This paper reports the results of a review of the Nurse Consultant role at Nottinghamshire Healthcare NHS Trust the aim of which was to provide a clear picture of the current role remit and impact of each Nurse Consultant to inform recommendations for [any] required revision and ensure that Nurse Consultant’s roles and responsibilities are aligned to the evidence on best practice, reflect the Trusts business priorities, and that there is a well understood model in operation.
Using multiple methods of data collection, we investigated perceptions of the impact of Nurse Consultants among general managers and clinical directors, service users and carers, and selected other colleagues using semi-structured interviews and a focus group, as well as exploring with Nurse Consultants their view of the impact of their role via semi-structured interviews. In addition, we evaluated the leadership skills of Nurse Consultants using a 360 degree evaluation. Finally, we examined the activities of Nurse Consultants by analysing their diaries during a three month period.
Nurse Consultants spend 38% of their activity on expert practice, 26% on professional leadership and practice, 19% on education, training and supervision and 15% on practice development, research and evaluation; 2% is spent on other activities. On the 360 degree evaluations, Nurse Consultants scored highest on enabling others (median 52/60), followed by modelling, encouraging and inspiring others (51/60). They scored lowest on challenging others (47/60). General Managers and Clinical Directors reported the positive impact Nurse Consultants have on clinical leadership and their contribution to improving clinical strategies and service developments. Service users and carers reported that they value the role, but were critical of the absence of Nurse Consultants in acute mental health wards.
The practices of Nurse Consultants at Nottinghamshire Healthcare Trust reflect the suggested domains of the role, but they fall short of national expectations of the percentage time NC should spend on expert clinical practice. There is widespread recognition of the positive impact of the role on service development and evidence of the positive impact of Nurse Consultants on practice. In general, colleagues recognise that Nurse Consultants are positive role models, who inspire, challenge, encourage and enable others. There is a widespread belief in the untapped potential for Nurse Consultants to play a more strategic leadership role in the Trust. Recommendations are made for the future development of the Nurse Consultant role.