Good nurse leadership can lead to motivated and effective staff, better patient care, lower drug errors, lower staff turnover, lower rates of sickness absence and fewer patient complaints.
Research says that good nurse leaders are clear about what is expected of staff, set simple and attainable goals, give feedback to improve performance, minimise bureaucracy and only enforce rules, policies and procedures that are necessary.
The Department of Health has launched several initiatives to boost nurse leadership, but has tended to change direction frequently and drop schemes that have proved popular.
Nurse leadership has developed well since Labour came to power in many ways. Nurses can now become ‘modern’ matrons, nurse consultants or run nurse-led units.
There have also been several leadership development programmes including Leading Empowered Organisations (LEO), Leadership at the Point of Care (LPC), the RCN’s Clinical Leadership, and Breaking Through (for black and minority ethnic NHS staff).
Despite these, the future of nurse leadership is in doubt, particularly since the demise of the NHS Leadership Centre and the radical reconfiguration of health authorities and primary care trusts.
The NHS Modernisation Agency – which oversaw the NHS Leadership Centre – and training body the NHSU were merged into the Institute for Innovation and Improvement last year.
Such a merger has worried many in nursing because the Modernisation Agency also oversaw the NHS National Nursing Leadership Project, which sat at the centre of most nurse leadership initiatives.
The Leadership at the Point of Care (LPC) programme has been running since 2003 and was designed to complement the more management-focused LEO programme that ended in 2003.
LPC is no longer funded centrally but individual trusts and strategic health authorities can run the programme themselves with basic implementation materials provided by the Department of Health’s NHS Institute for Innovation and Improvement.
The problem is that without central funding for such training, it is up to individual trusts to decide how much they can afford to provide, which seems difficult in the tight financial climate in the NHS.
Uptake of these programmes has been good – around 100,000 NHS workers (mostly nurses) went through LEO, around 8,000 went through LPC and more than 2,000 nurses have been though the RCN’s Clinical Leadership programme.
LPC was seen as particularly useful because it was open to nurses at the frontline to give them skills to influence and improve patient care. Such skills are becoming increasingly useful as nurses are taking on more responsibility in multidisciplinary settings.
Updated: September 2006