Empowering leaders on the frontline: why better leadership means better care

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To mark World Cancer Day (4 February), three junior sisters who work on two units of the cancer wing at St James’s University Hospital Trust, look at the importance of their role as leaders on the frontline.  

Kathryn Bootyman-Yates
Kathryn Bootyman-Yates, Junior Sister from the cancer unit at St James’s University Hospital Trust

Research suggests having good leadership at the helm of an organisation means better care being delivered at the frontline. The shocking failings at the Mid Staffordshire NHS Foundation Trust are evident of this and were highlighted in The Francis Inquiry. It showed that there’s a need for compassionate leadership rather than a results-driven approach, which contributed to more than 300 unnecessary patient deaths at the trust.

Kathryn Bootyman-Yates, Elfie Goule and Stephanie Ferguson work at the flagship Bexley Wing at the St James University Hospital Trust. This £220 million development is home to the St James’s Institute of Oncology and includes 10 floors dedicated to providing treatment for cancer patients.

The junior sisters play an important role in ensuring the smooth running of the unit and are responsible for supporting a large team of staff including staff nurses, clinical support workers and non-clinical staff such as housekeepers and ward clerks. As a part of their role, the sisters predominantly provide care to patients by administrating treatment, carrying out blood tests and transfusions as well as offering support to patients and their families. They’re also responsible for ensuring relevant medical processes and protocols have been followed correctly and supporting senior managers with performance management, staff rotas and sickness.

Elfie Goule - Junior Sister from the cancer unit at St James University Hospital Trust
Elfie Goule – Junior Sister from the cancer unit at St James’s University Hospital Trust

“Having good leadership is needed for high quality patient care to be delivered. If you’re leading your team effectively then ultimately you’ll deliver excellent patient care. Here at the Bexley Wing we work together toward our ward and unit objectives.” Elfie explains.

“I consider myself as a leader; it’s a part of my role even though it’s not in my official title. I think good leadership inspires confident staff who feel like they can deliver excellent care. Staff will know what their goals are, feel able to ask questions, challenge bad practices and develop themselves, which will ultimately impact the care delivered on the frontline.” Stephanie added.

Colleagues at the frontline account for more than 66% of the NHS workforce so we must encourage and support their development, investing in their future for better patient care to be delivered. A report from the CQC in 2015 found that a significant majority of services that were rated as good or outstanding had good leadership at the helm of their organisation. Despite this we still rely on a temporary fix, the widespread use of consultancy firms by NHS providers (the NHS spent £420m on management consultants in 2014/15), is often because we are buying in skills we could much more efficiently and productively develop in our own staff if we invested in them properly, with the return on investment that would inevitably bring.

Kathryn agrees with the research: “Everybody’s aim is the same, to provide high quality patient care. The only way we can do this is to support staff.”

Stephanie Ferguson - Junior Sister from the cancer unit at St James University Hospital Trust
Stephanie Ferguson – Junior Sister from the cancer unit at St James’s University Hospital Trust

“It’s not really that complicated. We need to provide excellent care to those who need it the most – that’s what the NHS is about. This isn’t just in clinical settings but across the patch, from doctors and nurse management roles to multi-disciplinary teams. Leaders must ensure staff are treated well, their training is updated and they are supported with encouragement and guidance. If we do this properly, high quality care will be delivered.” Stephanie added.

Despite the importance of leadership within the NHS, there are examples of both good and bad leadership across the health service. The Francis Inquiry was a learning curve for the NHS, clearly showing the need for leadership development. In an article printed in 2013, The British Medical Journal (BMJ) highlighted that two in five health professionals thought leadership in the NHS was ‘poor’ or ‘very poor.’

Says Elfie: “Unfortunately I’ve witnessed poor leadership where colleagues haven’t been supported or given the opportunities to develop their skills and become better. I think it’s really important that staff are given the chance to fulfil their potential.”

Stephanie would also like to see changes: “I think encouraging staff to learn develop and progress is really important. We need to help staff feel motivated to come into work and give the best they can to make a difference. We’re lucky that our leader has good qualities and truly inspires us.”

“I think a good leader must be someone who has the ability to listen, can move ideas forward and is very supportive of their staff, encouraging them to develop and progress. We’ve been lucky to have this support at the Bexley Wing.” adds Kathryn.

Continues Elfie: “I would advise everyone to take control of their own learning and development. Even though ‘leadership’ may not be in our job titles, we’re all leaders in our own right. We need to develop so that we can lead better and create a good working environment which will lead to high quality care being delivered at the frontline.”

The NHS Leadership Academy provides a range of programmes, resources and interventions to help leaders at all levels develop their skills and abilities. The Academy is a firm believer that better leadership leads to better patient care, experience and outcomes.

The Academy has a number of offers to help develop people who are in the early stages of their leadership journey. These include:

  • The Edward Jenner programme: This free online programme helps colleagues build a strong foundation of leadership skills to improve their confidence and competence in their role. You can apply for your place and find out more here
  • The Mary Seacole programme: Aimed at people in the first formal leadership role, this six-month programme aims to develop knowledge and skills in leadership and management. You can find out more here
  • Our Inclusion programmes – the Academy is passionate about changing the culture for black Asian and minority ethic (BAME) staff within the NHS. The Ready Now programme supports senior BAME colleagues to develop further by helping them aim for a role on the board, while the Stepping Up programme is for aspiring BAME leaders who want to progress their career
  • Other resources – as well as all our programmes, the Academy offers a range of other resources. These include the Healthcare Leadership Model, which gives leaders the chance to evaluate their leadership behaviours to develop themselves further while the talent management resource pack helps managers nurture talent within their organisation.