Nursing as a force for change

Jane Cummings, NHS England’s Chief Nursing Officer, gives her one year on report to the CNO Conference in Birmingham:

I can’t believe it’s nearly a year since I was in Manchester where I published the Compassion in Practice strategy.

This year’s report celebrates and shares the work that has been done since the launch of the strategy last December. Recognising the work that this profession along with the SROs and their teams have put in spreading, embedding and displaying the 6Cs. Putting them in action locally, regionally, nationally and personally.

I thought it really important to do this report as I want to share with everyone here and the health service that the care and compassion that us professionals hold so close to our heart are the fundamentals we of what we do every day to all that we care for and work with.

Care is something within us and the reason why we are in this profession. Whether you are on the frontline, or driving improvement via policy and commissioning, we do it for a reason and that reason and that purpose is our patients. They are our patients who trust us with their health. We hold such a fortunate and privileged position, we are the majority clinical profession where we have the most contact with patients and who place their care in our hands. We have so much responsibility as well as having such a powerful voice.

Yes, the media has been negative to this profession and in most cases singled us out. But we know that we can now only move forward from this to show we are true to our values and hold dear the vision that we are here to serve the best needs and the care that our patients deserve. It is not to say we should dismiss any failings that occurred but we must continue to share, communicate and assist in delivering the best practice across England.

I have seen many changes in the way we work:

Digital Professional:

As well as the hundreds of webinars we have held that build a strong and committed community, Twitter has also become a craze. I do this and I am sure I am not alone, I am able to share information and good practice at the press of a button. Nursing has moved on so much since I started. It isn’t all about completing paperwork. Technology and embracing it has enabled us to spend more time with patients ensuring patient safety is the number one priority.

6Cs Live!:

What an amazing tool that we have all come across or accessed. This is another way of the wider health profession sharing stories and sharing learning. We have had stories of the month submitted for the past 3 months, judged by a varied panel. This has been a difficult task as there are so many good stories that you have shared. I want to thank you for this and to continue to spread the message about this.

Care Makers:

Again these are the voice in embedding the 6Cs. The care makers who are here supporting this conference have committed to embedding the values locally and in the care maker community. They are the pioneers, the generation of the nursing profession in proving that nursing values are everywhere and are the catalyst in delivering change. The change our patients, the media and others wish to see.

The front line

We see care in many settings but this is truly the one place where bravery meets delivery. The ability to work in such conditions, heat, confinement, etc. the public don’t see enough of the care that is delivered to those that are protecting us as a nation.

Open and honest care

The ability to speak out, harnessing and embracing a culture to deliver real change to those we encounter. Care isn’t static and nor is the way we deliver it and that’s because due to economic situations and the complex care of patients change it must be ever evolving. Embracing change and its impact on what we do and how we do it will enable us to grow and develop for ourselves and our patients for the better.


A good starting point is the introduction of FFT. Patient safety and patient care cannot be separated.

A call to action:

Reducing and improving health inequalities is key to delivering change. Understanding those we care for, their needs and background makes them as a person and assists us in delivering individual personalised care.

Leadership for change – bringing together the right people from our system, connecting the locally, regional and national front. Using evidence base learning through the use of the change model. It is an enabler, a way to ensure change is mapped to delivery and outcomes.

Spread of innovation – collaboration and engagement is powerful especially in a community of our size. We are one and one voice. Building the skills to improve ourselves, our staff/colleagues and ultimately improve our patients’ outcomes.

The current focus has been on organisation not community where it is shifting. It has been in power and hierarchy and not through connection. It has been on mission and vision not a shared purpose. It has been about engaging patients and not about passionate users. It has been about clinical networks not mass communities. It has been on transactions and not relationships. The shift is where we need to focus our energy and efforts. Bringing people together in a forum such as this is the starting point of creating this shift, the mind set into a new world of health and it’s delivery. You are change agents, marching along and flying the flag in the ones who has the passion and drive to want to see and be part of real change. In your heart you are here as you are leaders who want to lead change. Leaders are not those in a hierarchy but those who lead at the forefront. Sticking your head above the parapet to speak out and do things differently to enable change to nurture and grow.

Experience has reinforced the strong link between staff experience and patient experience. Healthy cultures are quality cultures. The FFT for staff will enable and create new opportunities for trusts to engage staff about their own experiences and how those affect patient experiences. Not only do we have a duty of care for patients but for our staff. Without staff with the right staff with the right capability we are unable to deliver care to those who most need it.

I am so humble and thankful that you are here to celebrate and share the passion with me of the profession that we all live, breathe and deliver every day to those who need us the most, our patients.

Jane Cummings

Professor Jane Cummings is the Chief Nursing Officer for England and Executive Director at NHS England.

Jane specialised in emergency care and has held a wide variety of roles across the NHS including Director of Commissioning, Director of Nursing and Deputy Chief Executive.

In February 2004, she became the national lead for emergency care agreeing and implementing the 98% operational standard. She has also worked as the nursing advisor for emergency care. In January 2005, she was appointed as the National Implementation Director for ‘Choice’ and ‘Choose and Book’.

Jane moved to NHS North West in November 2007 where she held executive responsibility for the professional leadership of nursing, quality, performance as well as QIPP, commissioning and for a time Deputy Chief Executive Officer. In October 2011, she was appointed to the role of Chief Nurse for the North of England SHA Cluster.

She was appointed as Chief Nursing Officer for England in March 2012 and started full time in June 2012. Jane is the professional lead for all nurses and midwives in England (with the exception of public health) and published the ‘6Cs’ and ‘Compassion in Practice’ in December 2012, followed by publishing the ‘Leading Change, Adding Value’ framework in May 2016.

Jane has executive oversight of maternity, patient experience, learning disability and, in January 2016, became executive lead for Patient and Public Participation.

She was awarded Doctorates by Edge Hill University and by Bucks New University, and she is a visiting professor at Kingston University and St George’s University, London.

She is also Director and trustee for Macmillan Cancer Support and a clinical Ambassador for the Over the Wall Children’s Charity where she volunteers as a nurse providing care for children affected by serious illnesses.

Follow Jane on Twitter: @JaneMCummings.


  1. Angela says:

    I left nursing eight years ago when patient safety concerns began to fall onto deaf ears then a serious incident occurred as a result of insufficient staffing levels. I have since become a Chartered Occupational Psychologist with one aim – to support the NHS clinically transform to be great again. I was delighted when the Francis recommendations provided the much needed focus onto culture and transparency. I am also very pleased to see that accountability is beginning to increase in some areas; now we just need to convince the majority that this really can make a difference.

  2. Terence Singleton says:

    The greatest impact nursing could have is on Sciatica/Low back pain, it is now possible to remove this pain in one session of Nursing care with exercise using the Mysingy Protocol approved by spine surgeons.
    For too long patients have been subjected to 9 Sessions of Physiotherapy over 12 weeks promoting anxiety and depression and ultimately mental illness, Physiotherapy has never relieved pain, Nursing care must now be given the chance to prove what it did in the past with compassion, skill and determination.