This website is intended for healthcare professionals


‘Nurses have been behind some of the greatest innovations in care’

Alex Turnbull discusses nursing, public health, and Brexit with the new RCN chief executive

Dame Donna Kinnair was appointed as RCN chief executive in April 2019, following a tumultuous period in the organisation’s history. She spoke to Independent Nurse about her priorities for the future of the nursing workforce.

What does it mean to you as a nurse to be the chief executive of the RCN?

In many ways this is the best job in nursing and I’m proud to represent nurses every day and unite nursing staff under one banner. When I first became a nurse in the 80s, it really mattered to me that my colleagues were all treated equally, with respect, especially my nursing colleagues who had only just arrived to work here from overseas. I try to remember that now that I’m representing over 400,000 nursing staff members. Whether they work within the NHS or outside it, their goodwill has been abused for too long.

What is the biggest challenge facing nursing today?

Undoubtedly the biggest challenge facing nursing is that demand for our services is increasing and yet there aren’t enough of us to care for us. Successive governments have promised they would think of health in the long term but short-termism still dominates when it comes to health policy. As a result, the Government hasn’t properly planned for a nursing workforce to match the needs of the population. Almost one in ten registered nursing posts are vacant and the pressure falls on the nurses left behind to go above and beyond to keep patients safe. It means experienced nurses who’ve dedicated much of their lives to healthcare fall by the wayside. And since the nursery bursary was scrapped, the nurses of the future are hesitant to take out loan debt and we aren’t seeing the numbers we need apply to study nursing. It’s why the RCN is campaigning for staffing for safe and effective care. Wales and Scotland have already made plans to enshrine safe staffing levels in law but England is lagging behind.

Where do you see nursing in 10 years?

Despite the difficult climate, nursing is a profession that opens doors and nurses have been behind some of the greatest innovations behind the way we care for people today. We launched a cadet nursing scheme in Wales in partnership with the Prince of Wales, the NHS and further education colleges. This provides another way for people who might have thought a career in nursing was beyond their reach into the profession. We’d like to see this extended to other countries in the UK so young people can see what opportunities nursing provides.

What is your view on the Health Secretary’s increased use of tech in the NHS?

It’s promising to see how technology can become a more integral part of the day-to-day care patients receive. Whether that’s more intelligent rota redesign using AI, or genomics to tailor treatment to patients. But nurses have to be considered at the heart of these improvements. If these systems aren’t designed with nurses in mind, using their knowledge and experience as a guide, it would just become another missed opportunity and these revolutionary advances could be underutilised because they’re not fit for purpose.

What is the biggest challenge to public health in your opinion?

We’re living in times when people, in general, living longer lives but often in poor health. Hospitals are seeing demand from older patients with more than one medical problem increase. Sometimes these problems have been caused by lifestyle that could have been prevented like conditions related to obesity. Decision-makers are only starting to properly consider a preventative agenda when generations of nurses have been trained to operate in this way even since I was a health visitor. Despite everything we’ve heard about money making its way to the frontline, planned cuts to public health budgets of local authorities remain in place. When public health responsibility transferred to local authorities, there was potential to radically reform how we prevent ill health in populations. But nurses can’t operate smoking cessation services, or raise awareness of how to eat healthier without vital funding. Similarly, nurses working in fields essential to public health, in community services, district nursing and health visiting, see widespread vacancies. Without tackling these problems head on, the new focus on prevention could be seen as just talk without action.

How do you think that Brexit, particularly in the event of a no-deal, will affect nurses?

With almost 40,000 vacancies, nursing staff from the European Union have played a key part in making sure we are providing the best healthcare possible. Their impact is felt in the NHS, but also the care sector.

It’s for these reasons its concerning the lack of clarity we are receiving from the Government about freedom of movement rules, whether those will end immediately when the UK departs from the European Union, and whether European nurses will be subject to the proposed £30,000 cap for Tier 2 visas. With the health and care system facing a chronic shortage of nurses, we simply cannot afford to lose any more due to uncertainty. There needs to be urgent clarity and assurances from the government that there will be no sharp cut off to freedom of movement and that their systems are up to the job of enabling these applications or we risk losing even more nurses at a time when we can ill afford to.

What is your message to our readers?

Nursing is at a crucial moment and decisions taken now could have far reaching consequences for the stability of our profession. It’s essential that we unite and speak with one voice to ensure we are heard and that patients know that we will not stop until the conditions are in place for us to do our job and look after them with complete certainty that we are doing all we can.