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How does your manager recognise excellent practice?

Chief nurse Carolyn Fox explains the power of celebrating what staff do well

Chief nurse Carolyn Fox explains the power of celebrating what staff do well


Carolyn Fox: ‘There’s much to learn when things have gone well.’ Picture: Tim George

A handwritten note is among the ways that chief nurse Carolyn Fox lets staff know they are doing a great job.

‘It happens if I see good practice when I’m out and about,’ says Ms Fox, who works at University Hospitals of Leicester NHS Trust, one of the biggest in the country. ‘It takes just a couple of minutes, but it’s very powerful.’

Learn from successes

Recognising excellent nursing practice is at the heart of her approach. ‘Of course, it’s critical that we learn when things have gone wrong, but there’s as much to learn when things have gone well,’ says Ms Fox, who came to Leicester in October 2018 from Northampton General Hospital, where she was director of nursing. ‘It’s really important to celebrate.’

‘I’m trying to foster a culture where people can say “you did a great job today” to a colleague’

While the organisation already has some well-established ways of acknowledging the contributions of its staff, Ms Fox plans to introduce more this year, including the international Daisy Foundation Awards for extraordinary nurses.

She also wants to introduce the Cavell Star Awards, which are for nurses, midwives and healthcare assistants who demonstrate exceptional care to colleagues, patients or patients’ families.

‘We often focus on the extraordinary, but we also have people who turn up day in and day out and deliver great care. They should be recognised too,’ says Ms Fox.


(Clockwise from left) Carolyn Fox on the ward with ward sister Nichole Parrish, trainee
nursing associate Lydia Parker-Whelband, discharge coordinator Dania Siyam and staff
nurse Aswathy Janardhanan. Picture: Tim George

Recognise a job well done

She now wants to build on the trust’s strong foundation. ‘I’m trying to encourage nurses and midwives to recognise each other’s contributions, fostering a culture where people can say “you did a great job today” to a colleague,’ she explains.

‘It’s about saying thank you, but being quite explicit about what the person did, with details of how they might have shown compassion, technical skills and competence. You need to be specific about why you’re saying well done.’

In her previous role, Ms Fox was instrumental in Northampton General Hospital becoming the first NHS hospital in the UK to sign up to the internationally recognised Pathway to Excellence programme.

What is the Pathway to Excellence?

Under the programme, organisations must meet six practice standards deemed essential to an ideal nursing environment. The practice standards focus on:

  • Leadership.
  • Shared decision-making.
  • Quality.
  • Safety.
  • Well-being.
  • Professional development.

Later this year Ms Fox plans to introduce the programme for Leicester’s 5,000 or so registered nursing and midwifery staff, as part of the trust’s overall quality initiative.

‘It’s a much bigger organisation here, so I’ll be thinking very carefully about its introduction and what I learned last time around,’ she says. ‘But ultimately, I think it leads to a happy workforce and great patient care.’


Ms Fox shows her appreciation with a hand-written card for ward sister Julie Godrich.
Picture: Tim George

For Ms Fox, well-being is a key element. ‘The emotional labour of nursing, midwifery and support staff shouldn’t be overlooked,’ she says. ‘One of the expressions I use is that you can’t pour from an empty cup. As an individual, you need to take some responsibility for self-care, but we also need to play our part in topping up the emotional bank accounts of our nursing workforce.’

She also wants to introduce a shared decision-making and governance model, adding to the trust’s existing good practice. ‘The nearer decisions are made to the patients and the front line, the bigger the impact they can have,’ says Ms Fox.

Giving staff a voice

The Pathway to Excellence programme originated in the United States, and Ms Fox has faced questions in the past about introducing it to the UK. But she says it is now an international programme, ‘which makes you feel part of the global nursing family’.

Other challenges include a perception that it’s a bit lightweight. ‘But there is key strategic thinking behind it,’ she says. ‘It’s about empowering the workforce.’

She believes the programme has substantial benefits for staff. ‘It gives them a feeling of self-worth and pride, and they have a voice. Although I’ve only been here for a few months, I know the staff here are fantastic and have a can-do attitude. They’re keen to embrace new challenges and try new things.’

‘If you have an empowered, engaged and happy nursing workforce, it’s bound to carry the organisation, because they are the largest group of staff’

Earlier this year the trust joined forces with four other health and social care providers in a large recruitment campaign. Your Future is hoping to attract nurses, doctors, health and social care professionals to work in hospitals, hospices and communities across the county.

Other organisations taking part are Leicestershire Partnership NHS Trust, LOROS Hospice in Leicester, Rutland County Council and Leicester City Council, who between them have a workforce of 38,000.

‘Leicestershire is a great place to be,’ says Ms Fox. ‘We’ve got big cities and beautiful countryside.’

While the programme may be perceived as nurse-centric, Ms Fox believes it has huge organisational advantages, including improving the recruitment and retention of staff.

‘That was the evidence from my previous role, and it’s one of the reasons why I’m so keen to introduce it here,’ says Ms Fox.

‘If you have an empowered, engaged and happy nursing workforce, it’s bound to carry the organisation, because they are the largest group of staff.’


Lynne Pearce is a health journalist


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