A voice to lead – A vision for future healthcare.

Today on May 12th, International Nurses’ Day, the day that celebrates the birth of Florence Nightingale, the founder of modern nursing, Paul French, IEPA Board member and clinical academic based in Manchester England, prompts us to reflect on this year’s theme “A voice to Lead – A vision for future healthcare” and to take a moment to recognise the value and contribution that nurses make to societies around the world. 

As we have seen over the past year, in the midst of emergency situations that impact on our health, we turn to our clinicians and scientists for guidance and direction on how to manage the health and wellbeing of our communities. This might seem an obvious way forward, but typically, health care is much more of a negotiation with lots of people and organisations involved. Sadly, what this leads to with multiple negotiations can often be a diluted intervention or service model somewhat divergent to the scientific or clinical perspective.

This last year, we have constantly heard messages of “follow the science” and in many countries we have seen our clinical colleagues delivering messages alongside our political leaders, delivering guidance about how to manage through these difficult times. There have been differences of opinion between clinicians and politicians over this past year but these differences have generally been transparent and the delineation of expert clinical advice and the enactment of policy articulated, acted upon and visible to see.

This has been a very welcome but typical response in times of emergency. Unfortunately, when the emergency is over there is often a swift return to previous practices where managers, accountants and others prevail and the dance and negotiations regarding health care strategies once again emerge. But at least for a period of time we can witness the value of clinical leadership and the potential impact on our health care. Importantly, clinical leadership continues although it returns to a much less visible role in our health care systems.

Generally speaking, clinical leadership tends to be closely associated with our medical colleagues. This makes lots of sense and in many cases our medical colleagues have a level of expertise that warrants this. But to conflate clinical leadership with medical leadership is wrong. There are senior clinicians from a wide range of professional backgrounds that have a great deal to offer and not to hear their voice does disservice to the multidisciplinary team-based approach which is central to health care. During the pandemic we saw the wide range of clinicians emerge from intensive care units exhausted and devastated removing their Personal Protective Equipment following extended shifts caring for people with COVID-19. It was the multidisciplinary nature of care, as ever, that was so important.

Despite this, I have heard on numerous occasions about senior clinicians from non-medical professions who have not only been over looked, but actually excluded from being able to apply for senior clinical positions across our health care systems. Typically, job descriptions list a host of skills and attributes which may be applicable to a wide range of professionals but as part of the essential criteria there will be the requirement of a medical degree.

Personally, as a mental health nurse I have been approached to apply for senior clinical positions but been confronted with the usual essential criteria that the person must be either from a medical or psychology background. This clearly sells an assumption that mental health nurses don’t have the necessary skill set to carry out senior clinical duties or provide necessary guidance, despite meeting all other criteria highlighted on the job description. I have still applied for these posts ignoring the essential criteria and highlighted clearly in my application form that despite not meeting that aspect of the job description all other aspects of my cv indicate my ability to carry out the post.  Fortunately, this has been recognised and I have been offered and carried out several senior clinical leadership positions. However, I wonder how many nurses have been put off applying for senior clinical leadership posts due to a skewed job description which inadvertently prioritises a medical degree.

This is not saying we don’t need senior medical leadership; it is clearly vital. But I doubt its vital in every single clinical leadership post. In fact, bringing a wider clinical perspective to these senior posts is likely to bring a welcome professional diversity and voice.

On May 12th, International Nurses’ Day, the day that celebrates the birth of Florence Nightingale, the founder of modern nursing, let’s take a moment to recognise the value and contribution that nurses make to societies around the world. This year, the theme is “A voice to Lead – A vision for future healthcare”.

It’s time to value our colleagues ability to contribute to the senior mental health agenda regardless of professional background. It’s time to welcome the contribution of our nurses as senior clinical leaders to help shape healthcare of the future.

Paul French is a clinical academic based at Pennine Care NHS Foundation Trust in Manchester England, and Manchester Metropolitan University. He has been involved with the development of research and clinical services in early intervention in psychosis for a number of years. This has included extensive research in the area of emerging psychosis and At Risk Mental States and the development of treatment strategies to support these individuals, more latterly looking at family based interventions for this group. He has published widely on CBT for psychosis including treatment manuals for this approach.  He has always been keen to work across research and policy to ensure rapid translation of emerging research into clinical practice.

He has supported the development of clinical services, locally, regionally, nationally and internationally. He was a member of the Expert Reference Group that established the Access and Waiting Times Standard for EIP in England where people with an emerging psychosis are seen be EIP teams within 2 weeks and subsequently offer the wide range of interventions recommended in the NICE guidelines. He continues to provide clinical leadership nationally in this area in order to support the uptake of these standards as joint National Clinical Advisor within the Royal College of Psychiatry for the EIP National Clinical Audit of Psychosis.

You can follow Paul on Twitter @pfrench123