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Thursday, 3 March 2011

Failing nurse leadership puts jobs at risk, or how nursing needs to do better

Three Nursing Times headlines today led to me creating the title for this blog; see https://mail.google.com/mail/?shva=1#inbox/12e7ad7e48c73a94

The United Lincolnshire Trust is taken to task for its poor record keeping, associated with poor standards of care. Where were the managers? What kind of compaints does this Trust get? It would be easy to pick on the front line staff - and they must be responsible for either actions or inaction that led to this situation. However someone should have been checking the quality of the care on offer, and looking for the evidence it was being deliverred. Nurse leadership would help with this; providing a framework for staff to learn and develop. It'll be the spring before the CQC reports - I'd put money on this saying nurse leadership is lacking, and the United Lincolnshire Trust have been tasked with making immediate improvements. I hope the managers are up to it. The staff will need support and opportunities to develop - I don't hold out much hope for that in the current financial situation.
Meanwhile NHS Trusts are still in a state of flux over nurse leadership and its importance - a survey has found areas where development of leaders takes place - but plenty of evidence leadership and management are being held back by financial pressures. The survey was following up after the Francis inquiry into Mid Staffs last year. 
My esteemed colleague Dave Dawes head of the Foundation of Nursing Leadership was quoted a saying: "It’s sad that nursing leadership has been identified as an issue in almost every [NHS] inquiry in the last 20 years.
“The same issues seem to come up again and again, and don’t seem to get any better.”

With financial pressures building to squeeze education and development spending we are surely storing up trouble that will result in further failure at some future point. United Lincs Trust may have been spotted before it's too late and so avoid becoming a disaster - but can we be sure the CQC will always be there to catch the next oranisation in time?
And on the financial pressure theme - at the Pennine Acute Trust they are warning about 1,000 posts being under threat. Amongst other ideas they want to stop using temporary staff and redeploy permanent staff into new roles. I feel pressure coming on for those who may manage or have specialist skills; perhaps really good leaders who help mainitain good standards of care and maintain the delivery of a safe effective and appropriate environment in which the people of the Pennines can have their care.
At risk are not just jobs but standards of care and the reputation of nursing - all because we keep doing the same thing; not investing sufficiently in leaders and managers.

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