How did it feel to be appointed to the role of chief nurse for adult social care in England?
I was appointed as interim chief nurse in December 2020 and made substantive in September 2021. In all honesty I had mixed emotions because it was a bit of a wrench leaving my team at the Royal Hospital Chelsea where I worked as director of health and wellbeing.
We’d worked through the first year of the pandemic together and I felt a huge sense of loyalty to the people I’d been with on the frontline.
I was also very humbled. I saw it as a huge responsibility and felt an overwhelming sense that I mustn’t let anyone down.
In your words, what is social care?It’s diverse – spanning across physical and mental health needs – and it’s a vital part of the whole health care system. For me, it’s about trying to maximise people’s opportunities for independence and supporting them to reach their potential throughout their whole life – from young people to older adults.
It’s highly skilled and highly complex, and much needed in communities where it strongly interlinks with housing, employment, and the NHS.
It's about trying to maximise people's opportunities for independence
Why was your role created?
The work around COVID-19 highlighted the need for national representation of social care nursing and parity with the NHS, as well as for enhanced clinical leadership for the workforce. Seeing the need for a championing voice for wider care professionals working in social care, Ruth May, Chief Nursing Officer for England, was instrumental in pushing for the role to be created.
What motivates you?
Making a difference, that’s what gets me out of bed in the morning. Social care is something I’ve been drawn to for more than 30 years. It’s only now, looking back, that I can see pathways to this point were being carved out throughout my career. As a student nurse working on an older people’s ward, I remember there were three women in their 80s who had dementia, and all called Catherine. They were segregated in a small sitting area and collectively known as “the three Cs”.
I found it so upsetting, it was so dehumanising. I spoke to my tutor and she said you have two choices – you can leave or you can stay and do something about it. It sparked something in me and I knew I could only change things if I stayed.
I went on to do my health and social care masters, self-funding it while I worked as an agency nurse on night duty. I learnt so much through the research I did around care homes, and I also witnessed some fantastic care which spurred me on even more.
As I’ve moved through my career I’ve been motivated not because a job might pay the most but because if I can do that job, I can influence more and have a greater impact. If you’ve got a skill set that can help improve something, then you should use it to best effect.
What are you responsible for?
Supporting civil servants and UK government ministers to deliver on national policy and providing operational insights into decision making. The most significant part of my role is to act as a champion and voice for social care nursing staff at a national level, representing their interests in government.
It’s vital that I’m open and receptive. I’m often out and about talking to people at grassroots level, making sure my reality is grounded and using feedback to inform my thinking and advice. I’d like to encourage people to get in touch with any questions they have. I can be contacted by email and welcome your ideas and views.
Unless we have a well-supported workforce, how can we expect people to care for others?
What are your main priorities at the moment?
Number one is the workforce – that’s the absolute priority in terms of recruitment and retention. How do we develop the future nursing workforce and make sure it has what it needs to thrive? How do we move towards talking about careers in social care?
Secondly, the adult social care white paper and reform agenda – what does that look like as a career pathway for people? We need to be lifting people up and having that recognition of their skills.
And finally, wellbeing and how we best support our staff emotionally. COVID-19 has shone a light on the vital jobs people are doing and the sheer emotional investment they put into their roles – the long-term relationships, getting to know individuals and their families in a very personal way. Unless we have a well-supported workforce, how can we expect people to care for others?
What are the biggest challenges facing adult social care at the moment?
Again, the workforce. We need the right people with the right values and attitude to come into social care. How do we get all nursing students to have an experience of social care as an undergraduate? For me, that’s absolutely key. My experiences as a student in a care home had a huge impact on me.
My ambition goes to everyone in health care, really – I’d like to see all undergraduates in health care spend some time working in social care to experience it. People need shared insights into how each other’s worlds work and to value and appreciate each other to create change.
What are you most proud of in your work?
The people I meet. Being around people who are so passionate, with a common and shared belief that we can do even better for people.
The joy that good professional care can bring to people’s lives. It always comes down to people – we look after people, and it’s people that look after those people. They amaze me every day with their hard work and commitment.
We all have to be advocates for social care
What’s the best piece of advice you’ve ever been given?
My sister once said: not to challenge is to condone. If we don’t challenge poor behaviours in others, how do we value each other – particularly around how we are treated and cared for? I feel passionately that if we don’t take a stance, we are complicit.
Anything else you’d like to say?
Just that I’m looking forward to helping build a positive future for social care. If we can all come together in a positive way, we can be very strong about it, but everyone needs to take ownership.
We all have to be advocates for social care – we’re all part of the solution. And although we must always acknowledge what needs to be changed, it’s equally as important to share the great stuff that’s going on and have the confidence and self-belief to do that.
Deborah was made a Fellow of the RCN in 2019.