The new chief nursing officer for England has vowed to foster greater positivity about the profession and to promote a “contemporary” image of nurses and midwives by stamping out old stereotypes.
In her first interview with Nursing Times since becoming the country’s most senior nurse at the start of this year, Dr Ruth May has outlined the goals she wants to achieve while serving in the role.
“I’m very, very proud to be a nurse. It’s really important to me that we celebrate the profession”
She told Nursing Times that boosting pride in nursing and midwifery was her “first priority” and was one of four “cornerstones” that she wants to focus on during her tenure.
“I’m very, very proud to be a nurse,” said Dr May. “It’s really important to me that we celebrate the profession, celebrate the achievements, our diversity [and] the contemporary nature of the profession for nurses and midwives.”
In a move welcomed by nurse leaders, she is also set to reclaim a space for the CNO at the heart of the government.
Before Dr May was confirmed in the role, it was announced that the next CNO after Professor Jane Cummings retired would sit across both the government arms’-length bodies, NHS England and NHS Improvement, in their new joint NHS executive group.
However, it has now been confirmed that Dr May will also be working across the Department of Health and Social Care as health secretary Matt Hancock’s direct advisor on nursing policy.
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“I am absolutely part of the DH conversations and that’s a very big positive step forward,” Dr May told Nursing Times. “I think the important bit is it leads to action – it isn’t just sat around a table, it leads to action.”
The role of CNO in England was previously moved from the Department of Health to NHS England as part of a major reorganisation of the health service brought about by the 2012 Health and Social Care Act.
The restructure attracted criticism at the time from key nursing voices, most prominently at the Royal College of Nursing. The Francis report into care failings at the former Mid Staffordshire NHS Foundation Trust also called for the position of the CNO role to be kept under review.
Meanwhile, as one of the only CNOs in England to have had a young family while in post, Dr May said her biggest fear about taking on the job was how she would manage to juggle her work-life balance.
Dr May, who is also executive director at NHS England and NHS Improvement, said her workload had “exploded” since she started as CNO at the beginning of this year and her Twitter account had gone “viral”.
“Workforce has to be what I’m going to be concentrating on”
She has pledged to not spend more than two nights a week away from home and her eight-year-old daughter, Lucie, who has already supported Dr May in her new role by being one the first to model her new “future nurse” children’s uniforms on social media.
The mini uniforms are gender-neutral and Dr May plans to take them into primary schools to encourage both boys and girls to think about a career in nursing and show the profession in a modern light.
“That’s part of the work we want to do is to inspire the next generation, so we want to work with primary school kids so they start considering nursing, it’s not just a female profession and a more contemporary profession,” said Dr May.
The future nurse uniforms have been launched as part of the global Nursing Now campaign, which England backed at the end of last year and is aspiring to encourage more young people to consider a career in nursing, get more men into the profession and also support nurses to expand their roles.
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Latest Nursing and Midwifery Council figures show there is just one male nurse and midwife on the register for every eight female.
Asked why she believed nursing is dominated by women, Dr May said: “It goes back to some of the stereotyping many years ago. You think the playsets and doctors always have white coats, nurses always have dresses.
“That’s why it’s so important to do these gender-neutral uniforms so that we can encourage both,” she told Nursing Times.
As the country struggles with tens of thousands of nurse vacancies, some campaigners believe that redressing the gender imbalance could be a solution to the staffing shortages.
While Dr May would not commit to an opinion on this, she has assigned workforce as another one of her four areas of focus for her time as CNO.
“We know that we’ve got a significant shortfall, 41,000 vacancies in the provider sector alone in the NHS and we know that workforce is a big priority for those people, whether it’s a director of nursing, whether it’s a community team leader, whether it’s a nurse going onto a night shift,” Dr May said.
“We know people are wanting to make sure they have got enough workforce with the right skills and experience,” she said. “Therefore, workforce has to be what I’m going to be concentrating on.”
Dr May is among a panel of experts selected to formulate England’s “workforce implementation plan”, which will set out how promises around staffing in the NHS Long Term Plan will be met.
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She said work on this was “full on” and that she was aware that there was “lots resting on it”, describing the workforce deficit as “the biggest challenge” for nursing.
The implementation plan, the development of which is being led by NHS Improvement chair Baroness Dido Harding, would bring both long-term and short-term actions to fight the staffing difficulties, Dr May said.
The NHS Long Term Plan, published in January, raised hopes that massive cuts to continuing professional development (CPD) for nurses and midwives since 2015 would be reversed.
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The document stated that funding for CPD would increase “each year” but with a caveat that it would depend on Health Education England’s allocation from the government for its training budget.
Dr May has shown passion about the importance of CPD in the past. At the Queen’s Nursing Institute annual conference last year, she said was “absolutely convinced” that the lack of CPD had negatively impacted retention and vowed to “argue heavily” for funding to be restored through the long-term plan.
Questioned by Nursing Times for an update on whether the pledge to refuel CPD would be fulfilled, she said the matter was “under discussion”.
Maximising the contribution of nurses and midwives in the long-term plan is also a cornerstone for Dr May while she serves as CNO.
She noted how there was a “big draw on specialist nursing” from many of the key priorities of the plan, such as mental health, learning disabilities, cancer and community care.
Meanwhile, the RCN has embarked on a campaign for safe staffing legislation to be introduced in England. Pressed on whether she supported the idea, Dr May said: “For me that’s a decision that is made by ministers whether we have safe staffing legislation or not.
“My role right now is to advise Dido in particular about what actions we need to take as part of the workforce implementation plan,” she said.
”I plan to do this as a team effort, making sure that everyone has a contribution to make”
Dr May added that her priority in terms of workforce was around boosting the supply of undergraduate nurses and prevent the current nurses in the system from leaving prematurely.
Since starting in her role, Dr May said she had been all over the country visiting nurses and midwives who she described as “caring with heart and head”.
She said a common theme that had occurred when talking to those on the frontline was their desire to hear more positivity about their profession – and she vowed to help make this happen.
The new chief nurse’s fourth cornerstone is her #TeamCNO initiative, which she said was around creating unity among the nursing and midwifery profession.
“This is how I plan to do business really in that I plan to do this as a team effort, making sure that everyone has a contribution to make and everyone getting their say and to be one voice in nursing and midwifery so that we act as one, we argue as one too and we are co-ordinated in our approach,” said Dr May.
Last month, Nursing Times spoke to Dr May’s predecessor Professor Jane Cummings about her legacy and challeges as CNO.
Biography: Ruth May
Ruth became chief nursing officer for England in January 2019. She works across both NHS England and NHS Improvement as part of a new joint leadership team called the NHS Executive Group.
Source: NHS England
Prior to becoming CNO, Ruth was from April 2016 executive director of nursing at NHS Improvement and deputy CNO and national director for infection prevention and control.
She was previously nursing director at former regulator Monitor and before that NHS England’s regional chief nurse for the Midlands and East region, where she championed the Stop the Pressure campaign.
Ruth started her career with a variety of nursing roles before being made a theatre sister at Frimley Park Hospital. She was subsequently acting director of nursing at Barnet Hospital and then director of nursing and deputy chief executive with Havering Primary Care Trust.
In October 2005, she became chief executive of the Queen Elizabeth Hospital Kings Lynn Trust a post she held for two years. She has also been chief executive of Mid Essex Hospital Services Trust.
Ruth May’s four cornerstones as CNO for England
1. Pride: Celebrating the achievements of nurses and midwives and showing roles as “contemporary”
2. Workforce: Tackling shortages by boosting undergraduate supply and improving retention
3. NHS Long Term Plan: Maximising the contribution of nurses and midwives to the plan
4. #TeamCNO: Unifying nurses and midwives by creating “one voice” for the profession