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Inspectors to look for ward manager supervisory status


The government has given its support to making ward managers supervisory to clinical practice – saying trusts will need to give a “valid explanation” for not doing so.

The argument for ward sisters and charge nurses to be counted as supervisory – or supernumerary to the ward or team’s nursing provision – has been made on numerous occasions before.

Last month’s Mid Staffordshire Foundation Trust Public Inquiry report called for ward managers to “operate in a supervisory capacity… except in emergencies”.

In its initial response to the report, the government highlighted examples of supervisory status at four foundation trusts: Wrightington, Wigan and Leigh, County Durham and Darlington, Central Manchester University Hospitals and Salford Royal.

It said: “There is a good body of evidence to demonstrate that supervisory roles for ward managers are important to delivering oversight to all aspects of care on a ward and in a community, from cleanliness to allocation of staff.

“We recognise that many ward managers currently have the same caseload as other nurses on the ward, which does not always allow them time to perform the full scope of the supervisory role.”

The government stopped short of making supervisory status compulsory, but argued that trusts were being encouraged to do so by December, as part of the national nursing strategy Compassion in Practice.

It also highlighted supervisory ward managers as an example of “known good practice” which would now be looked for by hospital inspectors under a policy of a “comply or explain”.

“Where there are well-established practices that benefit patients, inspectors will expect to see these being used across hospitals, or a valid explanation given if this is not the case,” it said.

Professor Anne Marie Rafferty, dean and chair of nursing policy at King’s College London, said: “I think this was an opportunity for a flagship moment to strengthen the role of the ward sister.

We said the same things about strengthening the role in the previous Prime Minister’s Commission on the Future of Nursing and Midwifery. If some of those recommendations had been taken forward, it might have mitigated some of the problems that we now face,” she said.


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Readers' comments (10)

  • Lets hope that the Francis report acutally brings about a meaningful change for ward managers. In Scotland we are back to being Senior Charge Nurses and despite a 'training' programme designed to better equip staff to this role the irony of many SCN being expected to manager two or three areas continues to be conveniently overlooked. It is impossible to be a clinical role model, visible to patients and visitors in more than one physical area. No amount of training can make someone be in two places at the one time.

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  • This supervisory status does not seem to be clear or distinct. Where I work as a Ward Manager I am counted in the nursing numbers on every shift and am in charge on every shift. I enjoy this part of my role but it means that other staff get few opportunities to take charge and the other aspects of my role I end up doing by perpetually staying on after my shift has ended. Tasks such as audits, recruitment, appraisals, investigating complaints, the list goes on.
    The Trusts is responding to Francis by reducing nursing establishments on wards through natural wastage and telling me that I can have ONE day a week as a management day - if staffing allows!

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  • Our ward manager is already in supervisory status "not in number" but sitting in the office all day. We hardly see her.

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  • What stage did nursing go right off the rails or has it been a gradual process? My guess it is with the introduction of general management in the 1980s when managers took over many of the decision making roles of nurses with the idea that it would free them from administrative duties to concentrate more of their time on direct clinical patient care. the result seems to be that they removed the authority from nurses, took over much of their autonomy and decision making and dumped far more paperwork on their plates but still leaving them with all the responsibility not only towards patients but for much which is now also beyond their control.

    Prior to this was the introduction of a new management structure which pushed many senior nurses beyond ward sister into several layers of managerial posts where they sat in offices instead of spending most of their time on wards.

    Where it used to take time and experience to be promoted to a sister's post, nurses could reach this level not long after qualifying with the result that the only upwards move after that was into management in the office.

    Prior to these two major changes outlined above nursing seemed to focus on the needs of patients and work fairly well as far as quality of care was concerned.

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  • will the staff nurse co-ordinating the shifts when there is no ward sister on duty also be supernumerary?

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  • We were discussing the impact of Francis at work. If you are coordinating the shift and doing a decent job you cannot be in the office.
    You have to be out on the ward engaging with staff, patients and everyone else.
    That means you do not have enough hours in the day to undertake your other management responsibilities; recruitment, audits, action plans in response to audits, reviewing probationers, ordering, balancing the budget and so on.
    My Matron advised me that people in my job will always have to stay late to get on top of things, so she said I have to accept it.

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  • Anonymous | 29-Mar-2013 1:45 pm

    wouldn't part time or full time administrative support solve this problem?

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  • Anonymous | 29-Mar-2013 10:25 am

    Why should they be? Unless they are doing all the admin and taking responsibility for other wards and unit, like many ward sisters, there is no reason why a staff nurse should be supernumerary. It is part of their job to take charge of a ward.

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  • Anonymous | 1-Apr-2013 9:29 pm

    As a staff nurse, I fully expect to take responsibility for the running of the ward during my shift. That's my job. Not all staff nurses need to be led by the nose through a shift.

    I wouldn't want my ward sister's job for anything. She spends as much time as she can on the ward, deals with all the senior admin, rotas, supervision of other wards when their managers are off duty, gets all the sh*t from management and issues/complaints from staff, patients, relatives, etc. Basically, the buck stops with her and she never gets off duty on time. Worst of all, she has no real control to fix or change anything, but gets most of the blame. I don't ever want her job.

    No doubt there are ward managers who don't work as hard. Are they the sensible ones? They get their manager role fulfilled and get off on time. There are certainly staff nurses who do the absolute minimum, send all problems/issues to the ward manager (even if they are capable of dealing with them), don't support the ward manager and make sure they get off duty on time.

    There is a problem with perception. As soon as a nurse sits down at a desk, others seem to think that they are doing nothing. The real issue is that there are not enough staff....anywhere.

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  • I am a band 7 ward manager and I am always in the numbers and told I need to work the late (as hours owing that I never get) to keep on top of managerial work. I am told this is normal and I should just put up with it. If this is the case why aren't matrons putting a pinny on and helping Out?
    I shall be leaving the NHS for good, sick of feeling burnt out and taken advantage of. The NHS will never retain staff if it treats people this way. A lot of my nurse friends who have gone into junior and senior sister roles end up as staff nurses once they start, I thought the NHS was supposed to be open and honest? At no point in my interview or contract does it state I may never have opportunities to manage my ward. I feel totally let down, next I shall be performance managed for not managing the ward effectively.

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