About you
What is it about your job that you feel would surprise the public?
The NMC is the largest professional regulator in the world. I think people would be surprised both by the huge variety of issues I address in my role and some of the limitations. We don’t have authority over organisations, staffing levels and how nurses, midwives and nursing associates are deployed or managed. But through the professionals we regulate, the NMC ultimately influences the experience of everyone using health and care services in the UK, which means my job is a huge responsibility and a great privilege.
What’s been the biggest change you’ve seen since you started working in the NHS and social care?
I started my career in 1986, so I might say email! Digital technology has certainly transformed our working lives. More seriously, over the last 30 years, care has become more effective but more complex. This has led to greater service demand, higher expectations and the need for staff, especially nurses and midwives, to be increasingly more knowledgeable and skilled in all health and social care settings than before. Our new educational standards seek to address these challenges.
If you could make one change to the NHS and social care over the next 10 years, what would it be?
That the principles of co-production between citizens, people using services, clinical staff, managers and policy-makers are truly embedded and mean something to everyone involved. We have got to value each other’s contributions and listen to and understand what matters to people. I have seen, particularly in my work at CQC, the huge positive difference this can make.
Change from the top
If you could give Matt Hancock one piece of advice, what would it be?
Please remember it’s all about the people and you forget social care at your peril. Fortunately he has already restored the role of the Chief Nursing Officer within the Department and we now have a Chief Midwifery Officer in England too. I am glad to see that Ruth May and Jackie Dunkley-Bent will be bringing their strong voices for nursing and midwifery to the highest tables or I’d have had to say that too.
What do you wish people at the top of the NHS understood?
People need time to care. Nursing and midwifery should not be focused on the bare minimum to maintain safety, there is a lot more to it than that. People's experience matters and that means making sure nurses and midwives have the time and space to pay attention to the details that make such a difference. Nurses and midwives didn’t just choose a job, they chose a meaningful career, and we need to nurture, cherish and support them to be the nurse or midwife they want to be.
Policy in practice
What policy have you seen successfully implemented, and why did it work?
I’m very proud to have been a part of the early development of NICE – this year celebrating its 20th anniversary. It worked because we had a clear purpose – a resolute focus on evidence-based practice alongside a commitment to involving patients and the public in our decision making. We had strong, stable executive and non-executive leadership, and a recognition from government that this independent arm’s-length body really did need to operate independently.
What policy have you seen fail, or not be as successful as first intended?
Integration. How many of us working in health and social care are battling with the system on behalf of family or friends, despairing of the complicated structures, lack of coordination, unexplained delays and the apparent inability to provide truly holistic, person-centred care? I know I am. And we're the ones who should have a clue, so what about everyone else?
What policy and/or change in behaviour are you currently trying to implement, and how’s it going?
I want the NMC to be a human, kind regulator treating all the people affected by what we do with dignity and respect. This means listening carefully and responding compassionately to the public when they approach us with concerns about professionals on our register, understanding the challenges nurses, midwives and nursing associates face, being responsive to their needs and providing appropriate support, and working well with our partners. We are working on a new approach to Fitness to Practise to achieve this.
Bonus question
The NHS is under pressure because...
Too often, the NHS operates as an island not recognising its interdependence with other sectors, particularly social care. The longer social care is treated as a poor relation, relegated to the shadows and unrecognised for the important contribution it makes to people’s lives, the less likely it is that the NHS will be able to withstand modern-day pressures.
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