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Nurses should make their voices heard on the future of nursing

  • 5 Comments

Ann Keen on how to contribute to the PM’s Commission on the Future of Nursing and Midwifery

Nurses and midwives are at the heart of England’s health service - and responsible for many of its great achievements. You are the people relied on to provide high-quality, compassionate care, the experts who know what services best meet people’s needs. There are now 81,000 more nurses and midwives than in 1997 - the highest number ever.

People want professionals who will make them feel cared for, respected and involved. Those expectations have not changed over the years but the context in which care is given has and will change enormously. That means we cannot stand still.

Sadly, frontline staff tell me they often find it hard to act as the champions of quality or to lead change. Barriers include exclusion from decision-making, outdated perceptions of your role and a lack of understanding of the complexities of your work.

The nursing and midwifery professions have instigated many changes, but there are still exciting initiatives that do not bear fruit. Barriers to good quality are complex and difficult to tackle. If the solutions were easy we would have already found them, so we need to redouble our efforts. Radical shifts in action and perception are needed to empower nurses and midwives.


That is why the Prime Minister asked me to chair his Commission on the Future of Nursing and Midwifery in England. We have brought together 20 of the brightest and best in the professions as Commissioners, to develop existing and emergent policies. We also aim to identify major gaps, look at the barriers and ways of removing them, and stimulate innovative thinking and imaginative campaigning.

‘The Commission aims to usher in a new era in nursing and midwifery. I want to hear your thoughts about how the role of nurses and midwives should change’


A lot is already happening. Many nurses and midwives contributed to the NHS Next Stage Review, from which Lord Darzi’s report High Quality Care for All identified the provision of high-quality care and the role of nurses and midwives as the driving force behind the NHS. He rightly advocates emphasis on patients’ experiences, including evaluation; health promotion; personalised care plans for people with long-term conditions; national standards for advanced nursing roles; and improvements in nursing education and career pathways.

An impressive range of initiatives on these issues is being implemented under the leadership of the government’s chief nursing officer, Chris Beasley. We are considering how to strengthen these developments - and how to align them with the evolution of nursing and midwifery over the next decade.

The pressure on resources means we must think hard about where best to focus. We must ensure frontline nurses and midwives have the support, skills and competencies to design and deliver excellence in health services. As a district nurse I learnt the importance of helping patients and families to cope with illness and disability, while finding practical ways of leading healthier lives. For nurses and midwives, that means moving many more of our interventions and services upstream, to focus on preventing illness and promoting health.

It is 37 years since the last review of nursing and midwifery when the Briggs Committee produced its report. The prime ministerial backing of our Commission gives it high status and visibility - a unique opportunity to shape the future. Hence the PM’s request that we engage health professions, patients and public in a wide-ranging debate.

Our website is gathering opinions and evidence. I have written to over 300 organisations asking for their views. The NHS and other stakeholders are holding listening meetings. This week the Commissioners and I will hear from patients and the public at a listening event.

This first phase of the Commission’s work ends on 10 August. There is still time for you to make your voice heard - see below how you can contribute. We will analyse all the submissions, reflect on them and map out the initial messages. We will feed these back to professions and public in a second phase of engagement, before finalising our recommendations in a written report to be launched by March 2010.

The Commission aims to usher in a new era that locates nursing, midwifery and care issues in a central position in policymaking and management, and stimulates wide interest in and ownership of the need to promote improvements. We will tell a new story about the future nurse and midwife, to create a modern, realistic but inspiring public image - or plurality of images.

As a nurse, nurse lecturer and professional leader, I know that there is a huge emotional labour in nursing. Nursing is dynamic and always challenging. From my own experience, I know just how big that challenge is.

Gordon Brown told this year’s RCN Congress: ‘It takes the courage of people who care so much about something that they want to see that change’. I agree with him that the nursing and midwifery professions have shown that courage of leadership throughout history. Now is a key moment for us to find our voice again, and stand up to be counted.

I want to hear your thoughts about how the role of nurses and midwives should change in the future. Please click here to contact me.

Ann Keen, MP, is chair of the Prime Minister’s Commission on the Future of Nursing and Midwifery and health minister

  • 5 Comments

Readers' comments (5)

  • The main priority in nursing today is budgets No one is interested in how hard worked or stressed nurses are, or how the boundaries are being pushe.For example I worked last night and 3 of us had to move a 27 stone man .He is supposed to be attended to by 4 staff but when you ask for help there is noone available because all bank staff have been cancelled due to the budget We had to roll this man to put him on a bedpan after hip surgeryHe cant go in the hoist as he is too heavy. We had to pull him to the side of the bed before we rolled him.Its all right saying we're not supposed to do this, but what do you do in the middle of the night when there's noone else there. Management are quite aware that this man is on the ward but came to the ward the other day to say there are cutbacks in staff and only to be 3 staff on at night Its disgusting to be exploited this way and pushed into jobs you know you shouldnt be doing for your own health but nobody gives a damn they are obviously expecting you to do it but when you hurt your back you will be told that you shouldnt be doing it in the first place So what exactly are you expected to do when patients and staff are put i this situation?.

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  • If there are 81,000 more Nurses since 1997 I would love to know who employs them and where they all work! (I would also like to look at the exit figures for Nurses over that period). It must be the private sector, because the public sector has been stagnated and starved of financial growth by Government imposed need for fiscal prudency by Trusts which has reached the point of depletion in terms of staffing levels across all aspects of care. From portering, catering, to cleaning and support services. And how could we have had all these Nurses employed when you look at the vast number of Hospital Closures over this time frame? No, I think this is political speak for re-vote for the Labour Party in any forthcoming Genaral Election. I think it really is time Nurses stood up for their profession and united in a single voice and cried 'Enough' and advocated for their patients and profession to be treated with more dignity, value and respect. The MNC and RCN should hang their heads in shame for allowing things to come to the present disaster in terms of staff Numbers and experience.

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  • As I was once told when the ward was short staffed and errors were occurring - Don't rock the boat or you'll be looking for another job. I was also told that we as nurses should not be an advocate for our patients as that would put too much stress on the system.....Needless to say I no longer work on the wards and turned my back on something I enjoyed but as I could not give my patients the best care they deserved and my health was suffering.

    I too would like to know how many nurses left in that timescale and also how many nurses quit in their first two years post training.

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  • Hello
    It's no different in the States. The budget takes priority. We can talk about all the advanced practice nurses, career paths, and voices for change all we want. Until nurses are independent by having unionization, we will always be subjected to the budget. I am not sure how it is in the UK, but in the US, our salaries come from bed and board. If we were nationally unionized, we could have our health insurance come from a plan set up by the union per union dies. In that way, we would free up monies from the hospital' budgets in which they could hire more staff. WE NEED MORE ASSISTANCE STAFF, PERIOD! Not any more advanced practice nurses who tell us what we need to do, let our voices be heard, yada yada, but never stick their necks out there to help us get more staffing to give the holistic care to patients that only nurses can give! Every nursing journal has authors of research, evidence-based practice implementation, opinions about nurse having voices, etc. But GET TO THE REAL ISSUE_STAFF US PROPERLY!!!

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  • Prime Ministers Commission!
    What a joke!!
    Ive been a qualified nurse for 10 yrs, and I'm not even allowed to write a new drug card for a doctor to sign...thats a process of taking the 'old' one and copying it! (In hand writing that other people can clearly understand btw)
    That about sums up the role of the nurse in todays NHS.
    A pen pusher with no experience in health care, and no contact with patients has more autonomy and professonal empowerment than a nurse.
    So dont give me Prime Ministers Commission...cos it was a Prime Minister that took the decisions that have made the NHS the asinine mess it is today.

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