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'Whatever I am doing, my job is to stimulate change'

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Phil DaSilva leads a QIPP programme but has never lost touch with frontline nursing

Most nurses are, not surprisingly, suspicious of anyone associated with NHS reform and the Quality, Innovation, Productivity and Prevention (QIPP) programme, says Phil DaSilva, who leads Right Care, one of the national QIPP programmes - they believe you think more about management than care.

“I am a nurse who is also married to a nurse. So I know and understand what the job at the frontline entails and the challenges many nurses face,” he says.

“It’s stressful enough seeing patients every day and dealing with carers and families without the fear of yet another reorganisation of services”

“And I also know from listening to many fellow nurses that there are three words that turn my clinical colleagues cold: ‘productivity’ because they are already working flat out; ‘efficiency’ because they think they are being accused of wasting money; and ‘innovation’ because they get frustrated that there is no real support to introduce new ways of working.”

Mr DaSilva recognises the message that these changes are about improving patient care is not getting across.

“It’s stressful enough seeing patients every day and dealing with carers and families without the fear of yet another reorganisation of services, or the perception of further change to nurses’ roles,” he says. “So we have a duty to help colleagues understand the changes and to help them realise their potential in delivering this agenda by using the resources they have in the best way to improve care, and reduce suffering and pain - and who isn’t interested in that?”

Mr DaSilva started out as a cadet nurse and, via many clinical settings, became a clinical nurse specialist. He developed new services in acute, mental health and primary care. When he left clinical practice, he continued to work closely with primary care colleagues, developing clinicians and services.

He has used his clinical understanding and leadership to navigate his way to senior posts at health authorities and primary care trusts, taking on roles as chief executive and director. Yet he admits he was reluctant to move away from frontline nursing care.

“I had participated in an executive nurse development programme, and believed the time was right to move - but I have to say that I really wasn’t sure about it.

“I was extremely lucky to get a lot of encouragement and support and, from that, I created my own personal development plan, shadowing senior nurse leaders and seeking out a good coach I knew, which helped dispel a few myths,” he says.

Most recently, he’s been seconded from a strategic health authority to the Department of Health to lead Right Care.

“Having seen all sides of the NHS, and operated successfully at all levels, I hope I can bring some benefit as a manager of what changes will work and how to encourage clinicians to own and implement them,” he says.

In an average week, he spends two days in London, one day working with clinical networks, and a third of his time with senior clinical leaders in SHAs, PCTs or GP consortia.

“Whatever I am doing, my job is to stimulate change and to remember QIPP is not about cutbacks - it’s about using resources to create the best benefits for patients, doing the right things and doing things right.”

He adds: “My job is to encourage people to try things a different way. My management experience, my clinical insight and my coaching skills enable me to do that with a fearless compassion.”

So, what advice would he offer to other nurses who want to use their nursing skills in a different way?

“Be careful you don’t chase a title. I often remind clinical colleagues that the name on their badge is irrelevant. It’s about them as a person and what they can offer,” he says.

“Get some good support and coaching through your transition and, if a job comes up, you should create your moment and seize the opportunity.

“I took a risk when leaving clinical practice but have been privileged and fortunate to be able to maintain a strong commitment to developing nursing and clinical practice throughout my career.”

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