Essence of Care Background

• Enables practitioners to sit down together in a supportive way to discuss what is best practice and what change process is necessary to deliver it

• Encourages team work within areas and networking between areas 

• Allows innovative practice to be recognized & celebrated - enabling others to learn from good examples

• Getting the basics right and improving the patient experience

• Process is supportive & enabling. It does not involve competition

Benchmarking is a great opportunity for all staff directly involved in patient care to lead a focus upon the quality of basic patient care. It gives us an exciting opportunity to make a difference by critically appraising and being explicit about gold standards (or “A” standards) of care we should all work towards. 

The Essence of Care is an empowering tool that offers us* the prospect of identifying and leading change that will directly benefit our patients and their carers.   

*us = health care staff working at patient level who can really see what changes are needed and how best to make them - "Essence" is not a management tool or a manager's stick!

THE ESSENCE OF CARE- Patient -focussed benchmarking for health care practitioners

The NHS Plan reinforced the importance of getting the basics right and of improving the patient experience.

The Essence of Care, launched in February 2001, provides a toolkit to help practitioners to take a structured approach to sharing and comparing practice, enabling them to identify the best and to develop action plans to remedy poor practice.

Patients and professionals worked together to agree what is best practice in what might be described as the softer aspects of care, which are crucial to the quality of care patients' experience.

These areas currently include:

• Principles of self care
• Food and Nutrition
• Personal hygiene and mouth care
• Continence and bladder and bowel care
• Pressure ulcers
• Record keeping
• Safety of patients with mental health needs 
• Privacy and dignity
• Communication

Nine fundamental aspects of patient care, designed with the aim of recognising and spreading best practice, have been introduced across the NHS as part of its commitment to drive up quality. The nine areas addressed by The Essence of Care document are all seen as fundamental to achieving the basics of care.   The Essence of Care, developed with the active participation of patients and their carers as well as hundreds of health professionals, offers a practical toolkit to be used as part of quality improvement programmes. It is also an integral part of clinical governance at local level.    

WHAT ARE THE AIMS OF BENCHMARKING ?  

At present there are unacceptable variations in care standards across the country, with the quality of care received depending on where you happen to live. The purpose of benchmarking is to raise standards across the whole country to achieve a truly NATIONAL HEALTH SERVICE.    

Consequently, the aims of benchmarking are as follows:  

1. To improve and ensure consistency in the quality of the 'softer caring' aspects of care  
2. To build on the success of others    

HOW WERE THE NATIONAL BENCHMARKS CHOSEN ?  

The national benchmarks were identified as areas of concern by both patients & practitioners.   These 9 national benchmarks were established after a review of the following:   * Patient complaints * Ombudsman reports * Professional practitioners views * Patient/consumer feedback

* Professional Conduct Committee meetings   

For each of the nine areas of care The Essence of Care benchmarking tool includes:

1.    An overall statement, which expresses what patients want from care in an area of practice.

2.    Suggested monitoring information that is currently gathered, which may let staff know that action is required to improve poor practice or that good practice exists which should be shared with others.

3.    Elements of practice that support the attainment of the patient  focused outcome.

4.    Patient focused best practice in each of the factors, THE BENCHMARK - which is placed at the extreme right of a series of statements and allotted an A score.

5.    A scoring continuum for each factor. These statements guide practitioners in awarding their own practice a score, and provide stepping stones for practitioners to consider taking, in order to achieve best practice.

e.g. Factor 4:- Assistance to eat and drink

          E                                 D                     C                           B                                  A

e.g. FOOD AND NUTRITION

USING ESSENCE

1.     An area of practice is identified as in need of improvement or as an area where good practice could be shared.

2.     A comparison group with membership from all who may have an impact on attainment of good practice, which includes patient representatives, identify together what practice would justify a claim that the patient focused benchmark has been attained.

3.     The comparison group members consider how near achieving the benchmark they are and then make an action plan together to help them improve practice or to share with others.

4.     Practice improves as reflected in monitoring of patient experience.

 
NOTE: For more information visit

http://www.cgsupport.nhs.uk/Programmes/Essence_of_Care_Programme.asp   where the patient-focused benchmarks for clinical governance, April 2003 (Word Documents) can be downloaded.This site also contains relevent National information about the programme and contacts.