Trusts set example of good practice with review of misleading job titles

A small number of NHS trusts in England are reviewing job titles for their nursing and support staff, against the backdrop of guidance and statements by NHS leaders that unambiguous titles are critical to avoid confusing or misleading patients

Director of nursing Janice Sigsworth says it is vital for the profession to tackle
inconsistencies around job titles. Picture: Charles Milligan

A small number of NHS acute, mental health and community trusts in England are leading the way in good practice by reviewing job titles for their nursing and support staff.

Out of 143 trusts that responded to a request for information from Nursing Standard, just 24 (17%) plan to review job titles at their organisations.

NHS leaders have made it clear that unambiguous job titles are critical to avoid confusing or misleading patients, and this renewed focus has prompted recent guidance to emerge from a variety of sources.

Earlier this month, England's chief nursign officer Jane Cummings announced she would be taking steps to protect the title of "nurse" in law.

It followed a letter she wrote with NHS Improvement executive nursing director Ruth May to trusts last autumn urging them to use the word ‘nurse’ correctly in titles.

Review of ‘advanced’ urged

Additional guidance on advanced clinical practice followed from Health Education England (HEE), which urged trusts to review titles containing the word ‘advanced’.

Some trusts are being proactive about reviewing job titles.

Imperial College Healthcare NHS Trust in London has recently undertaken a project to harmonise the titles used by nurses, midwives and support staff.

This included reducing the number of titles in use, simplifying them to provide unambiguous and gender-neutral titles, and standardising their usage.

The trust’s director of nursing Janice Sigsworth said: ‘It is vital that the nursing profession as a whole tackles inconsistencies around job titles.’

Recognising nursing’s role

Professor Sigsworth said: ‘The project was driven by three senior nurses involved in our award-winning leadership programme, who have worked hard to listen to and engage with nurses, patients and professional bodies to co-design a consistent approach for nursing job titles.

‘We believe that this simplification will help patients and staff recognise the role of the nursing profession in delivering high-quality, patient-centred care.’

Mid Yorkshire Hospitals NHS Trust director of nursing and quality David Melia said: ‘We were already in discussion with our registered nursing staff about job roles and titles.

‘While we were assured that only registrants were called “nurse”, there was a mixture of non ward-based nurses with a combination of job titles.’

Interchanging titles confuse

Mr Melia said these included clinical nurse specialist, nurse practitioner, nurse clinician and advanced nurse practitioner.

‘Many of these titles had been agreed over the years and took little account of a workforce requirement,’ he said.

‘There was confusion across the trust at the inter-changing of job titles – the nurses themselves were confused.

‘After a period of consultation, the nurses themselves have developed a series of core job descriptions and competencies against revised job titles.

Not disadvantaged or downgraded

‘These are just going through the formal HR processes before consultation. No member of staff has been disadvantaged or downgraded. I am proud of the way our professional nursing team have taken this forward and arrived at a solution.’

Brighton and Sussex University Hospitals NHS Trust is in the process of reviewing job titles containing the word ‘advanced’.

Its nurse director for education and workforce Clare Williams said: ‘We want to standardise job titles and take a consistent approach across the trust. As part of their review of advanced practice across the trust, a project team is therefore going to look at all the titles with “advanced” in them.’

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