Leadership scholarship: Dr Chris Caldwell

Introduction 

I had the great honour to be awarded a Florence Nightingale Leadership Scholarship in November 2015 which I pursued during 2016 and into 2017. Although I will formally conclude the programme of development and other activities in summer 2017, I know that I will continue to benefit from the experience and my learning will extend well into the future. Indeed I believe that the Scholarship will have a fundamental influence through the course of the rest of my working life.

Background

Through my career I can pinpoint several pivotal moments. On reflection, each of these points has been marked by my engagement in a significant leadership development programme. I was drawn to the Florence Nightingale Foundation Leadership Scholarship, as a consequence of my doctoral studies, during which a vocational passion for nursing, which I had feared lost, was re-ignited. I decided to set out on a mission to try to make a significant personal contribution to the profession. I knew that the Foundation’s Scholarship was exactly what I needed to propel me forward within nursing, and I can honestly say that it has delivered beyond my imagination. I was supported in my pursuit of the Scholarship by my managers at the North Central and East London local office of Health Education England and my Scholarship was aptly sponsored by the London Network of Nurses and Midwives. It has provided a privileged opportunity to engage in a programme of development activities and experiences which have equipped me with the skills and resources to set out on my mission for nursing, and, as an unexpectedly bonus, the confidence boost I needed to step into an executive nursing role.

Learning and Development

During my scholarship I engaged in a range of opportunities for learning and development:

• The application processrequired me to reflect on my career to date, appreciate where I had come from and clarify what else I wanted to achieve before the end of my career, the skills and knowledge I would need to acquire and how I might gain these
• During the scholarship interviewI was challenged to articulate my vision with clarity, find voice for an unexpectedly powerful emotional commitment to securing the future of the nursing profession, and see how it resonated with my interview panel and sponsors (and subsequently with my fellow scholars)
• The diagnostic assessment, including a 360-degree review of my leadership, emotional and political intelligence Myers Briggs profile and learning style helped me, through guided reflection and challenge to acknowledge and ‘own’ a set of strengths and characterise what else I needed to both learn and unlearn. Perhaps more importantly it also helped me to recognise howI wanted to practice, specifically, to exert the leadership required to be successful with the patient care improvement project. The assessment was accompanied by guidance on potential learning opportunities and experiences which might address the needs identified
• The Harvard/Stanford Leading Change and Organisational Renewal programme, particularly the Group Process element, gave me an opportunity to engage in an illuminating inquiry with fellow Scholars and gain confidence in my decision to adopt a collective approach to my leadership
• – With my mentor I designed a programme of shadowing, visits and guided readingactivities which I met with many of my nursing ‘heroines and heroes’ to learn about how they have built and sustained the courage to be activists in the service of the profession. This included afternoon tea with Baroness Emerton in the House of Lords just prior to her retirement
• I spent time talking to my mentor and others from outside of nursing, in the political and wider public sector field to gain a wider perspective on nursing and health care and to hone my political skills to influence effectively in complex and sensitive contexts. My mentor also spurred me on to have courage in my conviction and through sitting in the House of Commons Health Select Committee and I was learned to appreciate the important of health economics and the need to build a business case to demonstrate return on investment in any initiative
• TheRADA ‘Communication skills for Leaders’ programme helped to building my confidence as a public speaker and strengthen my personal impact. Subsequently, I have spoken to many different audiences, drawing on my new skills to inspire others to join our ‘movement’ for change and reaffirm their own ‘joy’ in nursing work. I am particularly proud that I could co-facilitate a masterclass at the Florence Nightingale Foundation Annual conference with fellow Scholar Lorraine Szeremeta which was very well received.
• A study tour to Canada and the USAwas a collaborative learning journey with fellow London nurse leaders to five health care systems in Toronto, Chicago and Boston, including a bespoke experience at the Institute of Healthcare Improvement. The tour enabled us to reflect together on what we have in London already and co-create how we might share it more widely as well and sharing what we learned from others internationally for the benefit of the Capital and more widely. We returned with a shared vision and powerful and sustained commitment to collective endeavour to rekindle within nursing what IHI term ‘Joy in work’[1]. I also gained an amazingly supportive group of friends and allies. All of this was what was required to achieve success in my patient care improvement project.
• One-to one executive coaching, co-consultingwith peers and coaching training – I have engaged in 1:1 executive coaching with a professional coach and co-consulting with Fellow scholars to further examine and enhance my leadership practice. I am currently completing Executive Coaching for Organisations at Ashridge Business School to enable me to work in the future with nursing and other colleagues to help them to sustain their resilience to practice and pursue their own professional visions for the benefits of patient care.

Professional development

The scholarship experience has contributed significantly to a change in job role. I have taken up an executive Nurse Director role at Tavistock & Portman NHS Foundation Trust in London. I am also now the Programme Director for CapitalNurse.

Patient Care Improvement Project

Background

My patient care improvement project involved establishing a programme of activity focussed around one work stream of the CapitalNurse programme. Two years ago, the nursing leadership community across London came together to take collective action try to address the challenge of securing enough nurses with the right skills in the right places across the Capital so that the people of London could always receive excellent nursing care when they needed it. The CapitalNurse programme was formed, and is sponsored jointly by HEE, NHS England and NHS Improvement in London. It has three work streams focusing on Training, Recruitment and Retention. I chose to focus on the retention workstream with the aim of establishing the work stream and setting it out on a programme of delivery during the time of my scholarship.

Aims

The overall aims of the project is to improve retention rates for nurses working in London. The project metric is that within 2 years the mean one year retention rate of newly registered nurses in the NHS in London will be at least 85% (it is currently just over 83%).

The project has objectives linked to two areas of work: a specific focus enabling career progression and another related to examining good practice in the retention of nurses which focus on ‘what matters to me?’

• To develop and support a standardised London wide approach to education, career development and progression
• To reduce variation in approaches to post-registration raining and development to create excellence in nursing practice and improved outcomes for patients across the capital
• To identify, study, measuring and spread ‘nurse friendly’ employment practices.

Process

My project consisted of the following phases to date:

1. initiation: Following the initial whole programme brainstorming workshop a core group was formed, the initial idea outlined and provisionally scoped
2. Planning: The planning phase involved creating a brief including our vision and aims resources, governance and evaluation. Research was conducted to support the project through commissioning literature reviews, networking locally and nationally and through an international study tour. A research programme has also been commissioned to enable evaluation and to share learning.
3. Execution: We are now in the midst of delivering a range of project activities.

Activity and outcomes to date:

• The development and launch of a digital carer development framework for nursing (due Nov 2017)
• A project to harmonise the quality, experience and outcomes of preceptorship programmes across London (findings implemented September 2017)
• Developing a pan-London ‘passport’ to standardise training and certification to administer cytotoxic medication (launches September 2017)
• Agreement on a common approach to obtaining ‘qualification in specialism’ in urgent and emergency care nursing (to test in autumn 2017)
• A peer network and testing ‘grow your own’ model to training nurses for children and young people’s mental health care (network launched June 2017)
• A systems leadership programme to support older people nurses to agree a common approach to training in specialism (programme commences September 2017)
• An engagement and communications strategy to enable nurses to come together to promote ‘joy in work’ through celebrating nursing in the capital and sharing good practice in recruitment and retention (two conferences held – over 600 nurses engaged).

These phases will be followed over the next 18 months by phases of deployment and evaluation.

Additional reflections and acknowledgements

Through reflecting on the outcomes of the learning and development I have engaged in, undertaking the patient care project and the personal development that has been achieved, I can appreciate that the Scholarship has given me the courage and confidence to flex my leadership practice to work collaboratively and to trust an innovative and creative process through which to inspire others for the development of nursing and health care.

The many experiences and consequences of this Scholarship year are the result of the support, encouragement, enthusiasm, coaxing and cajoling and challenge provided by wide range of people. I cannot name them all here but I particularly want to acknowledge just a few.

Firstly, and most importantly, I must thank the Florence Nightingale Foundation for the opportunity they made possible by awarding me the Leadership Scholarship.

Next, my award sponsors, The London Network of Nurses and Midwives and their originator, Dame Christine Beasley. I have been fortunate to work with Chris over the last few years, first at the Department of Health, when she was CNO and then at Health Education England whilst she was Chair of the North Central and East London Local Education and Training Board and now as Chair of HEE for London and the South East. Chris is the ultimate ‘Capital Nurse’ and I am inspired by Chris’s ongoing passion, enthusiasm and practical commitment to the nursing profession. I hope that through my work I can, in some way, continue to pursue her vision for nursing in London and nationally.

I also want to thank my mentor, Lord Philip Hunt. Philip encouraged me not to lose faith, and helped me to appreciate nursing within the wider context of the current political landscape, whilst remaining optimistic. Baroness Audrey Emerton is another inspiration, reminding me of the ultimate value of personal integrity.

Liz Robb has been a significant support, encouraging me to apply for the Scholarship a second time and offered encouragement during difficult times. Janet Shallow and colleagues in the FNF office have always been there to tirelessly respond to my many requests.

I would also like to thank my sponsoring manager, Therese Davis, without whose support none of this would have been possible and my team and wider colleagues at HEE, for a being brilliant group of people to work with and try out new things and then take these to pastures new. I would like to thank Paul Jenkins for inspiring me to make a significant career move, to Lis Jones and Abi Masterson for encouraging me to take the leap, and my new colleagues in the Trust and across mental health care for welcoming me so warmly. I would like to thank and celebrate the hundreds of nurses, students and other colleagues across London who have embraced CapitalNurse with such joy – may your enthusiasm, commitment and infectiousness continue to spread. Finally, I would like to thank my family, my friends and the Quartet for their ongoing support and patience. It is in relationships with each of these people that I have could learn, apply, test, reflect, develop myself and deliver the aspirations of my patient care project and it is with and through them and others in the future that I hope what has begun will continue.