Celebrating 10 years of the Northern Care Alliance’s Nursing Assessment and Accreditation System

Nursing teams across the Northern Care Alliance, Salford Royal, The Royal Oldham Hospital, Fairfield General Hospital in Bury, Rochdale Infirmary and North Manchester General Hospital, are celebrating a scheme which has become the bedrock of their work to improve standards for patients over the past 10 years.

The Nursing Assessment and Accreditation System (NAAS) was introduced at Salford Royal in 2008 as a mechanism to assure patients, visitors and staff that patients are receiving Safe, Clean and Personal care (SCaPe) every time.

It provides nursing teams with a set of standards and indicators, including patient experience, patient safety, end of life care, communication, infection control and team work, to strive towards with the end goal of achieving SCaPe status.

Wards are inspected on an unannounced basis and are assessed against the standards and given a level 0 to 3 (0=Red, 1=Amber, 2=Green, 3=Blue). A ward must achieve Green status three times, eight months apart before being awarded Blue, which is SCaPe status. This ensures that the ward can demonstrate reliability and sustainability of the standards.

Alongside a ward becoming a SCaPe ward, the ward manager is promoted to matron to recognise their outstanding leadership. A ward must openly display its SCaPe status to patients, visitors and staff on an information board at the entrance to the ward. 

Nursing teams were involved in the creation of NAAS and the system has created a great sense of pride and ownership amongst the organisation’s nurses and the colleagues they work with in their wards and teams.

With Salford Royal part of the Northern Care Alliance NHS Group with Pennine Acute Trust, NAAS was rolled out at Pennine’s hospitals towards the end of 2016.

Currently, 34 of Salford Royal’s 44 wards have SCaPe status along with 11 community teams who achieved it via the Community Assessment and Accreditation System (CAAS). CAAS was developed and rolled out in November 2012 to provide a framework for community teams and services.

Wards across North Manchester General Hospital, Fairfield General Hospital, Royal Oldham Hospital and Rochdale Infirmary are also making fantastic progress.

Two wards, J6 at North Manchester and Ward 2 at Fairfield, have both recently gained SCaPe status and 52 per cent of areas across Pennine Acute Trust now hold Green status.

Chief Nurse for the Northern Care Alliance Elaine Inglesby-Burke said: “At the heart of NAAS is the ambition for teams to reach and then sustain high standards of care for our patients. For me, it’s a very simple formula: Great leadership = Great teamwork = Great care.

“Working towards SCaPe status is a journey for the whole ward or service. It entails the nursing staff linking in with many other colleagues like housekeepers, doctors, allied health professionals and domestics whose input is vital in reaching the standards of NAAS.

“NAAS may be 10 years old now but when I see a team reach SCaPe status and the pride and excitement staff feel and the ward matron walking the corridors in the red uniform they move into upon gaining SCaPe, I can honestly say it feels as wonderful now as it did in 2008.

“When Salford Royal started working with Pennine Acute, we put different options to the teams at North Manchester, Fairfield, Rochdale Infirmary and Royal Oldham in relation to the system they could use to guide their standards. They were clear to us that they wanted to work to NAAS. We were thrilled as it demonstrated a clear desire to push for the highest standards for their patients.”

NAAS has been praised as exemplary practice by the Care Quality Commission in both Salford Royal’s 2015 and 2018 inspection reports (the Trust was rated Outstanding on both occasions).

Similarly, in Pennine Acute’s 2018 report when their rating improved from Inadequate to Requires Improvement, NAAS was cited as leading to clear improvements at the Trust.

Additionally, other Trusts across the country have emulated the NAAS scheme, for example, Gloucester Hospitals NHS Foundation Trust and the healthcare system in Jersey.

Elaine added: “Of course it’s great to have this external affirmation from the regulators and to see other Trusts using and adapting NAAS in their work to improve care for patients. It is a scheme that is proving to stand the test of time because it’s flexible and it has evolved and changed to meet the needs of the organisation and also external factors, such as changing guidance, for example, in things like pressure ulcer management.”