Career advice

From midwife to senior commissioner – one chief nurse’s curvy career path

Diane Jones talks about the hunger for autonomy that’s driven her ambition – and how BME nurses are held to a higher standard

Diane Jones talks about the hunger for autonomy that’s driven her ambition – and how BME nurses are held to a higher standard

For Diane Jones, making the leap from providing care to commissioning was not
straightforward from day one

As chief nurse and director of quality for NHS North West London Collaboration of Clinical Commissioning Groups (CCGs), Diane Jones is one of only a few black or minority ethnic (BME) nurses in England to hold such a senior post.

One in five people employed by the NHS in England is from a BME background, yet latest figures from the Workforce Race Equality Standard (WRES) show there are only eight NHS trust chief executives of BME background and three BME executive directors of nursing.

Confidence built on extensive clinical and management experience

When I first met Ms Jones at a CCG governing body meeting a couple of years ago, I was struck by her softly-spoken determination as she challenged her fellow board members on quality issues. She exuded a quiet confidence borne from years of experience as a clinician and senior manager.

A nurse and midwife, Ms Jones has worked in the NHS for more than 25 years. She was inspired to enter nursing after her grandmother developed type 2 diabetes, and her original plan was to work with people with the condition.

Frustration at lack of nurse autonomy

But after qualifying in 1992, the year her grandmother died, Ms Jones' first staff nurse post was on an adult male orthopaedic ward. However, she found the lack of autonomy for nurses did not suit her.

‘I found nursing to be very medicalised, with doctors having to prescribe everything from paracetamol to pethidine,’ she says. ‘Nurses had limited autonomy, which I found quite frustrating.'

After considering careers in mental health and midwifery – disciplines which Ms Jones viewed as having greater autonomy – she chose the latter, qualifying in 1994. She went on to become a delivery ward sister and consultant midwife, where she led the midwifery unit while managing her own caseload, just like the consultant obstetricians.

A career path is not always straight and predictable Picture: iStock

Career transition allowed greater influence on clinical outcomes 

Although she enjoyed running her own clinics and caring for women in labour, something was still missing. ‘I had decision-making powers, but I didn’t hold the budget,’ says Ms Jones. ‘I still had to go via the director of midwifery to make certain changes and see them implemented. That’s when I made the transition to becoming director of midwifery at Newham General Hospital.’ 

It was in this role that Ms Jones began working with commissioning managers, advising them on maternity services. ‘As a consultant midwife, I could influence clinical outcomes for a wider cohort of women. As director of midwifery, that influence had much wider impact,’ she says.

‘Commissioners were setting the tone on key performance indicators, but they were non-clinical and I felt they were focusing on the wrong things,’ she adds. ‘Services should be clinically driven. I wanted to learn about commissioning so that I could influence maternity services and deliver the best outcomes for women and families.’

The move into clinical commissioning

In 2009, Ms Jones was appointed maternity commissioner with Wandsworth Primary Care Trust, but the shift to a commissioning role was challenging. ‘It was very different – the pace and level of urgency wasn’t the same and there was more bureaucracy than with provider organisations,’ she says. ‘I found it hard to adjust initially and missed not having contact with women.’ 

After holding director posts with CCGs in Redbridge and Greenwich, Ms Jones was appointed director of quality at Brent, Harrow and Hillingdon CCG in March 2017. 

When a chief nurse and director of quality role was created at Northwest London Collaborative, Ms Jones decided to apply.

‘As a black person, you’ve got to demonstrate over and above that you can do the job’

‘There was competition from someone with far more experience than me as a director, so it wasn’t a given that I was going to get it,’ she says. ‘I really went for it and was proud of myself when I got the role. It was tough but worthwhile because it says a lot about me – what I stand for and what I can represent to others.’

Tips for developing your nursing career

  • Seek out opportunities They are not going to be handed to you, so make sure you go looking for them
  • Identify your goals Then make a realistic plan for achieving them
  • Learn from every setback Learning from mistakes is vital for career progression
  • Network beyond your usual circle It is important that people know who you are 
  • Work with a mentor or coach It is good to talk to someone who can advise and guide you


The extra demands made on black people to gain promotion

Ms Jones took up her current role in June 2018. Asked if her career pathway was as smooth as it sounds, she says: ‘My path was very curvy, not dissimilar to those of BME colleagues. I have worked with white female leaders whose career trajectory was very different – they tended to go from being a qualified nurse straight to being a director but I didn’t have a straight route.

‘I ended up with two degrees, a master’s and a postgraduate diploma. I undertook a number of leadership programmes and worked as a lecturer for two years at City, University of London, while continuing to practise part-time.

‘As a black person, you’ve got to demonstrate over and above that you can do the job.’

The trajectory of black nurses is steeper than for white counterparts, says Diane Jones Picture: Ian Dodds

A strategy for step-by-step development

Despite the winding career path, Ms Jones does set career goals. She says setting two steps, or two-yearly goals, works best for her. This involves looking at job descriptions, identifying the skills and qualifications required, then comparing these to her own so she can work towards building competence in any gaps identified. 

She believes networking is also vital for career progression. ‘You have got to be in a position where your name comes to mind when people are being considered for certain roles. As well as having a diverse portfolio, people have to have heard of you,’ she says.

She adds that moving into senior roles has a lot to do with being trusted to lead others to deliver, so it is important to build a good reputation.

‘It’s about integrity, being true to yourself and others believing in you,’ she says. ‘It’s great when your reputation goes before you, for all the right reasons.

‘But we all make mistakes,’ she adds. ‘This is how we learn and we shouldn’t be defined by them. We should be defined by coming back from mistakes and demonstrating that we can do better.’

H Michelle Johnson is head of communications and engagement at Brent Clinical Commissioning Group. She is also communications lead for the chief nursing officer's BME strategic advisory group, a radio broadcaster and author. @mshmjohnson

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