Emerging Leader Scholarship: Influencing and Developing an Integrated model of Diabetes Care with attention to One DSN team
Surrey and Sussex, has allowed me to develop leadership capability. As a Senior Diabetes Specialist Nurse (DSN) I want to be able to lead the diabetes team at Western Sussex Hospitals Foundation Trust in the future. Through a bespoke leadership programme I have been able to define long term career objectives and maximise professional impact. Additionally, by identifying a patient care improvement project, I have had the opportunity to practice leadership skills and raise my profile as a leader to our immediate team and wider stakeholders. During the scholarship period I have had promotion, due to the fact that the experiences through the scholarship enabled development of Nurse Consultant competencies.
Our experience was one of increasing complexity of healthcare needs, finite resources and increased pressures on services with diminishing workforce and capacity. As a senior nurse, I want to lead a service to deliver high quality, safe, patient care, ensuring the person seeing the patient has the right skills, the place of care is matched to patient need and the delivery of care is timely, preventing complications and promoting a healthy life with diabetes. People with diabetes should be empowered to manage their condition in the primary care setting, reserving specialist secondary care for the most complex of cases. Concurrent to my scholarship award, NHS England issued plans to transform national delivery of care, in recognition of rising demand, finite resources and a diminishing workforce. Importantly, these plans for new ways of working need to demonstrate sustainability.
I identified the need to transform services to enable a more integrated approach to diabetes care across primary and secondary care. It is necessary to identify and eliminate inefficiencies where possible in order for any transformation to be worthwhile and sustainable. One inefficiency is two DSN teams, as two separate providers, providing a mixture of diabetes services across primary, secondary and community care. This has resulted in inequity, inconsistency and duplication of care.
The Florence Nightingale Leadership Scholarship has enabled me to influence and lead as a clinician, through a bespoke leadership development programme. I have attended a leadership course at Cranfield University entitled ‘Accelerated Leadership Power’, had training on impact and presence from RADA and attended courses on measuring improvement which have developed my knowledge and impact as a leader.
I have networked within my own organisation and with leaders and stakeholders to influence the new model of integrated diabetes care. Through study trips, I have been able to contribute ideas following visits to Camden, London and Canterbury, New Zealand, where I have networked with leaders and gained on-the-ground knowledge of new ways of working. This has led to the building of a new model of diabetes care that has evolved with wider input from the local multi-disciplinary team via a steering group. From this early conception of the new model, I led the proposal for One Team of DSNs, as the new model demonstrated the need for One team for a more unified approach as a means to improve efficiency. The recognition for me to lead on developing One team has been enabled by the scholarship and dedicated time for leadership.
Gaining the Florence Nightingale Leadership scholarship has given me the opportunity to develop leadership skills, maximise professional impact and work on a patient care improvement project. Having the scholarship raised my profile as a leader and allowed me to be around the table to influence commissioning decisions. When meeting with commissioners and influencing a future state of diabetes care, it was decided that I should design a ‘One Team’ nursing model to help address the inequalities of diabetes care in the CCG and standardise procedures.
As I write this report, I am still on a journey of leadership and have the agreement of the Community Trust and Acute Hospital Trust for organisational and operational implementation for One team; the workforce model for this has yet to be confirmed. However, achieving this agreement is a cause for celebration, and has been facilitated by the learning and experiences I have had through the Florence Nightingale Leadership Scholarship.
I have become more aware of personal attributes and leadership capabilities through leadership diagnostics and have had the opportunity to reflect and read more widely on intrinsic enablers.
I can now appreciate the importance of aligning improvement projects with organisational strategy. This gives the project power and in times of difficulty or obstruction when leading forward, empowers decision-makers in organisations to advance the project and help prevent derailment.
I have discovered that a large project cannot be implemented in isolation by a sole person. Therefore, it is important to identify early on key stakeholders and followers ensuring they are appraised of project progress and can assist as necessary to advance implementation.
Building relationships is so valuable as it leads to the identification and establishment of trusting partnerships and useful networks. I have built relationships internally within our organisation and externally, including overseas, all of which add to a tapestry of ideas and diverse solutions that might not have been otherwise discovered. I have also found that these relationships are further enhanced through language and that my preferred medium of communication is face to face. Through face to face conversation, although using valuable time, the relationship is enhanced and the time given for the meeting is maximised to full potential, adding value to this leadership activity.
The overseas visit to Canterbury was, without doubt, a career highlight. I have experienced on-the-ground knowledge and gained unique insight into ideas and methodology which is adding impact and influence both to me as a leader and also to the diabetes team as I share the learning. This, in time, can only improve patient outcomes.
I intend to share my learning with colleagues and present to our executive board. I also intend to maintain contact with people I have met in Canterbury, perhaps building a partnership working relationship, to share experiences and exchange ideas. I have plans to publish an article and will also present my learning experiences from the scholarship, when opportunities arise.
My intention from the learning contract at the beginning of the year was to increase leadership skills, practice negotiation skills, manage change for significant improvement, experience resource management and increase Senior Nurse experience. I believe that I have achieved this and will continue to develop the skills that I have learned.
Finally, I would like to take this opportunity to thank The Florence Nightingale Foundation; the sponsor- Health Education Kent Surrey Sussex and Western Sussex Hospitals NHS Foundation Trust, for making the generous scholarship possible for my benefit to affect improved patient care.