A year ago, I stepped into the role of Regional Director for the North West at the Royal College of Nursing. Twelve months later, I’ve taken some time to think about what this first year has really meant.

Listening First
The North West is a big and varied place – busy cities, rural communities, coastal towns, major teaching hospitals, community services, the independent sector and universities.

So my starting point was simple: listen.
To members.
To activists.
To staff.
To students.
To senior nurse leaders.
To those who feel proud of the RCN.
And to those who feel frustrated by it.

What has struck me most is the depth of commitment across the profession and the weight people are carrying.

After years of financial pressure, a global pandemic and constant demand, it’s no surprise that nurses are tired. Every day, people are holding complex risk and working in systems that feel stretched and often reactive. And yet, the professionalism never slips.

Recentring Clinical Leadership
Throughout the year, I’ve come back to the same principle: the NHS should be clinically led, operationally managed and financially enabled. Too often, those priorities get turned upside down.

Finances matter. Operational grip matters. But when financial thinking pushes aside clinical judgement, the system becomes fragile. When professions are talked about in terms of cost rather than value, morale falls and patients feel the impact.

Part of my role has been to say clearly, both publicly and privately, that nursing cannot be pushed to the edges. Ours is a safety-critical profession, grounded in evidence, skill and ethical decision-making. Sometimes that has meant challenge. Sometimes it has meant quiet diplomacy.

Pay, Progression and Professional Value
Nationally, we are seeing early signs of movement on pay and career progression. But across our region, we still feel the effects of inconsistent workforce planning and big differences in how roles are banded.

Agenda for Change was built to bring fairness and structure. Twenty-two years later, without proper workforce planning behind it, the system feels stuck and progression feels uncertain.
These conversations about pay, development and advanced practice are not just HR issues. They are conversations about value and respect. If we want experienced nurses to stay in the profession, progression needs to feel fair, clear and achievable.

Representation and Inclusion
This year, I’ve spent time with members from African, Asian and minority ethnic backgrounds who still face barriers to progression and disproportionate experiences in disciplinary processes.
I’ve listened to internationally educated nurses trying to find their way in new and unfamiliar systems. I’ve been part of conversations about inclusion, identity and what it really means to represent a workforce as diverse as ours.

For me, inclusion cannot be performative. It has to be about creating a place where people genuinely feel they belong, without letting identity become something that divides us.

The Personal Dimension
This year has also mattered on a personal level. I’ve been building new networks and relationships, balancing regional responsibilities with national work and learning how to lead strategically while still being present with my team.

What has become clearer is this: leadership is relational before it is positional. A job title might suggest authority on paper, but trust is earned through how you show up, how consistent you are and how you hold boundaries, especially when conversations are tense or emotions are high.

What I Have Learned
Members want honesty more than perfection.
Clarity stops conflict before it starts.
Boundaries are not barriers; they are protective.
Systems change slowly, but small shifts matter.
Nursing remains one of the most intellectually and ethically demanding professions in the UK.

Looking Ahead
The year ahead will not be easy. Integrated Care Systems continue to change, new organisations appear, whilst others are dismantled. Financial pressures are not easing. Workforce supply remains fragile. Political scrutiny is growing.

But there is opportunity:
To strengthen activism in a thoughtful, mature way.
To improve the working lives of nurses and nursing support workers.
To deepen our partnerships with universities and nursing leaders.
To ensure the RCN stands confidently as both a professional body and a trade union.

One thing is absolutely clear to me: nursing isn’t an add-on to the health and care system – it is its foundation. Our job is to make sure that truth is heard, understood and acted on.

One year in, I feel even more certain about the importance of that work.