Ruth May, Chief Nursing Officer, England

Ruth May Health Chat – With Roy Lilley, nhsmanagers.net

Chief Nurse, NHS England. On the Board. Reports into Chief Exec, Simon Stevens. I wish I’d been there to take in the atmosphere. It’s not bad on Periscope (link here to view the whole – well worth it!). This is my take after viewing the event.

Roy Lilley felt a bit more belligerent, in your face and more intent on disagreeing then normal. I’ve been to nearly all the Health Chats. My hunch is that if Roy thinks the job of the interviewee is crucial to the NHS being a haven of excellence and to continue to get better, he is even more passionate than normal (and he is pretty passionate anyway, as you will have witnessed). Ruth May gave as good as she got – and there was a lot of support from the audience, which did sound like it had a number of very interested nursing warriors in it!

Nursing was in the family. She went to gain experience of nursing  after A levels. Degree later – MBA in Hospital Management. We had the graduate chat – do nurses need a degree, really? She knew that was coming, and sort of ignored it. “We need to have graduate level conversations”. End of. Then another humdinger. Being accepted as a woman in senior role? She knew that was coming. Recounted a story when she met the then Health Secretary, Virginia Bottomley. Ruth’s boss in the gratuitously demeaning and condescending way that us thoughtless men sometimes manage said “where’s the little girl gone…”. Virginia came back in at the end of the meeting and said to Ruth “Don’t let that happen again”. And I’m guessing she hasn’t?

2 years as a theatre nurse, Frimley Park to St Albans/ Hemel Hempstead before the transition to management. She wanted to be at the leading edge. And to still be clinical. I got the feeling she thought it was crucial – people tell you a lot more if you wear the uniform with pride too, and get your hands dirty. You keep the door open.

I get the impression Ruth learned as much from working with excellent bosses and leaders, and she stole their methods and ideas with much pride. I contend you learn as much from bad leaders – you know you would never do it like that seems to be a stronger learning for me. But I suppose it says a lot about her mindset that many of her learning examples and her current experiences were all couched in the positive.

Ruth’s number one priority is workforce. She knew that question was coming, too. How do we stop people leaving? How do we get people to come back? How can we be more flexible? How do we stop people moving from hospital nursing to primary care – where the shift work is much less onerous? How do we stop 20% of newly qualified nurses leaving almost as soon as they are graduates? Should we really be stealing overseas nurses from their home countries?

And that wasn’t all the question areas!

Roy banged on. “We don’t want business cases, we want action. You’re the Chief Nurse. Go to the Board and tell them”. OK. There’s no magic thing you can do. No really instant fix (except getting returners to consider coming back via Mumsnet , which sounds like an excellent idea). But sharing best practice can turn the megalith around. Churn of nurses is now 11.9%. Lowest it has been for 4 years. This chat was on Ruth’s 137th day in post. She has already got 5000 extra clinical placement places for nurses for this Septembers intake. 168 Trusts have signed up. It’s the biggest increase ever.

The flexibility issue exercised both the protagonists a lot. It appears that some people just push the boundary well. One of the many software packages for working out the rotas is called Allocate (others are available…). Milton Keynes worked with the software people and made it more flexible. Roy contends that this makes sense to be a national solution – a nationally worked out piece of kit that is then provided more cheaply? Makes sense to me…

The flexibility issue is there even in other areas – like training of new nurses. Why have the only graduate course starting date in September? Surely there could be intakes in January and March or whatever too? And what about the Apprentice Levy? £2 bn. is tied up in this. Why do it? When an apprentice has to be supernumerary on the ward, so it doesn’t really help with cover and rotas. Ruth could just go to the Board and ring fence the training budget and make a special case for the apprentice levy?

 It all sounds so easy in a chat…

Ruth’s other priorities are about pride in the work and celebrating success. Make everyone proud to be a nurse – so more likely to stay? 2020 is going to be the year of the nurse. Should there be a national nurse uniform? This audience thought so. One job. One linking sense of belonging. One enormous proud workforce. Simon Stevens has often stated that we want the NHS to be the best place to work for. I think Ruth’s level of priorities, including a very strong collective voice will help this to become a reality.

There were lots of great questions – what about the 55% of nurses who work outside of the NHS? What about Community nurses? What about primary care nursing? You’ll have to watch the recording to get to these answers. But the last question was from Amelia Tickell, who had started the show too. “When I go back to school, what can you say to the question why should I become a nurse?”.

“It’s an amazing profession, where you are with people at the most profound moments of their lives. At the start, at times of illness and at the end. That to me is priceless”

I can’t really add to that. Thank you Ruth.