This section introduces the leadership theme. Resources to support this theme are:


The Prime Minister’s Commission on the Future of Nursing and Midwifery in England stated that senior nurses should champion quality from the point of care to the management board. In the report’s recommendations, commissioners said senior nurse managers must accept full managerial and professional accountability for high quality care. ‘Employers, managers and professional colleagues should be fully committed to involving nurses and midwives in making policies and decisions, from the board to the point of care.’ (Department of Health, 2010, p. 83).

We know from the literature on leadership (Adair 2002, Alimo-Metcalfe 2003) that individuals are effective when they are confident and competent, aware of their own behaviours, strengths and areas for development, when individuals work well with their team members and are patient-focused, when they are good at networking and are politically aware (both organisationally and nationally). Those that are able to match their leadership approach to the teams they work with have a major impact on performance.

We also know that people working in health and social care need to modernise services and harness the potential of new technologies. They need to make services more responsive to the populations they serve. They must manage resources, and an increasing number of opportunities and requirements for partnerships with different kinds of organisations. Furthermore, increasing pressures to adopt a more corporate approach to commissioning and social enterprises is forcing nurses to rapidly adapt and change in response to the current turbulent nature of the NHS.

There are clear links between this section of the clinical governance resource and the RCN Principles of Nursing Practice, launched in 2010. The Principles set out what patients, colleagues, families and carers can expect from nursing. Principle H encompasses themes of leadership contributing to an open and responsive culture.

‘Nurses and nursing staff lead by example develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs.’ (McKenzie C and Manley K, 2011). Principle H explores the themes of leadership and responsive care in all care settings. Principle H is essential to enable nursing teams to provide care that consistently reflects all of the other Principles of Nursing Practice. For further information, see Principle H.


Adair J (2002) Effective Strategic Leadership London: MacMillan

Alimo-Metcalfe B (2003) Leadership Stamp of Greatness. Health Service Journal 113(5861) 26 June pp.28-32

Department of Health (2010) Front Line Care: the future of nursing and midwifery in England. Report of the Prime Minister’s Commission on the Future of Nursing and Midwifery in England 2010. London: Department of Health

McKenzie C, Manley K (2011) Leadership and responsive care: Principle of Nursing Practice H. Nursing Standard 25(35) 4 May pp.35-37 (PDF 94KB) [see how to access PDF files].