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DH – Leading the nation’s health and care The Carter Review: The Findings of Specialling (Enhanced Care) programme Lyn McIntyre MBE Senior Nurse Adviser – Workforce Efficiency
DH – Leading the nation’s health and care
The Carter Review: The Findings of
Specialling (Enhanced Care)
programme
Lyn McIntyre MBE
Senior Nurse Adviser – Workforce
Efficiency
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What Are The Aims of the Carter Report?
“As Chair of the NHS
Procurement & Efficiency
Board Lord Carter will
help the NHS to cut
waste, save money and
drive efficiencies which
can then be spent on
frontline patient care.”
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Interim Report
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Final reportCarter report –
Recommendation 2g
Trusts implementing the
guide on enhanced care
(previously referred to as
‘specialling’) by October
2016, which will be
monitored by NHS
Improvement, using an
approach developed by
them as an improvement
priority;
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Specialling Project: Aims
• Raise awareness of the differing physical and mental
health conditions where specialling may need to be
commenced
• Recognise the centrality and importance of patient
engagement and therapeutic alliance
• Support the development of a robust specialling policy
which can be integrated into clinical practice
• Recognise how improvements can be delivered within
current budget constraints
• Sharing good practice and lessons learnt
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Specialling numbers
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Policies, risk assessment and terminology
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Areas of review & development
• Theming – areas of highest use, difference in days of week,
periods of specialling
• Understanding of ‘who’ currently specials – ‘highest risk
patients’
• Run charts – impact of improvement and use of PDSA
cycles and ramps
• Specialling ‘pool’
• Increased establishment
• Terminology
• Use of security staff to undertake or support specialling
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Evaluation 1
• Delegates found it rewarding to learn from each other
• To develop a coherent national plan – including agreeing
national terminology and processes
• To recognise risk assessments and scoring charts currently
in use and evaluate them making evidence based
recommendations for national use
• To investigate and articulate the skills which will lead to
national training guidelines and resources demonstrating
‘what good looks like’
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Evaluation 2
• Recommendation that Trust Board members
undertake an hours observations
• To consider differing clinical needs and clinical areas
and investigate skills specific to that area
• Highlight as an area of importance for NHS
Improvement
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‘Patients may not always
remember what you said but they will remember how you made
them feel’
(Anonymous)
