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Major London hospital trust sets up new group to collect views of frontline nursing staff

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The largest NHS trust in England is inviting nurses, midwives and allied health professionals to join a “clinical senate”, as part of efforts to ensure they “a voice to be reckoned with” in the planning and delivery of services.

Barts Health NHS Trust’s new senate, to be chaired by its chief nurse Caroline Alexander, will be made up of about 80 people who will meet three times a year to debate key professional and care issues and identify potential solutions.

“I am very keen to have people who are not the usual suspects involved in this”

Caroline Alexander

Ms Alexander told Nursing Times that the initiative was designed to ensure the large organisation was “engaging properly from ward to board” and to “strengthen the voice” of nurses and others.

“Nursing in particular – but all of the disciplines I am covering in this – have not always had the loudest voice in this organisation,” she said.

“I want to make sure that if we are going to design the right care, right place, right time with the right staff, we have a strong forum for those voices to come together and really start influencing leaders like me as chief nurse – so I can make sure I am setting things in the right direction,” she said.

“The risk in big organisations like this is that nurse leaders go away into a room and agree strategy or policy,” she said. “I don’t want anything we decide to do in this organisation not to have been tested by people who live and breathe it.”

Ms Alexander said she wanted the senate to include nurses at all levels, from student nurses and healthcare assistants to consultant nurses and midwives and nursing leads, and was particularly keen to engage “harder to reach” groups.

“I am very keen to have people who are not the ‘usual suspects’ involved in this,” she said. “That might include healthcare assistants but also jobbing nurses – head down, getting on with it, nurses – the ones who might not normally feel able to engage in something like this.

“That is why we’re getting directors of nursing and senior nurses to really champion this, so people feel they would be supported if they put their head above the parapet,” she told Nursing Times.

“It is a different way of working that really is about collective leadership”

Caroline Alexander

As well as the trust’s own staff, the senate will include representatives from partner organisations including university deans and nurses on local clinical commissioning group governing boards.

Staff who wish to take part will have to go through an application process, which closes on 6 March, to ensure they are “committed” and have the backing of line managers when it comes to attending the half-day sessions.

Ms Alexander pledged that the senate was “not all talk”, and would result in practical action being taken.

“It will drive the business of the nursing, midwifery and AHP board – it is a different way of working that really is about collective leadership – our job is to deliver and enable and not always to make the decisions,” she said.

At its first meeting on 21 April, she planned to ask senate members to identify the top three things they would like to change locally from a clinical or professional perspective.

Individual priority issues would then be looked at in more detail by the group, including exploring what would and would not work when it came to making changes.

caroline alexander

caroline alexander

Caroline Alexander

“At the first meeting, I want them to come up with some of the things that are getting in the way or what they would like to see different,” said Ms Alexander. “It will then drive the machinery of me and my team to make sure we ask the questions, do the work and then go back and test it out, so it is a live environment for open and transparent change.

“It is a real opportunity for us to sense check some of the things that are going on in the organisation at the moment,” she said.

“I will be expecting stuff to come out around staffing, nurse associates and issues coming out of nurse induction,” she said. “But there will be some things we might not have realised, which is really good for us.”

Ms Alexander said the reaction from staff had been positive and “lots of people were very excited” about the concept.

Being part of the senate would also help nurses and midwives with their revalidation and may count towards continuing professional development (CPD), she added.

“I think it will give nurses, midwives and AHPs much more confidence to become the leaders of future and a voice to be reckoned with,” she said.

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