The Future for Nursing Leadership : rethinking what works at the core of primary and community nursing

Williams, L. and Burton, C.R. and Rycroft-Malone, J. (2014) The Future for Nursing Leadership : rethinking what works at the core of primary and community nursing. In: Community Nursing Research Showcase Conference, 2014-11-05 - 2014-11-05, Swalec Stadium.

Abstract

In Wales, developing the capacity for leadership in community care is crucial as services continue to expand and evolve (RCN –Pillars of the Community, 2010).Community nurses are pivotal to the implementation and sustainability of service improvements in/near patients’ homes, which is why developing their collective capacity to be influential and proactive leaders is essential and timely. Although programmes have been developed to promote leadership skills and behaviour (Welsh Assembly Government, 2009), the evidence base about leadership in community nursing remains limited (Haycock-Stuart et al, 2010). The appropriateness of well-established leadership theories for the community context is largely unchallenged. This work draws on the findings from a recent research study to explore ways in which leadership in community nursing can be developed and nurtured at team and organisational levels. The study (Williams, 2014) demonstrated the importance of clinical leadership functions in secondary care, but transferring the findings to the community setting, underpinned by unique social, environmental and cultural influences, may be challenging. Further, the traditional focus on individuals’ leadership skills and behaviour may miss the potential for community nursing to benefit from different strategies which can develop team and organisational leadership capacity. As the King’s Fund highlights; “NHS organisations must turn away from the traditional individualistic models of leadership towards leadership that is shared, distributed and adaptive” (2013:29).The study will lead to action/leadership development across community services. Drawing on the findings of Williams (2014), and other theoretical principles, the study will examine features unique to the community setting that harness leadership development. Systems leadership aims to develop leaders who operate beyond their own contexts, and is underpinned by the idea that leadership is “much about a system receptive to and generative of broader forms of leadership as it is about the leaders themselves” (National College for School Leadership, 2006). In complex systems leadership theory, the focus is on learning how unintended changes can occur in organisations or systems when leadership results from people collectively using “specific behaviours and actions” to effect change (Lichtenstein & Plowman, 2009). This study will seek specific features about “actors” in different primary and community nursing contexts. Williams (2014) found that presence, proximity and visibility, as functions of clinical leaders’ roles, triggered different behaviours or actions to effect change in attitudes or practice. However, the community context may uncover other features about leadership that have the potential to be nurtured and developed to improve patient services. The Bevan Commission (2013) has highlighted how it is imperative for primary and community care professionals’ skills and development to be addressed in light of health needs change across Wales. It is timely to have a new perspective on leadership in community nursing, so that we can develop a robust evidence base to show what works, and to develop the leadership principles that fit primary and community nursing across Wales