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'One of the most important issues raised by Francis was lack of clinical leadership'

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Many ward sisters work clinically, providing clinical leadership while doing the administrative parts of their role in their own time

I recently attended a conference when someone asked, “Do you remember the Francis report?” Published only three years ago it was the report to end all care scandals, but failure to make many of the nursing recommendations mandatory (for example, regulation of health care assistants) has diluted its effect.

One of the most important issues raised by Francis was lack of clinical leadership, there was considerable support from the nursing profession for the recommendation for a supervisory role for ward sisters. Free from burdensome administrative tasks, the aim was to free ward sisters to take on the critical role as leader of clinical care, setting the values and standards for her team.

Yet in the government response to Francis this recommendation was not made mandatory and it was sadly left to ’local flexibility’. I commented in a blog 2013 that the government had failed to grasp the critical importance of ward sisters who are pivotal to the safe and compassionate delivery of care.

Sadly, comments, such as the following one, posted on my blog reflected the frustration felt by many at the time: “The answer is not to tell people to get out of the office. It is to remove the very real obstacles which keeps most ward managers in the office. Give them back control of their ward/unit budgets and a much bigger say in staffing (levels and who is recruited). Stop issuing them with impossible targets and mountains of paperwork, endless audits and data input.”

What is clear is that any ward sisters work clinically, providing clinical leadership while doing the administrative parts of their role in their own time. Is it any wonder that there are still problems recruiting and retaining nurses in these roles?

This week our archive issues focuses on some of the innovations that followed the Francis report and highlight how ward sisters’ time can be liberated and become effective clinical leaders. The first article looks at a trust where ward sisters were spending less than 40% of their time on clinical leadership and highlights a number of trust-wide initiatives that aimed to free up their time to focus on clinical issues. Our second article highlights an initiative driven by a ward sister to develop a ward-based clerical role to take on administrative tasks. This project was subsequently rolled out to other areas in her hospital. Our third article is the first in a series of three that looks at teamwork and explores the dynamics of leading and developing a team.

As the authors of this series note: “In healthcare, good team building is where all team members understand, believe in and work towards the shared purpose of caring and working for patients”.

Ward sisters need the time and support to help their teams achieve these goals. After all they are the individuals who ensure safe and effective care all day, every day.

  • 1 Comment

Readers' comments (1)

  • peter rolland

    Excellent point, well made. Leadership is key to the quality of the service delivered and of the patient/ client experience. There is no doubt clinical leaders (sisters/ matrons) play a pivotal role in demonstrating leadership and must be supported in achieving that part of their role. It is equally important to recognise that culture has a part to play, there are leaders at every level within the organisation and marshalling those to a common goal creates the organisational culture.

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