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Sisters doing it for themselves

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VOL: 97, ISSUE: 19, PAGE NO: 33

Sally Gooch MSc BA RGN RHV

A fuss has been made about the £5,000 ward environment budgets recently bestowed on ward leaders, but it seems to have been forgotten that they have long controlled nearly £500,000 each - more than most directors of nursing.

A fuss has been made about the £5,000 ward environment budgets recently bestowed on ward leaders, but it seems to have been forgotten that they have long controlled nearly £500,000 each - more than most directors of nursing.

Many ward leaders and their managers play down their management of such large budgets. Some confess to opening their post only once a week, on their 'management' day, and too many do not know how to read a budget statement or realise that underspending is as bad as overspending, that money can be moved around to maximise its effectiveness and that they can take assessed risks.

A huge percentage of the NHS's historic multimillion pound debt is derived from overspends on ward leaders' budgets. Hiring expensive agency staff instead of establishing cheaper temporary-staff schemes, and a lack of budgetary control are the root of the problem.

Some ward leaders have not been daring enough to use skills and time better by refusing to sanction pointless tasks that do not help patients through hospital.

Too many think that showing their budget statements is tantamount to showing their knickers. Too few understand how to make the best use of financial services' staff. Each time there is a vacancy, we need a review of skills, grading and hours.

In the past 10 years, ward leaders have been expected to take on recruitment and selection, disciplining offenders, handling complaints and budget management - often without training. With patient dependency rates rising exponentially, throughput was increased while the NHS was facing its biggest nurse shortage ever. This pressure caused the now familiar cycle of stressed leavers being replaced by ever fewer starters.

No wonder half the ward leaders in the land became souped-up E grades, covering the unfilled shifts no one else could do. Another quarter left because they could not use their clinical expertise and people-management acumen to good effect any longer. But some have managed to remain and become extraordinary clinical leaders - focusing on patients while supporting and developing their teams.

Now that the political will - and new money - is flowing, these stalwarts can insist that their jobs are simplified. They must command the fiscal and human resources to deliver the most efficient service. As well as ensuring that patients are moved quickly through the wards and receive exemplary therapeutic care, this means that ward leaders must ensure that every team member is enabled to grow, develop and stay in nursing.

The challenge is for us all to play our part in repositioning ward leaders to lead on these priorities. In the words of an old RCN pay slogan: I love nursing - let me do it properly.

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