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Leading future leaders

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Helping nurses to fulfil their leadership potential is one of Caroline Alexander’s goals 

caroline alexander

caroline alexander

“Much of my career has been spent in East London, and that’s one of the reasons I really wanted this job,” says Barts Health Trust’s new chief nurse, Caroline Alexander. She may have spent the past three years as chief nurse for NHS England (London region) but she says that despite her love of her regional leadership role, the East End has always owned her heart.

As well as working with Barts Health as chief nurse of London, she was formerly director of nursing at Tower Hamlets Primary Care Trust, and has worked in the area since 1997.“This role feels like coming home,” she says.

But this is a tough gig for Ms Alexander. The trust is the largest in England, with five sites and community services, 7,000 nurses and 1,000 vacancies. It has struggled with performance and finances: last year the Care Quality Commission rated it “inadequate” and it has been in special measures ever since.

Her answer to all those challenges is to prioritise developing and supporting her nursing workforce. She wants to build on the work of her predecessor, interim chief nurse Janice Stevens, continuing to engender “pride and professionalism” among her nurses.

Having supported black and minority ethnic nursing leadership development in her regional role, she is excited by having a workforce that is 50% BME, and wants to embrace and celebrate the trust’s multicultural staff. 

“This role feels like coming home”

“I want to ensure we are a role model organisation for developing BME nurses in their journey to become directors of nursing,” she says. “I intend to make sure they are coached and developed and given leaders to mentor them.”

She knows that throughout the organisation “high-quality, visible leadership” is essential. 

Having worked nationally and regionally, she believes she has seen nursing’s huge potential and wants to see this achieved everywhere – and that starts with strong clinical leadership.

“I’d love Barts Health nurses to be world recognised, and to be known for their expertise,” she says.

“I intend to make sure they are coached and developed and given leaders to mentor them.”

Ms Alexander may not have worked in the acute sector since the 1990s but says her commissioning, community provider leadership, and national and regional role working for the chief nursing officer for England has given her many strengths. 

“I bring to the role different insights and relationships. I can influence and bring a different hat to this role. I have a great nursing leadership team at the trust and will work with them to maximise the breadth of knowledge and experience we all bring” she says.

“I want to create forums with stakeholders including NHS Improvement and other NHS and independent providers to maximise our nursing leadership potential across the patch.”   

On developments such as the proposed nursing associate role and removal of the student bursary, she is open to the idea that things need to change. 

She introduced the Capital Nurse programme in her former role as chief nurse of London in partnership with Health Education England to ensure nurses can easily transfer between trusts in London, and ensure that if you have trained in London, you can find employment there. The fledgling initiative is considering the impact of education funding reform at organisational and individual levels, aware that the impact on Great Ormond Street Hospital will be different to that on Barts Health.

“We must role model and share what we are doing”

Ms Alexander is keen to be a pilot for the nursing associate role but says nursing directors must be clear how it works “with and for nursing”. However, she concedes that “we have never been good at skill mix and developing really effective workforce models” in healthcare.

“We must role model and share what we are doing,” she says. Most of all, she says she is “excited and proud” to be the chief nurse at Barts Health. “I want to leave a legacy for doing something useful for nursing and for the East End. I want to have a feeling that I have made a real difference.

“My real dream is to champion the value of nursing and to support Barts Health nurses to be the best that they can be.”

Jenni Middleton



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