Lynne Williams, Christopher R. Burton, The Future for Nursing Leadership: rethinking what works at the core of primary and community nursing Lynne Williams, Christopher R. Burton, Jo Rycroft-Malone Prifysgol Bangor University Community Nursing Research Showcase 5/11/14

Aim of the presentation consider what’s current for community nursing in Wales and why it is timely for new perspectives about leadership to be considered report findings from recent research study which showed the promise of a different style of leadership for nursing share ideas about proposed developments to examine and rethink leadership for community nursing

Wales –what’s happening? 21st Century Healthcare - “continuing to modernise and reform” “We have set out our aims to move to a culture of prudent healthcare in Wales, to deliver health care that fits the patient’s needs and circumstances of patients and that actively avoids wasteful care that is not to a patient’s benefit” (Welsh Government, 2014) Safe Care, Compassionate Care (NHS Wales, 2013)

Clinical leadership in Community Nursing Capacity for leadership crucial (RCN, 2010) Existing leadership programmes (WAG, 2009) Lack of evidence base about leadership in community nursing (Haycock-Stuart et al, 2010) Lack of challenge to the appropriateness of well- established leadership theories

Findings from recent PhD study: The Role of Intermediaries in Promoting Best Practice in Infection Prevention and Control (Williams, 2014) Presence Not about hierarchy, but effects of presence on people’s behaviours, leadership styles (authentic leaders with sense of self) Proximity Not about geography or the environment, but about importance of sharing experiences, space, norms and proxemics Visibility Promoting awareness of own & others’ practice (Lateral surveillance)

Shifting thinking about leadership Traditional focus on individuals in roles (Inglis, 2004: HSE, 2009) Traditional focus may miss potential contribution of others/team members (Tomlinson, 2012) Shift from “heroic” models (Inglis, 2004) to “shared, distributed and adaptive” models (King’s Fund, 2011)

Leadership –what’s new? “NHS organisations must turn away from the traditional individualistic models of leadership towards leadership that is shared, distributed and adaptive” (King’s Fund, 2013: 29) Francis focus on “dispersed leadership” Patient-centred leadership (King’s Fund, 2013) Multidimensional model of clinical leadership (Leigh et al, 2014)

Proposed study/development Case studies to answer the “how” questions An in-depth examination of key features unique to community nursing/settings and how they might harness leadership development Identify the “actors” in different settings What is their impact e.g. how do they motivate others? how are they visionary? how do they instill a sense of purpose?

Study will draw on.. Complex systems leadership theory Systems leadership (National College for School Leadership, 2006) How to develop leaders beyond their context/situation How to prepare the system to be receptive to “broader forms of leadership” (NCSL, 2006)

The future for community nursing leadership The future for community nursing leadership? Energy, efficiency, visibility, communication, synergy, teamwork, rotating

References Haycock-Stuart, E., Baggaley, Sarah., Kean, Susanne & Carson, Maggie.(2010)Understanding leadership in community nursing in Scotland Community Practitioner Volume 83, Number 7 HSE (2009) A review of the literature on effective leadership behaviours for safety Inglis, L. (2004)Alternatives to the heroic leader: an investigation of distributed leadership in non-profit organisations. Working Paper 49/04 Leigh, J., Wild, J., Hynes, C., Wells, S., Kurien, A., Rutherford, J., Rosen, L., Ashcroft, T. & Hartley, V. (2014) Transforming community services through the use of a multidimensional model of clinical leadership Journal of Clinical Nursing NCSL (2006) System leadership in action: Leading networks leading the system RCN (2010) Pillars of the community www.rcn.org.uk Welsh Government (2009) All Wales Ward Sister-Charge Nurse Development Programme www.cymru.gov.uk The King’s Fund (2011) The future of leadership and management in the NHS: No more heroes The King’s Fund (2013) Patient-centred leadership –rediscovering our purpose Tomlinson J. (2012) Exploration of transformational and distributed leadership Nursing Management 19(4) 30-4. Welsh Government (2013) Safe care, Compassionate care www.cymru.gov.uk Welsh Government (2014) Programme for Government www.cymru.gov.uk Williams, L. (2014) WHAT WORKS? A REALIST EVALUATION OF THE ROLE OF INTERMEDIARIES IN PROMOTING BEST PRACTICE IN INFECTION PREVENTION AND CONTROL Unpublished Thesis