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'We must unite behind a strong leadership voice'

  • 3 Comments

The points I made last week about the lack of a senior voice standing up for the nursing profession seem to have created something of a storm on Twitter.

While the vast majority of people agreed with me, questions have been raised about whether the debate I initiated was “perpetuating a blame culture” and “dividing the profession”. This was not my intention – I was asking for public views on some of the key issues facing nursing in an attempt to find a way to unite the profession behind a strong leadership voice. There is so much to be said right now, but no one is saying it. Here are just a few questions of huge significance that have raised little, if any, comment from the top of the profession.

”There is so much to be said right now, but no one is saying it”

How will the profession survive if scrapping the bursary does have a negative impact on student nurse numbers? Is there a plan B if those in favour are wrong and the loss of the bursary does cut the number of people signing up for nurse training? 

What is the plan to ensure ministers understand nursing issues and the profession can contribute to healthcare policy when the Department of Health’s nursing, midwifery and allied health profressions policy advisory unit is closed this autumn? What do nursing leaders think of NHS Improvement’s tightening grip on staffing, and its constant link to money? 

”Nurses deserve to know what their leaders think”

There’s more.

How will we ensure the introduction and possible regulation of nursing associates really will improve patient care and isn’t just a way to save money? Who in nursing’s higher echelons is in favour of this role and why? And who thinks it should be regulated? What will it mean for registered nurses? And what is the plan for managing our workforce challenges in the wake of Brexit?

Nurses deserve to know what their leaders think and are doing to stand up against some of these attacks against them. They may be fighting the profession’s corner but we need to hear from them; beavering away quietly isn’t enough – nursing needs vocal support.

By calling for an end to the silence I was trying to galvanise the profession. What does nursing want? What does it need? Who is vocalising that? Can Nursing Times help make policy makers listen? We don’t have to keep our heads below the parapet – we can amplify the nursing voice. Nursing leaders should work with Nursing Times and see our strong, independent voice as something that can help the profession through these challenging times.

  • 3 Comments

Readers' comments (3)

  • michael stone

    Didn't I hear Diane Abbott saying something like 'we must unite behind a strong leadership voice' ?

    By the way, this is 'from another debate'. But I asked the DH a question in connection with its 'pledge' to promote a national Conversation about Dying recently'. My question in part amounted to 'will clinicians be allowed to say what they honestly individually believe, during this national conversation, or will they will they have to stick to the 'party line' of their employers ?'.

    This is what the Department of Health told me:

    Dear Mr Stone,

    Thank you for your correspondence of 8 July about the National Conversation about Dying. I have been asked to reply.

    The intention behind the National Conversation about Dying is indeed to promote conversations between individuals, rather than representatives of organisations or professions.

    These conversations may be between two or more people, with the opportunity to discuss in a variety of forums, which might be face-to-face or online. These conversations might also be based on community settings, or wider national discussions such as Dying Matters Awareness week.

    With regard to your question about professionals being obliged to express their employers’ views, people are entitled to state their own personal views. However, if expressing personal views on social media, people must make clear that it is their personal view being expressed. Any conversations taking place in the context of a professional/patient relationship would need to involve an honest discussion to support and advise the patient concerned.


    I hope this reply is helpful.

    Yours sincerely,


    So, based on that reply, senior nursing leaders should be able to 'give you honest answers' - I'm not sure that they will necessarily 'see things quite so simply'.

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  • michael stone

    As a PS to the earlier comment.

    I find it very helpful, when putting questions to the DH and similar, to 'box them into a corner': otherwise, you are at risk of getting 'very uninformative answers'. In the context of 'can the professionals speak their minds' the way I 'boxed the DH into a corner' was to include this in my e-mail to it:

    I find that ‘professionals cannot speak honestly’ issue is problematic, when I myself try to discuss end-of-life and the MCA. A few months ago, one of my professional contacts sent me an e-mail from a personal e-mail address:

    ‘Dear Mike,

    I just wanted to write to you as ‘me’ rather than in a way that might be seen as representing the XXXXX … I’m very glad that the thrust of your thinking is around improving practice for the future: we can deplore poor practice in the past, and, though unable to change what happened, it’s good to use this knowledge to improve the experience of people in the future.

    I would suspect, and this is only my personal opinion, that many of your correspondents see the sense and value in your suggestions, as do I, but may be inhibited by their public persona and hence sometimes reply stiffly or without passion. … With very best wishes for your continued energy and the logical approach you bring to identifying areas for improvement’


    This is a comparatively ‘newish’ contact – after a while, everyone drops ‘Dear’ and many people drop ‘Mike’ and just start the message - but this conversation (which has to be a conversation – and not the thing ‘the NHS’ typically arranges, which is a consultation) needs to include ‘the professional experts’ and they must ‘be allowed to speak their minds’ if you honestly want to facilitate the maximum learning of all involved

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  • When important issues arise affect the Nursing/ Midwifery profession, it is right that the professions should expect to hear not only what their leaders think but what they they intend to do. At the very least, there is an invaluable opportunity to engage in a dialogue with Nurses and Midwives to hear concerns, to provide reassurance, to explain what advocacy and representation are taking place and to identify strategies for resolution. We know that Nurse/ Midwifery leaders do not always know/ have the answers to the questions and non-leaders often have creative solutions. However, this kind of engagement does require leaders to put their heads above the parapet and to display some honesty and vulnerability. Clearly, leaders hold a tricky balance between being politically astute and being brave and bold but this is after all, part of the leadership deal. I for one am willing to engage but Nurse/ Midwifery leaders, I would love to hear form you.

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