It is widely recognised that the NHS is facing unprecedented challenges in trying to improve the quality of services provided, while managing the most severe and protracted period of resource constraint in its history (NHS Confederation, 2014; Today’s NHS, 2015). The hour-a-day project was specifically designed by the author’s trust as an efficiency initiative, with the aim of saving an hour a day for each team member, releasing half that time as cashable savings, with the other half retained for the benefit of patient care. Saving time across 4,175 trust employees offered considerable scope for achieving efficiencies and reducing costs.
In addition to achieving savings where possible, many services report that they now make better and smarter use of their time and resources (Berkshire Healthcare NHS Foundation Trust, 2015). The hour-a-day initiative was in place from autumn 2013 and drew to a close at the end of February 2015. A total of 92 services completed the process and delivered a combined saving of £1.9 million. Berkshire Healthcare NHS Foundation Trust (2015) demonstrated that the project was not overly complicated and simply offered an opportunity for busy staff members to take a reflective but introspective look at the way they work. For the majority, the hour-a-day initiative acted as a springboard for staff and managers alike to address and solve problems together.
Sue Ridout describes her role as a nurse practitioner in community care for older people
Sue Ridout NDND, ENB Higher Award, R38 Triage in Primary Care is a Nurse Practitioner for Older People, Harborne Medical Centre, Harborne, Birmingham. Article accepted for publication November 2003
Frank Booth gives an overview of contracting for continence services within the NHS
Frank Booth RGN, DN Cert is a District Continence Advisor/Continence Services Manager, Flyde PCT, Lancs
Article accepted for publication: February 2004
In a two-part article, Joanne Bennett and Ann Robinson critically explore the complex role of the community specialist practitioner in district nursing together with some of the changing expectations for the service. This first article will explore the current context of practice, highlighting some of the dilemmas they face.
