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Better leadership training for nurses needed to change care models

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Nurses and other health service staff should be offered more leadership training opportunities within their own organisations to help transform models of care in the way outlined in NHS England’s five-year plan, according to a health think-tank.

Most of the funding currently provided to the national bodies responsible for providing leadership training should be re-deployed to local NHS organisations so they can find “the time and space to develop the skills needed in the future”, said the King’s Fund.

“Individual organisations must own…how they develop their leaders and equip all staff with skills in quality and service improvement”

Chris Ham

The think-tank warned that NHS England’s ambition to see primary, community and acute care fully integrated would not be realised unless leaders were developed at a local level to ensure clinicians help develop the new models.

It claimed that “most” of the 1.4 million people who currently worked in the NHS were not focussed on NHS England’s Five Year Forward View, which includes proposals that could see nurses and midwives take on a stronger leadership role in community settings.

In a report published today, the King’s Fund proposed that NHS organisations should take on an individual responsibility for cultivating leaders that will engage clinicians about the NHS England plan.

Some of the models proposed in the five-year plan would see clinical leadership in primary and community care expanded to include more nurses, therapists and other professionals, while others would make it easier for midwives to set up their own NHS-funded midwifery services.

“When you go beneath the surface level of GP leaders locally…I don’t think there has been any penetration of thinking about the new care models”

Chris Ham

“The principle responsibility [for leadership development] should rest within the NHS itself,” said King’s Fund chief executive Chris Ham.

“Individual organisations must own and give priority to transformation of care and how they develop their leaders and equip all staff with the skills in quality and service improvement,” he said.

He added: “When you go beneath the surface level of GP leaders locally who do understand where we’re trying to get to, I don’t think there has been any penetration of thinking about the new care models and I’d say exactly the same about most staff who work in mental health, in community and in hospitals.”

The think tank’s report – called Implementing the NHS five year forward view: aligning policies with the plan – suggested that each NHS organisation should be required to report to a national body to show how much money was being spent on leadership training and which professionals were being put forward for it.

NHS England

NHS England chief executive Simon Stevens

This theoretical body could potentially be created from a merger of two existing bodies – the NHS Leadership Academy and NHS Improving Quality. It would provide support to NHS organisations on their leadership training and only deliver certain programmes, such as the graduate management training scheme, at a national level.

Speaking at the launch of the report, NHS England chief executive Simon Stevens said the challenge for nurses in helping to implement the Five Year Forward View would be for them to devise ways of working that increase “fluidity” between different healthcare disciplines.

When questioned about how there could be a robust national workforce plan if each NHS organisation were to experiment with different models of care and staffing mix, he said this tailoring of services should not be a substitute for “more coherent national action” on issues such as workforce planning.

He said: “So on workforce, one of the things the national bodies – Monitor, NHS Trust Development Authority, NHS England, Care Quality Commission, Public Health England, Health Education England – are doing is creating a national workforce board that is bringing together a space where we can have this conversation about what is required.”

Mr Stevens said he expected this work to tackle issues such as the high NHS spend on agency nursing, which should be “top of the action lists for hospitals”. ​

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