The Role of the Executive Nurse

A joint King’s Fund and Burdett Trust project

Ensuring a high-quality patient experience is a key issue for the whole board of NHS provider and commissioning organisations. Executive nurses are well placed to lead the ‘business of caring’ on their board’s behalf, not least because of the increasing breadth of their responsibilities. Much is required of executive nurses yet little is known about their impact and potential.

In 2007, the King’s Fund and the Burdett Trust for Nursing launched a joint initiative to work with executive nurses and their boards to ensure a high-quality patient experience. In particular, the initiative explores how the knowledge and expertise of executive nurses can contribute to board discussions and decision-making most effectively. This is intended to help trust boards have a better understanding of the clinical impact of budgetary and operational decisions and so improve the quality of patient care.

The initiative involves King’s Fund leadership fellows working with two small cohorts of executive nurses and their boards from across the UK – to explore through coaching, observation of board meetings and feedback how best to achieve high-quality, board-level clinical engagement. This practical work will be reviewed and interpreted in order to develop recommendations for wider dissemination. A literature review and web research were also undertaken at the outset to try to summarise what it already known about the role and impact of executive nurses. This report, A seat at the top table: Executive nurses and their impact in the boardroom, is available as a download from the selection on the right of this page.

Work with the first seven NHS trusts and their executive nurses began in October 2007 and a review of this work will be completed by the end of 2008. Recruitment of the second cohort of executive nurses and NHS trusts began in June 2008. The sites chosen were:

  • Lincolnshire Partnership NHS Foundation Trust
  • Dudley Group of Hospitals NHS Trust
  • Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust
  • Ealing Hospital NHS Trust
  • Weston Area Health Trust
  • The Rotherham NHS Foundation Trust

The executive nurses taking part in the initiative will also be supported to take part in a programme of personal development of their choice.

The joint initiative builds on work undertaken by the Burdett Trust, including: Who Cares, Wins – a report commissioned from OPM and published in 2006 that explored the business aspects of patient care; and an exploratory study commissioned from University of Plymouth into the clinical content of NHS trust board meetings that is now being followed up.

The initiative also has strong links with two other King’s Fund projects: