshirehealth | December 31, 2014

If I were granted three wishes by @fionacmcqueen

It’s what we do well in healthcare

At the gate of the year we are usually drawn to reflecting on the past year and then looking forwards to our future. 20142014 has been a momentous year by anyone’s standards; and not all in a positive way.

We started the year reeling from the helicopter crash into the Clutha Bar, and finished with the tragedy at George Square. And whilst our thoughts are with all those who are experiencing suffering and loss, you can’t help but be proud of the way that emergency services responded to those in greatest need. It’s what we do well in healthcare – and indeed wider.

So looking forwards to 2015; what’s in store for us? Well, I hope the energy and public engagement realised during the referendum campaign, never goes back in its bottle. If we are to truly make progress in improving outcomes for people, and co production, then we need that level of community and personal engagement.Three wishes

So, what am I hoping will be in store for us this year? What would my three wishes be?

Well, firstly that sub-optimal care is a thing of the past;

secondly that nurses and midwives embrace health and social care integration as a way to improve people’s lives;

and thirdly that revalidation of nurses and midwives makes sure that only those who are fit to be nurses and midwives are to practice.

Sub-Optimal Care a Thing of the Past  

Well, in the wake of the Vale of Leven public inquiry, the reviews of NHS Grampian, and HEI inspections showing a lack of cleanliness across most of our hospitals, my first wish has to be that this is the year we eliminate sub optimal nursing. Vale of Leven

This has to be the year that poor care becomes a thing of the past. I know we are delivering care in a challenging environment, and I really do understand the pressures clinicians experience on a day to day basis; however the leadership challenge has never been greater or the rewards so rich.

I honestly believe the tide is changing and if we don’t move with it the profession will lose a real opportunity to transform care.

Health and Social Care Integration

April 2015 sees health and social integration ‘going live’. Again, a real opportunity to do things differently. IntegrationI’m disappointed that many partnerships are taking a minimalist approach to which services are being included. I can’t see how we can transform public services by statutory bodies such as health and local authorities clinging on to ‘their’ services and not fully embracing the new order and new way of doing things.

None the less, nursing in an integrated world will offer opportunities to deliver services and support health improvement in a way that has never been available to us before.


NMCAnd finally, by the end of the year, the NMC is expecting revalidation of nurses and midwives to be live in the UK; a response to the tragedy of the poor care that was delivered at Mid Staffs. Clearly the care that was delivered in Mid Staffs was in many areas shameful, and revalidation is part of the answer to safeguarding standards.

But only part of the answer.

2020 Vision

Holding powerIn reality if we are to take that final leap towards the 2020 vision and truly transform the populations’ health as well as the delivery of care, leadership across all levels of the profession is required in measures that we haven’t previously seen.

Whether this is from our new graduates who can bring freshness and enthusiasm, from our Senior Charge Nurses or our more senior nurses within our services, this is a time for all of us to learn from the past and move forwards with courage and determination.

Paradox of Poor Care

Appreciative enquiry shows us how well we provide care and support right across our communities of practice. screen-capture-14However it also shows us where we need to focus our improvement efforts. The paradox of excellent care and woefully inadequate care being delivered practically cheek by jowl is perplexing, but with determination and minds open to change, I’m confident that poor care can be a thing of the past.

Tea cupCaring for someone for two months and not knowing whether they like tea of coffee; again this must become exiled to history of nursing books, when we can laugh at the absurdity of it, just as we laugh at the absurdity of parents not being allowed to stay with their children.

Time for change

screen-capture-17So, if the recent inspection reports aren’t enough of a catalyst for change; what is? Conditions and the climate to improve care are ready and waiting, in the form of revalidation, and integration. Care within our hospitals has been transformed by the Scottish Patient Safety Programme, in some areas beyond all recognition.

Family Nurse Partnerships and our Early Years Collaboratives are producing some world class improvements in people’s lives.

So what makes us reluctant to believe that we can be truly person centred in everything we do? From protecting that unborn child to supporting someone to a peaceful death at home?

Our time is now

Yes, finances will be tight in the public sector for the next generation; yes our workforce is getting older (and unfitter); yes we work in an incredibly complex environment with two elections coming up; and yes, social change gives us a much more challenging backcloth form which to deliver care.

But we were called into professions that always puts people first, and that puts us in such a privileged position we must act.

Our time is now.

Don’t wait. The time will never be just right………..

This week’s blog is by @fionacmcqueen (Fiona C McQueen), Chief Nursing Officer for Scotland (interim) at the Scottish Government.


  1. ……….let those amongst you that are perfect cast the first stone………
    I see you mention hospitals,other than the one you are/were responsible for.

  2. there is an old saying …….”less jaw work,and more paw work”…….this could be the answer,to bad care and indifferent doctors.

  3. As a student of Biomedical Science and a parent carer in Ayrshire, I look forward to a future of continued support from our wonderfully, supportive paed team here in our county!

  4. Thank you for your overview of the year Fiona…I enjoyed that. I truly believe we are getting better at delivering person-centred care. There are some terrific examples across A & A, and I’m sure in other Health Board areas too. You’re right though in that every experience should be good for every person – we should never tolerate care that falls below the high standards we set.
    I think the climate’s right at present though for transformative change…the Scottish Government is ensuring the strategic and policy direction is in place to support healthcare workers. Integration will be exciting (and I’m sure challenging at times) for all but I believe it offers us the best opportunity we’ve had in decades to truly improve care in our communities. Here’s looking forward to 2015! All the very best in the coming year.

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