Here we summarise key nursing policy documents that were intended to set the tone for the profession in England during the 2010s.
Background
Compassion in Practice: Nursing, Midwifery and Care Staff Our Vision and Strategy was a policy document published by NHS England in December 2012.
It was developed by Jane Cummings, then chief nursing officer for England, and Viv Bennett, director of nursing at the Department of Health and lead nurse at Public Health England.
The three-year strategy set out a shared purpose for nurses, midwives and care staff to deliver high quality, compassionate care, and to achieve excellent health and wellbeing outcomes.
It was built, said those behind the document, on the values, pledges and rights set out in the NHS Constitution that patients, the public and staff should and would expect.
The strategy, which was not directly backed with government funding, was underpinned by six fundamental values designed to support professionals and care staff to deliver excellent care.
The values were care, compassion, competence, communication, courage and commitment, and became commonly referred to as the “6Cs of nursing”.
Each of the six values, which were also backed by six areas of action, carried equal weight and focused on putting patients at the “heart of everything” that nurses do.
The aim was for the 6Cs to be universally adopted and embraced by everyone involved in commissioning and delivering care, and, therefore, to be an explicit part of planning guidance.
The 6Cs
The definitions of the 6Cs, as set out in the Compassion in Practice document, were:
Care – Care is our core business and that of our organisations, and the care we deliver helps the individual person and improves the health of the whole community. Caring defines us and our work. People receiving care expect it to be right for them, consistently, throughout every stage of their life.
Compassion – Compassion is how care is given through relationships based on empathy, respect and dignity - it can also be described as intelligent kindness, and is central to how people perceive their care.
Competence – Competence means all those in caring roles must have the ability to understand an individual’s health and social needs and the expertise, clinical and technical knowledge to deliver effective care and treatments based on research and evidence.
Communication – Communication is central to successful caring relationships and to effective team working. Listening is as important as what we say and do and essential for "no decision about me without me". Communication is the key to a good workplace with benefits for those in our care and staff alike.
Courage – Courage enables us to do the right thing for the people we care for, to speak up when we have concerns and to have the personal strength and vision to innovate and to embrace new ways of working.
Commitment – A commitment to our patients and populations is a cornerstone of what we do. We need to build on our commitment to improve the care and experience of our patients, to take action to make this vision and strategy a reality for all and meet the health, care and support challenges ahead.
Action areas
As well as the focus on developing and communicating the 6Cs, the strategy set out six areas of action where it said nurses could concentrate their effort and create impact for patients.
The action areas, which are explained in detail in the strategy document, were:
- Helping people to stay independent, maximising well-being and improving health outcomes
- Working with people to provide a positive experience of care
- Delivering high quality care and measuring the impact of care
- Building and strengthening leadership
- Ensuring we have the right staff, with the right skills, in the right place
- Supporting positive staff experience
A set of implementation plans, focused on each of the action areas in the strategy, was subsequently published in April 2013.
A further document, called Compassion in Practice: Evidencing the Impact, was published three years later in May 2016.
It concluded there was evidence to illustrate a wide range of programmes had been delivered and contributions made to service delivery.
The review also said the experiences of staff and patients suggested that, overall, Compassion in Practice had made a difference to the “people we care for and our workforce”.
It added that the evaluation of impact, as a whole, had provided an opportunity to reflect on what should happen next and how to improve in the future.
