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Collective leadership is nursing’s direction of travel

Every nurse can be empowered through collective leadership, says the chief nursing officer for England

Every nurse can be empowered through collective leadership, says the chief nursing officer for England


Picture: iStock

Over the past decade we have seen an increasing focus on nurses as leaders. We are all familiar with the traditional leadership narrative and the often complex debate about ‘how to lead’ in today’s challenging and frequently changing landscape of health and care.

Leadership is a requirement in standards of training and education, and we see it in measurements of regulation. But does a traditional leadership model still fit with today’s models of health and care?

‘The ability to influence a situation and its outcome is something we all have within our gift’

Collective leadership is about everyone taking responsibility, not just for their own job or role but for the success of their team and their organisation as a whole. It is about ensuring that all voices are valued and contribute to the conversations where decisions are made.

We are all leaders

To do this successfully we must embrace the fact that we are all leaders. Banding, titles and area of practice do not determine a leader. The ability to influence a situation and its outcome is something we all have within our gift. We must encourage and empower those in our teams and around us to be involved.

In my first few months in this role I’ve seen many examples of collective leadership firsthand, in my visits to trusts and with teams across England.

Nursing staff, including clinical support workers and newly registered nurses, have generated ideas for improvement in their work areas that the whole nursing team has agreed and embraced.

Engaged and empowered

This in turn has helped to sustain change and improved outcomes for patients. Staff are more naturally engaged and empowered, and learning and appetite for improvement is increased. Collective leadership style is about harnessing and enabling all nursing staff and teams to improve patient outcomes and experience.

In March we launched a ward accreditation resource that contains a variety of local initiatives that truly embrace the leadership potential of all staff. These are just highlights of a new style of collective leadership and decision-making that we are seeing more and more of in our professions and more widely across healthcare.

I take leadership very seriously. In addition to being CNO for England I advise the Department of Health and Social Care on nursing – something which enables me to be able to lead both strategically and operationally. This also provides a strong infrastructure to enable us to develop and speak with a powerful shared agenda.

Fit for the future

My position has the responsibility for bringing us together and ensuring that we can speak with a collective voice, not just within the NHS but across the entire system. During the past months while building my vision as CNO for England I have given much thought to this.

One of my main priorities is to build a workforce fit for the future. This means recruiting and retaining people with the skills we need, ensuring places of work are rewarding and filled with opportunity, tackling inequality that prevents anyone from reaching their potential and developing leadership at every level.

It is also about empowering this workforce to get involved and to know the value of their contribution – something that is at the heart of my call for us to speak with a bold, collective voice as #teamCNO.

We know there are lots of great examples of this, but how can we get to a place where collective leadership is the norm, something we are all part of?

Unique and valuable perspective

Nurses already work across systems and pathways and bring a unique and valuable perspective. We have strong and visible senior nursing leaders whose oversight of the quality and safety agendas is going to have our professions represented at the heart of the delivery of the Long Term Plan.

‘Our job now is to help turn collective leadership into our culture, wherever we may work’

The introduction of an external framework approach, such as the globally respected Pathway to Excellence means we are already seeing evidence of the power of involving all staff in key decision-making and enabling them to shape the change they want to see in their workplace and professional lives.

We’re hearing positive outcomes reported in several areas of quality improvement, as well as staff satisfaction and retention where this framework is used.

Experience and influence

Every one of us has experience and influence to effect change. I believe we now need to build on the great examples of collective leadership that are already out there, to grow a consistent, wider understanding of the value we bring. This work is in full progress in many areas – our job now is to help turn collective leadership into our culture, wherever we may work.

We need colleagues who are experienced practitioners in this area to work with nurses at the start of their careers, and with students and our service users and other health professionals. We need this combined wisdom to determine not just decisions about patient care but the direction of travel for our profession.

I believe that this is the new leadership model for today and the future, and with this in mind I hope we can work together as #teamCNO to grow our shared leadership mindset and voice. We all have different backgrounds and experiences and we are stronger together when using and valuing those differences.


Ruth May is chief nursing officer for England

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