Shared governance and collective leadership

A key priority of the Chief Nursing Officer (CNO) for England is to ensure that the nursing and midwifery collective voice is powerful and heard across health and care and that the professions’ contribution is valued and listened to in all decision-making conversations. To do this, an engaged and empowered workforce is crucial so that changes can be driven forwards locally to meet population need and address local, regional and national unwarranted variations and inequalities.

Collective leadership can support this. Through harnessing and enabling all nursing and midwifery staff to improve the outcomes and experiences for individuals, families and populations, a collective voice can drive forwards transformation across care sectors and across organisational boundaries. To achieve this, all staff must be supported to recognise and embrace that they are leaders. Banding, titles or area of practice do not determine a leader. It is the ability and opportunity for all nursing, midwifery and care staff to affect and influence a situation and its outcome.

Collective leadership is about everyone taking responsibility not just for their own job or role, but for the success of their team and their organisation as a whole. It is about ensuring that all voices are valued and contribute to the conversations where decisions are made.

Ruth May, Chief Nursing Officer for England.

Supporting this in practice there have been a number of successes utilising shared governance methods, which place staff at the centre of the decision-making process and sees managers having a facilitative leadership role. Shared Governance has been implemented in nursing for more than 30 years, and is a key element of professional practice models such as globally recognised models ‘Pathway to Excellence’® and ‘Magnet’® frameworks.

There is evidence that the introduction of such external frameworks, involving staff in key decision-making and enabling them to lead change results in positive outcomes in areas of quality improvement, as well as in staff satisfaction, recruitment and retention.

To support the shared governance collective leadership approach, in March 2019 a new Ward Accreditation Resource was launched, which contains a variety of local ward accreditation initiatives which truly embrace the leadership potential of all staff.