Nationally the NHS has a significant workforce challenge across all professional groups and nursing in particular is facing a huge shortfall in numbers. This is impacting in most areas and primary care in particular is facing a huge crisis in the next 5-10 years as in some areas more than 25% of the practice nursing workforce are due to retire. It is now recognised nationally that the whole NHS workforce including nursing must adapt and start to enhance existing roles and develop new roles to cope with the workforce challenge and ensure we can sustain services and maintain safe and high quality care. The recent approval of the Nursing Associate Role is a good example of a necessary response to the challenge.
However, if we are to develop and embrace new roles and new ways of working we need to be confident that there is robust governance in place to ensure staff are supported, enabled and developed to deliver safe and appropriate levels of care. In my experience prior to this scholarship as a new Chief Nurse in a CCG I noted an apparent significant level of variation in the use and supervision of non-registered nursing roles in GP Practices. The aim of my care improvement project was to evaluate the role of healthcare assistants across 35 GP practices in one Borough and to benchmark the role against a new national career framework. The primary outcome of this work was for the CCG to have greater assurance about professional boundaries and to develop a standardised role description for non-registered nursing roles in local GP Practices.
Secondary outcomes included:
Reduced risk in primary care (better clinical governance)
- Establish a local training framework for these roles
- Identify where the new ‘nurse associate’ role could complement nursing in primary care and help address the workforce shortages
This work is continuing but the findings to date are facilitating improved staff support which will indirectly ensure better standards of patient care.
Through undertaking the Florence Nightingale Leadership Scholarship I have improved my leadership skills and networks and have learned how to be a stronger leader. I have been able to undertake development to improve my presentation of self and the impact I have in meetings and on others. Through reading and meeting people during this journey I have increased my understanding of Health Education England and issues relating to nurse education, regulation and professional boundaries and I have been able to apply these to primary care in my role.
I spent a week at IHI in Boston and this has enabled me to understand their mission and learn about the science of improvement and more importantly it has enabled me to implement this as a leader and use the learning to affect and drive local changes to health and social care. I am now a convert and enthusiast for quality improvement methodology and this will shape me as a leader!
The opportunity to undertake this Florence Nightingale scholarship has been invaluable and has had a significant impact on my personal development and impacted on my ability as a leader in my current organisation to the benefit of staff and the patients we serve. It has enabled me to further enhance my underpinning knowledge of leadership styles and of organisational development and to develop my own skills and attributes. As a consequence I believe I am now able to lead with courage, tenacity, integrity and ambition and have an ability to lead an organisation and people through significant transformational change. In addition, by understanding my core values and drivers I have been able to translate these into practice and start to effectively improve the culture of an organisation. The scholarship has enabled me to refine and improve my networking skills and has improved my understanding of the political context of the NHS and how to use this to my advantage in my current role and for the benefit of my local area. I have been able to secure my first Chief Executive role during the scholarship and my quick adaptation into this role was helped by the scholarship. The learning from my project will have an important impact on nursing in primary care in St Helens and potentially elsewhere.