Comment

The RCN has crucial roles to play in support of nursing

Ainna Fawcett-Henesy, international consultant in Nursing and Health, on why the RCN has to do everything possible to achieve sufficient numbers of staff

The RCN must do everything possible to achieve sufficient numbers of staff, paid at a sufficient rate, while maintaining the status of the profession in a rapidly changing health service. At a time of stringency this is hard.  

The other major role, sometimes overshadowed, is the professional, intellectual and academic development of nursing.

There are parallels in other organisations where the talent is on the shop floor, for example in the BBC and the medical profession. Doctors, for example, have often divided the two roles, with the British Medical Association taking the lead in negotiations on pay, while the Royal Colleges of Physicians and Surgeons have scanned the future, and examined and argued for the best way to handle, for example, severe trauma, the development of the sub-speciality of emergency medicine and the move to the seven-day hospital.

The Royal College of General Practitioners initially pioneered the work of the GP though recently it has entered the political field, once the territory of the BMA. It can be argued that combining the two roles is difficult, as both are crucial and neither should be ignored.

Of course professional organisations also have subsidiary tasks, making sure that the books balance and advising government on professional issues. But an organisation that seems primarily concerned with shouting for more money risks reducing the respect accorded to its professional views. Government works within boundaries, for there are limits to the money available that can be wrung out of taxpayers.

Leaders at the RCN therefore have a difficult path to follow. As clinical nursing and medicine develop, no single person can now understand everything that is happening. Ara Darzi looked wide to colleagues when he wrote his reports. How within nursing, can we replicate this to shape primary care, hospital and specialty services of the future? George Godber, a founding father of the NHS, friend to nursing and probably the best Chief Medical Officer we have ever had, said in the 70s that you could not build tomorrow’s NHS with yesterday’s doctors. The same is true for nurses.

Perhaps the experts on the future are at the grass roots, where experienced clinical nurses are deeply integrated to their specialties, be they primary care, cardiac surgery or dementia, taking key decisions unthinkable 10 years ago. Nursing should be helping to fashion the structure of the NHS whether in the community or in the seven-day hospital. Anodyne reports – of which there are too many from all quarters – are rightly ignored. 

Leaders of the future need to be able to identify those who can speak for staff, the needs of the person being cared for and the best care for communities as a whole, with staff levels mattering so much to quality of care. Where is the new thinking to come from? Where are the anticipatory documents demonstrating and encouraging the ever-expanding role of nurses? Any organisation’s leadership and management must be judged in this way. Is the organisation expanding and solvent? Is it showing how its professional responsibilities are best fulfilled? Is it a good negotiator ensuring benefits both to the public and the profession? Does government get new ideas from it or is it seen as a drag on change rather than a catalyst?

As Janet Davies takes over the top job at the RCN, her challenge is to meld its professional and union roles, to motivate and inspire today's nurses to play a leading role in developing tomorrow's NHS, and reinvigorate its influencing role.

About the author

Ainna Fawcett-Henesy, international consultant in Nursing and Health

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