Nursing, midwifery and care staff should lead change, says England’s Chief Nursing Officer

The Chief Nursing Officer for England, Professor Jane Cummings, will today launch a new framework encouraging all nursing, midwifery and care staff to get in the driving seat and help transform the health and care sector.

Professor Cummings will say that these three groups of highly skilled compassionate professionals represent the largest group of health and care staff, and should play a key role in building a more effective and sustainable NHS and care system.

The new framework will encourage and enable nursing, midwifery and care staff to identify where and why there is variation in preventing ill health, care and efficiency – whether this is between hospital wards, care homes, entire NHS trusts or in any of settings where they work.

Professor Jane Cummings said: “The role that nursing, midwifery and care staff play should not be underestimated – we are on hospital wards caring for people, out in the community, care homes, academia, sitting on Boards, developing policy, and in the private sector.

“The framework – which can be used across all the sectors, whatever the setting – will support staff to demonstrate how they can use their expertise to drive change.

“The leadership potential in our workforce to manage the challenges of today and shape the future is boundless. From addressing differences in the incidence of pressure ulcers, to changing pathways of care and support in diagnosing diabetes – nursing, midwifery and care staff are ideally placed to be leading that change and demonstrating their value.”

Tackling this unwarranted variation is critical to efforts to deliver the NHS Five Year Forward View and the three gaps identified within it:

  1. Health and wellbeing: without a greater focus on prevention, health inequalities will widen and our capacity to pay for new treatments will be compromised by the need to spend billions of pounds on avoidable illness.
  2. Care and quality: Health needs will go unmet unless we reshape care, harness technology and address variations in quality and safety
  3. Funding and efficiency: Without efficiencies, a shortage of resources will hinder care services and progress

The framework also encourages staff to record and evidence their work to ensure lessons can be shared and the value they add in terms of achieving better outcomes and experiences for patients, and improved use of resources can be quantified.

To develop the framework over 11,000 pieces of evidence have been gathered from frontline staff, the public, academics and nurse leaders across the health and care system.

Feedback from an extensive consultation and engagement process not only governed the approach to closing the gaps on unwarranted variation, but it also resulted in the development of ten commitments that will support nursing, midwifery and care staff to lead in the present and shape the future.

The commitments are central to the application of the framework. They will help to ensure better experience for patients, outcomes and use of resources and are designed to be applied locally in any environment and at any level.

  1. We will promote a culture where improving the population’s health is a core component of the practice of all nursing, midwifery and care staff
  2. We will increase the visibility of nursing and midwifery leadership and input in prevention
  3. We will work with individuals, families and communities to equip them to make informed choices and manage their own health
  4. We will be centred on individuals experiencing high value care
  5. We will work in partnership with individuals, their families, carers and others important to them
  6. We will actively respond to what matters most to our staff and colleagues
  7. We will lead and drive research to evidence the impact of what we do
  8. We will have the right education, training and development to enhance our skills, knowledge and understanding.
  9. We will have the right staff in the right places and at the right time
  10. We will champion the use of technology and informatics to improve practice, address unwarranted variations and enhance outcomes

The framework also includes a range of case studies to show that nursing, midwifery and care staff are undertaking excellent work in doing this already and that anyone can do this no matter how big or small the organisation.


  1. kevin riley says:

    Kevin Riley Retired Prosecuting Solicitor
    Given that Robert Francis QC identified that one of the major causes of the “preventable” deaths that occurred at the two Hospitals run by the Mid Staffs NHS Foundation Trusts was the failure of the Chief Executive to employ enough front line “service delivery staff “ – particularly nurses ,- any action by Jeremy Hunt, Simon Stevens or any one of the 165 Chief Executives of the NHS Foundation Trusts to, in effect, create as serious shortage of nurses is potentially a criminal act. – see below.
    What the Royal College of Nursing (and any other professional organisation representing staff employed in front line service delivery in the NHS) should do is to refer the actions of the above to the High

  2. damian entwistle says:

    Strange that in the funding and efficiency section, it’s all about ‘efficiency’ and nothing about funding. And that ‘prevention’ has nothing in it about preventing food and drink manufacturers from marketing nutritional rubbish and calling it food. Or that wholesale geographic health inequalities related poverty and deprivation get no mention at all.

  3. Jane Farquharson says:

    Thank you Professor Cummings.
    At last the right group of people being supported to drive change in a sensible, practical way which will improve patient care everywhere and not just passively having to accept others constantly changing ideas about quality care and seeing the NHS we love being ruined.