BRIEFING: Frontline Nurse Leadership: An International Perspective

The Francis Inquiry of 2013 which investigated serious care failings at Mid-Staffordshire Trust, recommended holistic strengthening of nursing leadership “from ward to board”.  Robert Francis QC recognised the critical importance of visible, empowered and supernumerary ward sisters in delivering good patient care. This paper analyses the experiences of Australia, New Zealand and the United States on the issue of ward leadership, and whether these case studies offer any lessons for the UK around key areas such as: having clear roles and responsibilities, effective succession planning, and ensuring that leaders have realistic workloads.

Strengthening nurse leadership at all levels is an international nursing priority with many nursing organisations developing leadership roles and representation at national or board level. The RCN supports the Francis recommendation and believes that all ward management positions in the UK should be supernumerary with an explicit job focus on supervisory capabilities. Although none of the international case studies looked at in this paper officially recognise the Francis interpretation of ‘supervisory/supernumerary’, this does not mean that there are no ward leadership positions operating in a supernumerary context. In truth, many have been doing so for a long time and a lot of the essential elements of a ward manager’s role, as we would recognise them, are present across international care settings. What is striking is that although supernumerary might not be as acutely defined in these countries as in the UK, the challenges which international ward leaders face are often the same irrespective of this difference.

For further information, please contact fred.smith@rcn.org.uk