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'We need to start trusting people'

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Having come into nursing from an industrial software background, Jayne is able to take a step back and see how the two industries could learn from one another

Before my midlife crisis led me to seek a new direction and enroll on a nursing diploma course, I wrote and project managed industrial software. One of the topics I’ve followed in recent years is Agile as a method of software development. For those who aren’t aware, Agile as a term was taken from the Agile Manifesto ( and it states:

We are uncovering better ways of developing software by doing it and helping others do it. Through this work we have come to value:


Individuals and interactions over processes and tools

Working software over comprehensive documentation

Customer collaboration over contract negotiation

Responding to change over following a plan


That is, while there is value in the items on the right, we value the items on the left more.


So what does this have to do with nursing or the NHS? Well if you change “software” for “care”, and “customer” for “client” or “patient”, then quite a lot. Sat behind the manifesto is a set of principles, one of which I have paraphrased for nursing:

Build care around motivated individuals. Give them the environment and support they need, and trust them to get the job done.

I have yet to meet a more motivated and dedicated team than can be seen on most wards in most hospitals, but also the worst environment and support.

And as for trust, I work with colleagues I would literally trust with my life and whom patients do on a constant basis. If these principles can work for geeks bashing code in an office then just think how great this could be for the NHS? We need to start trusting people and empowering them with the autonomy to improve their environment and the care they provide for patients.

Another of the features of Agile is that “done” should mean “DONE”; when a task is finished it’s ready to be shipped to the client.

This is often a problem for software engineers who can always see another tweak or feature or modification to be added before it’s “perfect” and I see much the same in the NHS. Big changes are made to a service with countless little bits to be done and the “whole” never gets completed before the next change arrives from above. Better perhaps to have little changes to be made and completed, each one an improvement in its own right. With each task being given to individuals who have responsibility, have resources and a timescale, when all these little tasks are done they start to amount to major improvements.

“Big changes are made to a service with countless little bits to be done and the “whole” never gets completed before the next change arrives from above”

I could go on: Interacting with clients, responding to changes in patients, circumstances or requirements, collaborating with our patients or results being more important than processes. These are all topics well understood in industry and much needed in the NHS.


Jayne Parker is a staff nurse working for the NHS and living in the South East with her partner, a cat and a large motorcycle.


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