Day Five: My 10-point plan for change by Christina Patterson


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1 Reinforce the responsibility of the ward sister for the quality of the nursing care delivered to all the patients on his or her ward.

2 Ensure that all hospitals introduce "intentional rounding", where nurses visit patients at least once an hour to ask them about their needs.

3 Ensure that all patients are briefed when they arrive about who does what on the ward, and given a leaflet explaining what they can expect from the care they receive, and who to speak to if they have concerns.

4 Ensure that all nurses are aware of their responsibility to uphold the values of the NHS constitution, and of the action that will be taken if they don't.

5 Remind all nurses of their "duty of candour" to speak out if they see poor care.

6 Introduce a minimum level of training for health care assistants.

7 Ensure that all overseas nurses are tested on language skills, and given the support to reach the necessary standard if they're not up to scratch.

8 Ensure that all nursing courses include training in effective communication and empathy.

9 Ensure that all CEOs and board members of trusts make regular visits to wards. And that all trusts ask all patients about their care at the end of their stay, and publish, and display, the results.

10 Introduce a pledge, to be renewed every five years, for all nurses to deliver compassionate care.

If you agree with this 10-point manifesto, please write to your MP, the chief executive of your NHS trust, and Andrew Lansley or Anne Milton (Department of Health, Whitehall, London SW1A 2NS)

Special report: A crisis in nursing

* Day One: Six operations, six stays in hospital – and six first-hand experiences of the care that doesn't care enough
* Christina Patterson: More nurses, better paid than ever – so why are standards going down?
* Leading article: What can and should be done about nursing
* Day Two: Reforms in the 1990s were supposed to make nursing care better. Instead, there's a widely shared sense that this was how today's compassion deficit began. How did we come to this?
* Day Three: How can a profession whose raison d'être is caring attract so much criticism for its perceived callousness? Does nursing need to be managed differently? Or is the answer to develop a new culture of compassion?
* Day Four: The nurses who taught an ailing hospital how to care
* Day Five: My 10-point plan for change by Christina Patterson
* 'Nurses do not wake up each morning intent on delivering poor care...'
* Anne Milton: 'We need to raise the bar'
* Leading article: Manifesto for better nursing