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'We don’t know how lucky we are’

NHS England's director of nursing Hilary Garratt on leadership and optimising NHS resources. By Seeta Bhardwa

Hilary Garratt has just returned from the nurse’s equivalent of a busman’s holiday. Instead of a week relaxing by the pool, she chose to spend some down time volunteering in the Gambia.

Ms Garrett spent the week working with ex sex workers, keeping them off the streets, and working with people living on a rural island to build a health and wellbeing centre. These are far removed from her remit as the director of nursing at NHS England, but it helps her to appreciate the NHS all the more when she returns.

‘The problem is coming back and getting used to the NHS, it’s like re-orbiting,’ she says. ‘We don’t know how lucky we are to have the NHS, we just need use our resources wisely.’

IN spoke to Ms Garratt to find out exactly what is included in her national nursing role and how she is working to develop the primary care nursing role.

What is NHS England working on at the moment for primary care nurses?
We’re doing a lot of work with the vanguards and supporting primary care nurses to understand the models of care and be a part of the new models of care. We are supporting them to understand what real partnership with patients means. The vanguards are doing well, they’re at various stages of development. A lot of initiatives are being led by nurses and midwives which is fantastic.

Another thing I am leading at the minute is the new strategy for nursing. That is going to be a framework and will build on what we’ve achieved in Compassion in Practice which is our current strategy and will conclude at the end of March. We’ve engaged significantly across the country to build this framework and encouraged nurses to really demonstrate how they add value particularly in this current climate. We’ve had over 12,000 responses from frontline staff, professional bodies and academia.

How is health visiting continuing to be supported now that the implementation plan is over?
Before the transfer of commissioning of health visitors was moved to local authorities in October 2015 we put a national set of measures in place which demonstrated the value of them. This was the first time that had ever been done nationally so local authorities could see the impact of health visitors nationally particularly in early years programmes.

What is happening with the mandate to increase joint working across all four UK countries which was introduced at the Florence Nightingale conference last March?
It will be a national approach to describe and recognise the impact of nurses’ professionalism. Lots of work has been done but we haven’t really had a consensus narrative that we can use altogether so that’s what we’re aiming to do at the minute.

Your remit includes improving leadership roles for nurses. How have you been doing this and what progress have you made, particularly in primary care?
We are thinking about how to promote roles in primary care and demonstrate how attractive the roles are. I’m working on that with my primary care professional lead and we’re linking this to the 10 point plan for general practice.

We are thinking creatively about encouraging more nurses in primary to take leadership roles across primary and community care and we’re supporting that specifically in the vanguards. We’re trying to think of a programme like we did with health visitors to make the profession more attractive.

We’re in early discussions with Health Education England and the Royal Colleges. There is a real ambition to do this.

Hilary Garratt is the director of nursing at NHS England