FACING THE FUTURE

 

Report of the NHS Fife and Lothian Local Convention on Recruitment and Retention in

Nursing and Midwifery

Focus on Leadership

Murrayfield Conference Centre

19 April 2002

CONTENTS

1. INTRODUCTION

2. PARTICIPANTS

3. PURPOSE AND FORMAT OF EVENT

4. OUTPUTS FROM TABLETOP DISCUSSIONS

5. EVALUATION OF EVENT

6. APPENDICES

1. INTRODUCTION

In November 2001, the Minister for Health and Community Care held a national convention in Edinburgh to focus on the recruitment and retention of nurses and midwives in Scotland. The report of this event identified issues and an action plan around eight key themes as follows:

The national convention also signalled a series of local conventions throughout Scotland, each to focus on specific themes and to continue the process for identifying ideas for evaluation and action. NHSLothian was asked to organise a local convention for Lothian and Fife with a particular focus on leadership. This report summarises the outcomes of the local convention. TOP

2. PARTICIPANTS

Participants were invited from within the NHS Fife and Lothian areas from all sectors including primary care, acute care, four higher education providers (students and lecturers), colleagues with human resource backgrounds and local partnership organisations including the two employee directors of Lothian and Fife NHS Boards. Appendix A details the list of over 130 participants in the convention.

3. PURPOSE AND FORMAT OF THE EVENT

The event was organised to explore the key theme of leadership.

The convention was opened by Jacqui Simpson, Director of Nursing, NHS Lothian who presented an overview of the key themes of Facing the Future and the aims of the session. The foundation work that was already underway in both Fife and Lothian in developing nurse leaders through either the RCN programme or other programmes was discussed. Jacqui also stressed the importance of the event as an opportunity to actively participate and influence and shape the national and local agenda on recruitment and retention.

The Minister for Health and Community Care, Malcolm Chisholm then addressed the convention. Drawing on the location of the convention at Murrayfield, the home of Scottish rugby, the Minister opened his address by emphasising the importance of working together as a team to deliver services and lead change in the modernisation agenda for the NHS in Scotland. He stressed that staff are the "lifeblood of the NHS" and that "nurses and midwives are the visible symbol of the Health Service for the general public who value highly the work that they do".

The Minister outlined the work done already in recruitment and retention and work currently underway, including:

He then went on to share aspects of each of the local conventions held to date.

On the theme of leadership, the Minister set the tone for the convention by indicating that leadership can and should be exercised at every level. He very warmly welcomed the views and input of delegates at the convention and concluded by indicating that we need leadership that puts patients first and allows the creation of a fertile, supportive environment for creative thinking, challenges assumptions about how healthcare should be delivered and that helps build public confidence in NHS Scotland. The Minister then responded to a number of questions from delegates on recruitment and retention.

Pauline Small, the Nurse adviser for Fife NHS Board, introduced a series of tabletop discussions on leadership. The tabletop discussions centred on four questions:

    1. Is there anything missing in the national action plan on leadership that you
    2. would like to see taken forward either on a local or a national level?

    3. What else can we do to build leadership skills and capacity in our staff over and
    4. above formal leadership programmes?

    5. Directors of Nursing within NHS Board areas are tasked with producing annual
    6. career development plans. What are the components of a career development

      plan that you would like Directors of Nursing to take account of in developing

      this plan?

    7. How best can we engage local nurses in the development, implementation and

monitoring of this plan?

The tabletop discussions were deliberately designed around small groups of 10 or 11 participants to maximise participant input and discussion. Each discussion was facilitated and scribed to capture the discussions. Much groundwork had already been done in organising leadership programmes within nursing and midwifery. Each tabletop discussion was therefore informed by a briefing paper "Local perspectives on Leadership" which detailed work within NHS Fife and Lothian in this area (Appendix B). The scribed discussions from each group are contained in Appendix C. A summary of the discussions for each of the 4 questions posed on leadership is presented below.

Mark Butler, Director of Human Resources at the Scottish Executive Health Department, made the closing remarks for the convention. Mark picked up on themes he had heard throughout the tabletop discussions and particularly emphasised the need to pay attention to leadership development opportunities for part time staff and for women at different stages of their career. Otherwise, he indicated, we would miss out on a huge amount of potential leaders. He stressed the recurring theme of leadership being strongly linked to succession planning and good appraisal systems. He thanked delegates for their active participation in the convention and indicated that he looked forward to everyone playing their part in the delivery of this agenda as it progressed.

TOP

4. OUTPUTS FROM TABLETOP DISCUSSIONS

Key outputs from the tabletop discussions are summarised below for each of the 4 questions posed for participants.

The outputs ranged from practical suggestions to more thematic or philosophical statements that provide a basis for further exploration or refinement in the ongoing local or national discussions for recruitment and retention of nurses and midwives.

    1. Is there anything missing in the national action plan on leadership that
    2. you would like to see taken forward either on a local or a national level?

      Leadership should be a feature of personal development plans, at all levels. While it was acknowledged that charge nurses are a crucial place to start, one of the key themes to emerge from the table top discussions was the need to widen leadership development from charge nurse level to a wider group of staff, and in particular to look at mechanisms to build this in as early as possible in careers, especially pre-registration. Comments were made about how this should be accompanied by appropriate development and training for staff involved in pre-registration programmes. This would help with the detection of leadership qualities in students and people early in their careers.

      There is an opportunity now to move to a more integrated and joined up approach for leadership development that links to succession planning rather than being seen as a separate activity.

      Rotational posts and shadowing are clearly seen as ways of encouraging leadership, and should be promoted.

      There is more scope for joint working/learning on a multi-professional and interagency basis, including the private sector and leadership development should be considered in this context.

      Ensuring protected time is available for leadership development was repeatedly raised in the tabletop discussions.

      The information technology to support leadership development needs to be in place.

      Ongoing audit and evaluation of leadership programmes was identified as an area to be developed more fully, especially in terms of numbers of people engaged, details of local implementation, impact on patient care, and impact on other staff in the care settings.

      Practical issues like ensuring administrative support could make all the difference to clinical leaders being able to take forward their roles.

      A national competency framework for leadership was suggested by one group discussion as being helpful.

    3. What else can we do to build leadership skills and capacity in our staff
    4. over and above formal leadership programmes?

      Organisational culture featured highly in the responses to this question and

      included the need for top level commitment to leadership development to be

      demonstrated, and for widespread recognition that do not need to be in a senior

      position to be a good leader. Qualities identified in the discussions that might

      demonstrate such a culture included ensuring peer support mechanisms are

      in place, ensuring effective clinical supervision is in place, and ensuring

      a safe environment to ask for advice and freedom to challenge is

      evident. An organisation which is seen to celebrate success and praise

      what is good was seen to be conducive to developing leadership skills.

      Feedback suggested that organisations and individuals need to think more

      innovatively about their communication strategies, and to find ever more

      inclusive ways of communicating with staff.

      Again there was a recurring theme throughout the tabletop discussions about

      fostering leadership skills pre-registration and continuing these life long with

      close integration with career development.

      A number of more specific suggestions were made to build leadership skills

      and capacity in staff over and above formal leadership programmes including:

      More use of role models in clinical areas.

      Developing action learning sets locally.

      More creative opportunities to shadow, including use of Partnership and Trades

      Unions organisations.

      Development opportunities need to be proactively pursued, and the suggestion

      was made that perhaps the one year guarantee could have a rotational basis to

      increase skills and confidence of new starts.

      Training to reduce defensive practice.

      More use of exit interviews to find out why people are moving on from nursing.

      More lateral career development and secondment opportunities.

      Opportunities for sabbaticals at all levels.

    5. Directors of Nursing within NHS Board areas are tasked with producing
    6. annual career development plans. What are the components of a career

      development plan that you would like Directors of Nursing to take account

      of in developing this plan?

      The table top discussions highlighted a number of helpful and wide ranging suggestions regarding the components of a career development plan as detailed below. Clear pointers were made however about clarifying the status and nature of these plans at the outset. Are these organisational career plans and if so, clarity is needed about how they are built up from personal development plans linked to the appraisal process.

      There was a view that given the time to develop and implement these plans that annual plans may be unrealistic, and that rolling plans over a longer time period may be more appropriate. The need for plans to be adequately resourced was raised.

      It was also suggested that the career development plans should explicitly recognise the difference between professional/career development and service development. Linkages between career development and succession planning were also suggested as being areas to be explicitly highlighted within the plans.

      Suggested components of the plans centred on the following:

      Appraisal/development plans.

      Careers options should be a feature, including the opportunity to publicise/ market nurse consultant developments. The support nurses have to choose careers options and plan ahead their career development should be contained within the plan.

      Opportunities for flexible movement laterally and vertically should be recognised.

      Rotation and exchange/secondment programmes should be incorporated.

      Access to information technology and training should be component parts of the plan, e.g. video conferencing.

      Rostered time out for development should be built in to the plans.

      Demonstrable ways of valuing expertise at every level should be explored within the plans. This requires the recognition that some staff do not desire promotion to higher grades for example, but need to feel valued and that they are continuing to develop in their existing posts.

      Consider opportunities to retain older people within the service.

      Career breaks, exit interviews and flexible working arrangements should feature in the plans in line with national guidelines.

      Mechanisms for sharing learning and sharing specialist knowledge should be built in to the plans – reports, presentations, email, discussion feedback were cited as examples.

      Acknowledgement of skills in relation to competency and financial incentives was suggested.

      Ways of spotting and nurturing talent should be part of the plans, as should the ability to fast track people who demonstrate leadership potential.

    7. How best can we engage local nurses in the development, implementation

and monitoring of this plan?

A number of suggestions were made in response to this question as follows:

Nurses locally on the ground should feed into the development of the plan and suggestions to promote this included holding more events like this convention, focus groups, exploring peer support approaches e.g. facilitated action learning groups across organisations, and more use of email and road shows.

Other mechanisms to seek opinion were cited such as use of payslips, using the Intranet to get sign up to the development plan at local level.

Personnel should be identified locally to facilitate communication about the plan at all staff levels, with appropriate time identified for this.

How we currently engage and communicate with nurses and midwives and listen to them needs to be reviewed and improved.

Robust appraisal systems will aid the development and implementation of the plan.

Mechanisms are required to establish the career aspirations of individual nurses. We should find more ways to celebrate and congratulate what we do already. The involvement of Local Partnership Forums and professional advisory committees and members of other disciplines were suggested as being important in the development, implementation and monitoring of the plans.

Senior staff, Directors of Nursing and leaders at all levels need to be more visible, and "walk the job".

The plan needs to be backed up by effective monitoring of its effectiveness both at a strategic level and at a local level.

TOP

5. EVALUATION OF EVENT

The evaluation form used for the convention is enclosed as Appendix D. Of the 130 participants, 90 returned evaluation forms. As can be seen from the table below and the details of the open questions presented in Appendix E, the event evaluated very positively. The tabletop discussions were particularly identified as being the best part of the day. Both the Minister’s session and Mark Butler’s session were much appreciated, as was the opportunity for networking. In terms of areas that we could have done differently, feedback suggested that papers circulated in advance of the event would have been helpful.

 

 

Attendees 130, Forms Completed 90

Questions

Strongly

Agree

Agree

Don't Know

Disagree

Strongly Disagree

TOTAL

The supporting papers in the convention pack were helpful

15

69

3

3

0

90

The Venue Was Suitable

51

38

1

0

90

I had an opportunity to contribute

53

37

0

0

0

90

I found the content of the convention useful

36

54

0

0

0

90

I found the group work helpful in exploring the issues around leadership

43

45

1

1

0

90

I feel we came up with some solutions

26

46

15

3

0

90

I would welcome building on the approach for this event for future events

50

37

0

0

0

87

Total

274

326

19

8

0

627

 

In conclusion, feedback suggests that the approach taken was popular and we should build on such events for the future.

 

6. APPENDICES

 

Delegate List Appendix A

Local Perspectives on Leadership Appendix B

Notes of Individual Tabletop Discussions Appendix C

Convention Evaluation Form Appendix D

Evaluation – Open Questions Feedback Appendix E

Speakers Biographical Details Appendix F

 

APPENDIX A

DELEGATE LIST

 

Anderson Bruce (f)

Personnel Officer

Fife Primary Care NHS Trust

Armstrong Dorothy

Lead Nurse - Education & Practice Development

Lothian University Hospitals NHS Trust

Arnott Caroline (f)

Acting Directorate Nurse Manager

Fife Acute Hospitals NHS Trust

Baxter Jean

Charge Nurse

Fife Acute Hospitals NHS Trust

Bayne Anne

Staff Nurse

Fife Acute Hospitals NHS Trust

Bell Debbie

Student Nurse

Napier University

Bennett Willie

Assist Healthcare Planner

NHS Lothian Board

Brian Carey

Student

Nursing & Midwifery, University of Dundee

Brown Jane

Lecturer

Napier University

Brown Rhona

Lead Nurse

Fife Primary Care NHS Trust

Butler Mark

Director of Human Resources

Scottish Executive Health Dept

Campbell Libby Miss (f)

Director of Nursing & Quality

West Lothian Healthcare NHS Trust

Cassidy Jan

Clinical Co-ordinator

Fife Acute Hospitals NHS Trust

Chisholm Malcolm

Minister for Health & Community Care

Member of Scottish Parliament

Clark Yvonne

Asst Clinical Manager Labour Suite

New RIE, Lothian University Hospitals Trust

Cowie Linda

HIV / NURSE

North West Edin. LHCC

Cooper Caroline

Student

Nursing & Midwifery, University of Dundee

Connolly Chris

Staff Nurse A/E

Fife Acute Hospitals NHS Trust

Crawford Helen

Staff Nurse

Fife Acute Hospitals NHS Trust

Crombie Catherine

A/CN Radiology

Medical Division RIE, Lothian University NHS Trust

Crowther Carol (f)

Assistant Director Of Nursing

Lothian University Hospitals NHS Trust

Cushley Betty

Staff Nurse Ward 14

Queen Margaret College

Dawn Hazel

Regional Infection Diseases Unit

Medical Division RIE

Douglas Rena

Lead Nurse

Fife Primary Care NHS Trust

Douglas Sharon Mrs

Human Resources Manager

Fife Acute Hospitals NHS Trust

Douglas T Mrs

Local Facilitator, RCN Leadership Programme

West Lothian Healthcare NHS Trust

Duncan Elaine

Assistant Principal Nurse, Surgical Division

RIE, Lothian University Hospitals NHS Trust

Edwards Helen

Enrolled Nurse

Fife Acute Hospitals NHS Trust

Egan Eddie

Employee Director/Unison

Lothian NHS Board

Fevre Simon (f)

Employee Director

Fife NHS Board

Findlayson Emily

Charge Nurse Ward 4

RHSC, Lothian University Hospitals NHS Trust

Gillian Lenaghan

Royal College of Midwives

Gouge Deborah

Coronary Care Unit

Medical Division RIE

Grafen May Mrs (f)

Assistant General Manager Medical

West Lothian Healthcare NHS Trust

Green Wendy

Senior Lecturer

Nursing & Midwifery, University of Dundee

Gray Gordon

Assistant Healthcare Planner

NHS Lothian

Gregor Shirley

Lecturer

Napier University

Grey M Ms

Health Visitor

West Lothian Healthcare NHS Trust

Hanif Nahida

Practice Development Nurse

Fife Acute Hospitals NHS Trust

Hewitt Ann

Student

Nursing & Midwifery, University of Dundee

Heggie Fiona

Student Nurse

Napier University

Homes Julia

Clinical Manager Obstetrics / Gynaecology In / Outpatients

New RIE, Lothian University Hospitals Trust

Jamieson Rhona

Health Visitor

Dunbar Health Centre

Jones Jean

Sen lect

Napier University

Kenny Aileen

District Nursing Sister

North West Edin. LHCC

Keith Dennis

Service Manager

Fife Primary Care NHS Trust

Kirkland Nancy

Secondee Scottish Executive

Scottish Executive Health Dept

Laing Denise

Staff Nurse

Fife Acute Hospitals NHS Trust

Larcelles Danny

2nd Year Student

Dept of Nursing Studies, University of Edin.

Lavery Irene

Practice Development Facilitator

Lothian University Hospitals NHS Trust

Leitch M Ms

RCN Representative

West Lothian Healthcare NHS Trust

Makie Shela

Community Nursing Sister

East Lothian LHCC

Macdonald Sarah (f)

Clinical Governance Facilitator

West Lothian Healthcare NHS Trust

Marilyn Barrett

Scottish Executive Health Dept

Martin Lorna

Acting CSDM

Herdmanflat Hospital, Lothian Primary Care NHS Trust

Masson Lynne

RCN

Edinburgh and Lothian

McCallion Debbie

Charge Nurse

Fife Primary Care NHS Trust

McCallum Lesley

Regional Rep TGWU

Tayside Primary Care

McConville Wendy

Staff Nurse

Fife Primary Care NHS Trust

McCreadie Jennifer

Personnel Manager

Fife Primary Care NHS Trust

McDonell-Hayhurst Annie

Student

Nursing & Midwifery, University of Dundee

McEwan G Ms

Theatre Co-ordinator

West Lothian Healthcare NHS Trust

McGregor Anne

Charge Nurse Gynaecology

New RIE, Lothian University Hospitals Trust

McGuire Elaine

Project Nurse, Clinical Support Worker Team

Dept of Nursing, RIE, Lothian University NHS Trust

Mckegney Mary

Assistant Operations Manager

Critical Care RIE, Lothian University NHS Trust

McKinley Christine

CN Medicine of the Elderly,

Medical Division RIE, Lothian University NHS Trust

McLauchlan Stuart

RCN - Rep/Leaning Disabilities Nurse

Lothian Primary Care Trust

McLean Joan

District Nursing Sister

Fife Primary Care NHS Trust

McLeod Margo

Charge Nurse WD31

RIE, Lothian University Hospitals NHS Trust

McMillan Rhona

Infection Control Nurse

LUHT

Media Kath Professor

Department of Nursing Studies

University of Edinburgh

Milne Jenny

Human Resources Advisor, Dept Of Nursing

Lothian University Hospitals NHS Trust

Milne Pauline

Principal Nurse Med. Division

Lothian University Hospitals NHS Trust

Moy Maxine

Lead Nurse

Fife Primary Care NHS Trust

Muir David (f)

Senior Lecturer

Nursing & Midwifery, University of Dundee

Murray Diane

Personnel Officer

Fife Primary Care NHS Trust

Noreen Clancy

Head of Personnel

Lothian Primary Care Trust

Page Barbara

Dermatology Specialist Nurse

Fife Acute Hospitals NHS Trust

Page Barbara

Specialist Nurse, Dermatology

Fife Acute Hospitals NHS Trust

Palmer L Mrs

Community Midwife

West Lothian Healthcare NHS Trust

Paterson Isabel

Senior Lecturer

Nursing & Midwifery, University of Dundee

Peacock Julie

Clinical Practice Development Officer

Fife Primary Care NHS Trust

Peacock Karen

Staff Nurse

Fife Acute Hospitals NHS Trust

Percival Graham

Assistant Operations Manager

Critical Care WGH, Lothian University Hospitals NHS Trust

Philip Marilyn

Senior Lecturer

Napier University

Pollock Linda (f)

Nursing Director

Lothian Primary Care Trust

Poolman Colin

RCN

Highlands, Fife, Perth & Kinross

Quinn Ken

Senior Charge Nurse

Fife Primary Care NHS Trust

Rae A Mrs

Practice Development Facilitator

West Lothian Healthcare NHS Trust

Ritchie Agnes

Senior staff nurse

West Lothian Healthcare NHS Trust

Robertson Joanne

Charge Nurse

Princess Alexander Eye Pav.

Robertson Kathleen

Community Midwife

Fife Acute Hospitals NHS Trust

Rush Morag

Lecturer/Practitioner

RHSC, Lothian University Hospitals NHS Trust

Russell Susan

GMB Representative

GMB Representative

Scott C Mrs

Practice Development Facilitator

West Lothian Healthcare NHS Trust

Seabury Shirley

Midwife Counsellor

West Lothian Healthcare NHS Trust

Shearer Joyce

Member

Fife Health Council

Sibbald Sharon

Staff Nurse

Fife Primary Care NHS Trust

Simpson Jacqui

Director Health Planning/Director of Nursing

NHS Lothian Board

Sloan S Ms

Community Nursing Sister

West Lothian Healthcare NHS Trust

Small Pauline (f)

Nurse Adviser, Professional Development

Fife Primary Care NHS Trust

Smith Carol

Health Visitor

Bonnyrigg Health Centre

Smith Karen

Senior Nurse

Fife Primary Care NHS Trust

 

Speers Gavin

Training Development & Education

HEBS

Spence Liz (f)

CSDM

Roodlands Hospital, Lothian Primary Care NHS Trust

Steele Barbara

Lecturer

Napier University

Stewart S Mrs

Assistant Women & Children's Services Manager

West Lothian Healthcare NHS Trust

Stewart Val

Assistant Healthcare Planner

NHS Lothian Board

Sutherland Ben

Senior Nurse

Fife Primary Care NHS Trust

Tait Joanna

Student Nurse

Napier University

Theresa Fyffe

Nursing Officer

Scottish Executive Health Dept

Thom Avril (f)

Nurse Adviser, Workforce Planning

Fife Primary Care NHS Trust

Thomson Calum

Clinical Skills Co-ordinator

Edinburgh University

Tocher Jenni

Lecturer

Dept of Nursing Studies, University of Edin.

Walker Mrs Lorraine

Nurse Bank Manager

Fife Acute Hospitals NHS Trust

Wallace Angela Miss (f)

Depute Director of Nursing

Fife Acute Hospitals NHS Trust

Watson Carol

Professional Officer

NHS Education Scotland

Watson J Ms

Health Visitor

West Lothian Healthcare NHS Trust

Weedall Moira

Assistant Operations Manager

Orthopaedics New RIE

White J Mr

Project Manager, Human Resources

West Lothian Healthcare NHS Trust

Wilson Anne Mrs

Tissue Viability Nurse

Fife Acute Hospitals NHS Trust

Wood Isobel

Senior Nurse

Fife Primary Care NHS Trust

Young Mel

Charge nurse

Lothian University NHS Trust

Young E Ms

Continence Advisor

West Lothian Healthcare NHS Trust

Yuratich Laura

2nd Year Student

Dept of Nursing Studies, University of Edin.


TOP

 

APPENDIX B

LOCAL PERSPECTIVES ON LEADERSHIP

A. Leadership Initiative in Fife Primary Care NHS Trust

Fife Primary Care NHS Trust has and will continue to support the following developments in relation to nurse leadership:

1. BA in Professional Development

This course assists nurses to develop more effective leadership and management practice. They are required to study their own practice exploring ways in which they can test new ideas to reconstruct their practice and models of continuing professional development. The programme consists of core modules and specialist modules.

The aims of the course are to:

This flexible course has been developed and delivered in partnership with the Faculty of Education and social work, Department of Community Education University of Dundee. Students participate on a part time basis. The modules may be offered by face-to-face delivery, distance learning or work-based learning. The application of learning to the workplace and deriving learning from work experience is a cornerstone of the teaching/learning strategy for this degree course.

2. Community Nursing Leadership

Leadership skills of Community Nurses are being supported through the purchasing of a range of study programmes from various Higher Education Institutions following the Scottish Executive allocation of £49,258 in 2001-2002.

B. Leadership in Fife Acute Hospitals

In January 2001 Fife Acute Hospitals NHS Trust launched its Strategy for Nursing and Midwifery. This document is intended to be dynamic and enabling for nurses and midwives, and in conjunction with the Nurse Improvement Plan, should act as reference.

The strategy is focused on four key areas:

Within the strategy and under the heading of Nursing/Midwifery Practice, an objective states FAHT intended to "review and promote the role of the Charge Nurse as leader, educator and clinical expert to promote a partnership with the multi disciplinary team".

In March 2001, Caring for Scotland: The Strategy for Nursing and Midwifery in Scotland was launched. This document states that nurses and midwives in NHSScotland need to have the ability to lead in their local teams and organisations, across professional and agency boundaries and in national forums. It goes on to say that crucial to the idea of developing the leadership abilities of all nurses and midwives is access to training. Leadership Skills Training can bring out latent abilities and qualities in nurses and midwives, abilities and qualities which then benefit patients, the individual and the organisation.

An action from the strategy is that Directors of Nursing will ensure that every ward sister/charge nurse in their organisation will have access to a leadership development opportunity within a five-year plan, commencing 2001.

In FAHT, the Director of Nursing, Depute Director of Nursing and the senior nurse group took the decision to provide varying levels of Leadership Programmes to staff. It became clear that whilst we had an abundance of talent amongst our senior staff nurses, we had charge nurse posts we had difficulty in recruiting to. The Continuing Professional Development of some of our staff nurses had not previously been structured to develop and support them to undertake the role of Charge Nurse. Therefore, to prepare them educationally as well as professionally, a range of Leadership training was made available.

Leadership programme available:

The Xceed Programme commenced in October 2001. The programme has one senior nurse from the organisation participating.

RCN Clinical Leadership commenced in September 2001. Six clinical leaders currently on the programme. It is anticipated that a further 12 clinical leaders will commence the programme in September 2002

LEO programme will commence in April 2002. FAHT have purchased 25 places for Charge Nurses and senior staff within the Trust. This programme will be evaluated on completion.

Multi agency Leading and Learning Programme has two nurses from Fife and commenced in September 2001.

Transformation Leadership programme was developed in collaboration with Dundee University and FAHT. This programme currently has 25 staff nurses and Charge Nurses undertaking it. It is anticipated that 25 nurses/charge nurses will complete this programme annually.

Further to these developmental opportunities for staff, FAHT have also offered staff secondment opportunities both locally and nationally.

We currently have:

One further midwife was awarded research money to establish best practice in suctioning techniques of neonates.

In line with the five-year plan contained in the Caring for Scotland strategy, FAHT have opened up many different opportunities for staff of all grades to gain leadership training. As stated these opportunities range from secondments in house to national training programmes.

It is projected that a further 65 places on Leadership Programmes will be available annually and the secondment opportunities will recur six monthly.

The strategy states that all ward sisters / charge nurses must be empowered by their organisations to deliver the crucial aspects of patient care and professional leadership. We believe in FAHT that our staff have access to a vast range of opportunities which will enhance their clinical, management, leadership, education and research roles.

C. Leadership in Lothian Primary Care NHS Trust

In-house tailored courses have been organised for G Grades within the Trust. The development programme expects to target all charge nurses within the Trust over a three-year period. Each course is evaluated and will continue to be so, to ensure that the courses meet the needs of our future clinical leaders. G Grades from hospital and community settings are combined, and learning sets organised to offer continuing support to this group, after the course has finished. There is also, in addition a leadership development facilitator working with primary care team to develop community nursing team leadership and team working skills.

Our annual appraisal system and its implementation play an important part in the process of identifying nurse leaders. In LPCT we have also developed ‘competency frameworks’ for G grades and staff nurse roles: these tools are key, in helping nurses reflect on their development needs. Nurses then can and do access, within the Trust, a range of ‘management development and personal skills’ programmes. These are aimed at equipping staff with the range of skills needed to assume leadership roles.

In relation to ‘clinical skills’, our local ‘Professional Development Unit’ provides clinical skills training. This is complemented by the Nursing Director funding nurses annually to undertake externally run University courses. The intention is, by provision of modular-based degree training, to ensure nurses are kept up-to-date professionally, that they maintain and improve on clinical competencies and are enabled to assume key clinical leadership roles in the Trust. Clinical Supervision is in place to sustain learning and support the ongoing development of evidence-based practice.

D. Leadership in Lothian University Hospitals NHS Trust

LUHT's approach to developing nursing leadership has focused over the last two years on Ward Managers (G Grades in charge of wards), as this group was identified as the key change agents, integral to the huge transformational agenda facing the Trust i.e. redesign of patient services and physical transfer to the New RIE.

The leadership development programme for all 250 ward managers aims to provide the ward managers with the necessary skills, knowledge and support to undertake their challenging roles. The programme takes a peer action-learning approach, examining real issues in the workplace and focusing on problem solving and practical solutions. Action learning sets of 6-8 ward managers, takes place every 2-3 weeks, and are facilitated by organisational development experts within the Trust. This provides a supportive and encouraging learning environment, to share experiences with each other and to develop practical solutions to real problems.

In addition, the action learning sets are supported by management development workshops delivered by senior managers within the Trust, including the Chief Executive and Director of Nursing. These workshops concentrate on practical application of management theory and focus on the main elements of the role of the ward manager i.e. Leadership, Quality and Care Management, People Management, Finance and Information Management.

The programme has been extremely successful and has contributed to the smooth transfer of the first phase of patient services to Little France.

 

E. Leadership in West Lothian Healthcare NHS Trust

RCN Clinical Leadership Programme

West Lothian Healthcare NHS Trust is an integrated Trust with 12 clinical leaders currently undertaking the programme:

6 G-grade Primary Care

District Nurses, Midwife, Care of the Elderly and Elderly Mental Health, Nurse Specialist.

6 G-grade Acute

General & Acute Medical, Theatres & Recovery, Emergency Nurse Practitioner

The RCN programme can be adaptable across Acute and Primary Care. The appointment of a Local Facilitator has provided support and encouragement for all participants. The facilitator also acknowledges that as she completes the programme she is developing further skills in facilitation.

The programmes emphasis is on local flexibility, individual leadership skills and development of team members to enhance patient care. This has enabled the clinical leaders to learn and develop new skills, strategies and encourage team building within their clinical areas.

The clinical leaders have specifically valued the opportunities the programme provides to become more self aware, develop ‘personal development plans’, record patient stories and conduct observation of care which has led to changes in clinical practice.

The opportunity to build relationships between the acute and primary care settings locally and nationally has helped to break down barriers and share good practice. In time this should help change the culture in the NHS to the benefit of the patient.

The main challenge to management has been identifying appropriate skilled staff to replace the clinical leaders expertise at ward level. A culture needs to exist which allows individuals to continue to develop following completion of the programme.

 

TOP

APPENDIX c

NOTES OF INDIVIDUAL TABLE TOP DISCUSSIONS

TABLE 1.

Question 1.

Is there anything that you would like to see taken forward either at a Local or National Level?

  1. Bursary arrangements
  2. Paying off student debt

Question 2.

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3.

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan:

Question 4

How best can we engage local nurses in the development implementation and monitoring plan:

TABLE 2

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

    1. Lack of role models
    2. Negative attitudes off staff – demotivated
    3. Staff burned out; lack of support
    4. Not enough praise
    5. Appreciate team contributions

Key Points Question 1

JOINT WORKING OF LEARNING MULTI-PROFESSIONAL / INTER AGENCY WORKING (INCLUDING PRIVATE SECTOR) PARTNERSHIP WORKING

ROTATIONAL POSTS / SHADOWING ENCOURAGED. CAREER / LEADERSHIP PATHWAYS WHICH START PREREGISTRATION AND CONTINUE LIFE LONG

CAREER PATHWAY WHICH FACILITATES EARLY IDENTIFICATION OF LEADERSHIP POTENCIAL

 

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

QUESTION 2 - KEY POINTS

HELPING PEOPLE TO TAKE FORWARD INITIATIVES AT THE EARLIEST POSSIBLE STAGE IN THEIR CAREER

CONTINUE REFLECTIVE PRACTICE POST REGISTRATION

SHADOWING / NETWORKING – ENCOURAGE MORE STAFF AT ALL LEVELS INTERNALLY AND EXTERNALLY

CROSS PROFESSIONAL SUPERVISION

 

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

QUESTION 4 KEY POINTS

APPRAISALS SYSTEMS NEEDS TO BE ROBUST

ALL LEVELS ARE INFORMED OF TRUSTS PRIORITIES FOR

MORE DAYS LIKE THIS!

 

TABLE 3

Question 1.

Is there anything that you would like to see taken forward either at a Local or National Level

Key Points QuestIion 1.

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

QUESTION 4 KEY POINTS

APPRAISALS SYSTEMS NEEDS TO BE ROBUST

ALL LEVELS ARE INFORMED OF TRUSTS PRIORITIES FOR

MORE DAYS LIKE THIS!

TABLE 4

Question 1.

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Combined

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

Table 5

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

 

Table 6

Question 1.

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

 

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

 

 

Table 7

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

 

Table 8

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

 

 

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

 

TABLE 9

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

What is this?

Question 4

How best can we engage local nurses in the development implementation and monitoring plan?

No comment on this in scribe notes

TABLE 10

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

In put from all levels of nurses

 

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

TABLE 11.

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Combined with question 2

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

Table 13

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Key Points Question 1

  1. Need Planned development opportunities and funding to enable this
  2. Integrated & disciplinary Pre reg. & Post reg.
  3. Build into pre-registration nursing

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Key Points Question 2

  1. Don’t allocate to all
  2. Target those interested

  1. Tell the good news of leadership successes (not through traditional ladder

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Key Points Question 3

  1. Make appraisal a meaningful exercise
  2. Needs appropriate level of Finance
  3. Openness of information for all
  4. We must spot TALENT all levels

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

Key points Question 4

  1. Awareness day
  2. Get MES to produce leadership base information for all nurses
  3. Decision making processes need to be transparent

 

TABLE 14.

Question 1

Is there anything that you would like to see taken forward either at a Local or National Level?

Question 2

What else can we do to build leadership skills and capacity in our staff over and above formal leadership programmes?

Question 3

Directors of Nursing within NHS Board areas are asked to produce annual career development plans. What are the components of a career development plan that you would like Directors of Nursing to take account of in developing this plan

Question 4

How best can we engage local nurses in the development implementation and monitoring plan

TOP

APPENDIX D

CONVENTION EVALUATION FORM

Thank you for participating in this Convention. We would really value your feedback. Please take a minute or two to complete the evaluation form and return in box at end of event.

Please tick the appropriate box

Strongly Agree Don’t Disagree Strongly

Agree Know Disagree

  1. The supporting papers in the convention pack were helpful.

¨

¨

¨

¨

¨

           

2. The venue was suitable.

¨

¨

¨

¨

¨

           

3. I had an opportunity to contribute.

¨

¨

¨

¨

¨

           

  1. I found the content of the
  2. Convention useful.

¨

¨

¨

¨

¨

           

  • I found the group work helpful in
  • Exploring the issues around

    Leadership.

    ¨

    ¨

    ¨

    ¨

    ¨

               

  • I feel we came up with some
  • Solutions

    ¨

    ¨

    ¨

    ¨

    ¨

               

  • I would welcome building on the
  • Approach for this event for future

    Events.

    ¨

    ¨

    ¨

    ¨

    ¨

    What did you think was the best part of the day: ………………………………………………………

    ……………………………………………………………………………………………………………………….

    What should we have done differently: ………………………………………………………………………

    ……………………………………………………………………………………………………………………….

    Have you any further comments: …………………………………………………………………………….

    ……………………………………………………………………………………………………………………….

    Thank you.

    TOP

    APPENDIX E

    Evaluation – Open Questions Feedback

    No 1

    No 2

    No 3

    What did you think was the best part of the day?

    What should we have done differently?

    Have you any further comments?

    Table top discussions & sharing of ideas

    Some duplication of content during introductory sessions

    Good workshop; everybody had an equal opportunity to comment

    Table top discussions & opportunity to meet others

    More time for delegates to have idea of content and have suggested preparation

    Interesting to see the minister at such events

    Group discussions

    Discussion Groups

    Speeches

    More non nurses, too insular

    Group discussions

    Getting supporting papers prior to convention would have been better

    Table top discussions were very useful & everybody participated

    Table top discussions

    Nothing

    Table top discussions

    Feedback after discussion

    More of these events should be organised

    Discussion Groups

    The Group work was worthwhile in highlighting good practice for sharing

    Table top discussions

    More Information before the day

    Room could have been warmer, Would have liked coffee at the table

    Table top discussions

    Make sure our comments are seriously considered, if not what’s the point!

    Group discussions

    Information on the purpose of the event prior to attendance

    Group discussions - sharing view points

    Information (supporting papers) & background would be helpful prior to the Convention

    Discussion with colleagues

    Nil

    Good day; positive way forward

    Group discussion

    Networking

    Seating tight. Could have done with more space between seats in lecture room

    Thank you for a very stimulating afternoon

    Table top discussions

    Hopefully the post registration development will be up and running by Autumn

     

    Group discussions

    Discussion on the issues of leadership with different levels of experience

    Possibly increase in time convention

    Table top discussions

    No it flowed very well

    Thank you for allowing participation

    Table talk

    Could we have papers prior to convention

    Feed back to participants

    Group discussions

    Make "Facing the Future" available to those who have not seen it yet

    Group Work

    Papers prior to the event

    More of this type of event please

    Group work felt it was good being from different Trusts and Specialties

    Quite happy with it all

    Feel that the day should be more open to all nursing staff & other days could be programmed so more staff can contribute

    Group Work

    Nothing

    None

    Group discussions

    Events like this should be continued to enable sharing of ideas between Trusts

    Group discussions

    Longer day - further discussion

    The table discussions

    Nothing

    Please ensure that all areas are invited to give comments and keep up the good lines of communications

    Group discussion

    More Information and expectation before the day

    Table top discussion

    More notice

    Group Discussion

    Discussion participation and meeting other staff from different Trusts

    Group work round the table

    Table top discussion; Food good

    Sharing & hearing other participants viewpoints

    Tables a bit close - noise level difficult in discussion

    Good opportunity to network and meet others

    Group not balanced area specialty

    The delegates chance to ask questions of the Minister. Speak between midwives nurses Fife and Lothian and hear the differences

    Given longer opportunities to ask questions

    Table top discussion

    Follow up to discuss document

    Table top discussion

    The table top sessions & Mark Butler

    Do it more often & keep people involved as it develops

    Networking

    Not all groups in one room; a bit noisy

    Felt cold air conditioning? A well planned event

    Table discussions. Good Venue, Scrummy food

    Local perspectives, would appreciated having this in advance

    I really enjoyed this event as well as finding it extremely useful. Especially thanks to the super fit Willie Bennett

    Workshops

    Table top discussions/networking, thoroughly enjoyed he day

    My appropriate role identified on the name badge Either RCN Clinical Leader Prog or Clinical Nurse Acute Medicine, West Lothian Trust

    Enjoyed the opportunity to hear Malcolm Chisholm & his questions answers session

    Networking

    Raised awareness of what is actually happening now

    Would have been nice to have had our nurse leader present!

    Discussion

    Nothing

    Very well organised

    Hearing views from other staff

    Difficult to hear group members at table top discussion because all in same room

    Networking - group work

    Excellent afternoon many thanks

    Table top discussions

    Enjoyable day. I look forward to the report

    Being invited and being involved in such an event

    nothing

    All very good

    A full day

    Everything

    Nothing

    Liasing with a variety of different people in different positions

    I would have liked to have verbal feedback’s from the Groups

    I found this very interesting and would like to see more similar events in future

    Meeting a wide variety of professionals

    To go forward with comments from this and to provide more nursing staff on the shop floor in order to keep the experienced staff from leaving due to lack of support from management & low wages

    Group work was very interesting. Talking with colleagues form different areas

    Some information on facing the future prior to the event

    Staff at the group had to be supported before proceeding with the leadership programme

    Group work and discussion with others

    Description & remit prior to event to give an opportunity for more thought

    Good opportunity to have contact discussion with others I.e. minister very useful

    Around the table discussions especially as Malcolm Chisholm & Mark Butler participated

    Earlier notice of the event & receiving information before the event

    Good work

    Information prior to the event

    The group work

    I would have liked the papers before the event

    It was good to network with other colleagues from other areas

     

    Table top discussions & the opportunity to network (the cakes with tea)

    Presentation of the current position in localities

    Ability to get together & discuss issues

    Such a difference between Acute & Primary Care. Better balance would have helped the discussion

    Keep going with this approach

    Minister & the discussions

    Excellent a real change in approach, not just rhetoric

    Table top discussions

    Interesting afternoon. Useful to get others contributions

    Discussion

    Nothing really

    No

    All very enjoyable. Thank you; catering excellent

    Good balance of interaction and input from speakers

    Discussions re previous conventions and suggestions from same

    Might have been better to have offered the chance to discuss other issues

    Mark Butlers talk

    Better questions regarding leadership

    Table top discussions

    Mark Butler’s summary next steps. Some very valid points to take back

    Perhaps report back on group outcomes

    Better room temperature

    Well organised event with good variety of participants

    Table top discussions & presentation from Mark Butler

    Papers should have been distributed before the event

    Networking opportunity excellent. Good to thrash out issues with others from different areas and Trusts

    Table top discussions

    Include nurses not working in NHS settings - they are our poor partners

    Great mix of people from all levels

     

    TOP

    APPENDIX F

    SPEAKERS BIOGRAPHICAL DETAILS

     

    MALCOLM CHISHOLM is Minister for Health and Community Care. He has been a member of the Scottish Parliament since 1999, representing Edinburgh North and Leith, and was a Member of Parliament from 1992 until 2001.

    Mr Chisholm has been Labour’s Scottish Health Spokesperson in Opposition and Minister for Local Government, Housing and Transport during the first few months of the Labour Government. He was also vice convenor of the Scottish Parliament’s Health and Community Care Committee and member of the Equal Opportunities Committee between August 1999 and October 2000.

    Mr Chisholm was born in 1949 and, prior to becoming an MP and then MSP, was an English teacher.

    MARK BUTLER has been Director of Human Resources for the Scottish Executive Health Department since June 2001.

    He started his career as a NHS National Management Trainee, later going on to hold Director roles in Sheffield, Derby and Birmingham. He was Chief Executive at Worcester Royal Infirmary from 1996 to 2000, successfully completing the Pathfinder PFI deal for a new hospital.

    JACQUI SIMPSON is the Director of Health Care Planning/Nursing for Lothian NHS Board and has worked within Lothian NHS since January 1997. Jacqui began her career in nursing in Glasgow with her degree in 1981. Since then she has enjoyed a rich and diverse career in nursing practice, education and research, management, commissioning, public health and health service planning.

    PAULINE SMALL has been Chief Nurse Adviser for Fife NHS Board since 1996. Pauline began her extensive nursing and midwifery career in the Scottish Borders during 1977. Since then she has held a range of clinical and managerial posts within the Scottish health service including posts within public health, commissioning and health service development. Pauline is currently seconded to Fife Primary Care NHS Trust where she has undertaken the role of Nurse Adviser – Professional Development since January 2001.