This four UK country collaborative project which runs over 12 months until January 2019,  aims to identify the processes and indicators that Nursing, Midwifery, and AHP (NMAHP) leaders use to achieve and demonstrate impact and embed innovative practices across different contexts (clinical care, environment of care, social care & education, organisations, communities and multi-professional teams). Midwives and AHPs are included because of the potential for transferable learning across different contexts.

An in-depth understanding of NMAHP leadership practice and leadership development will be achieved through 4 objectives (O1-4):

  1. Explore the conditions that will enable a successful culture of transformative leadership in these professions.
  2. Develop understanding of the processes of leadership in nursing, midwifery and AHP identifying what works to encourage its growth and spread its insights.
  3. Determine process and outcome indicators to assess effectiveness and impact for leadership practice in nursing and other professions across different contexts.
  4. Link local and global expertise in relation to transformative innovation.

Why is this important?

Enhancing leadership capacity is considered by policy makers and practitioners as key to practice improvement and cultural change (Kings Fund, 2012). Despite significant investment in leadership development (£50 million by the NHS Leadership Academy programme) and the perceived central role of leadership in improving quality of care, there is limited empirical evidence of what works for whom and why.  Many transformational leadership programmes run across the UK with positive local results. A number of researchers recognise the priority need in leadership development is to focus on how to enhance learning from experience, ‘as experience in leadership is demonstrably the most valuable factor in enabling leaders to develop their skills..’ (Kings Fund 2015:25). Nurses have many of the eclectic skills and talents to be leaders at every level of heath care organisation, but their role and impact are often invisible (Cummings et al., 2010). Making these qualities and strategies more explicit will enable nurse, midwives and AHPs to capitalise on the increased leadership opportunities available across different contexts at every level of health care organisation. For example; the need for integration and whole systems ways of working that places the persons’ experience of health care at the heart requires  leadership.

The need to synthesise what works well in both formal programmes as well as everyday experience at every level is required to ensure that nursing’s and other professions’ contribution to leadership is visible. To do this requires the development of a collective imagination about nursing leadership for the future by thinking out of the box and creating a safe space for people to work together to build on and develop what already exists from the evidence base.

Phases of the Project

The project is divided into  three inter-related work streams :

Phase 1:

  1. a) An integrated review of literature embracing grey literature (O1).
  2. b) An E-Delphi study using social media informed by a recently developed UK-wide Social Media research strategy ( for health care research that draws on its unique selling point – ‘rapidity of access’ and ‘scale of consensus’ to engage many nurses, midwives, AHPs and other key stakeholders across the UK, and internationally to answer the questions:

-What are the enablers of transformative leadership in nursing?

-What are the processes of leadership in nursing that work in different contexts?

-What are the outcome indicators to assess transformative nursing leadership across different contexts?

-How would local and global expertise in transformative innovation be recognised? (O2-4)


The two data sets from phase one will be triangulated to develop a provisional set of processes, impact foci and indicators for each context. This phase will also identify 20 expert clinical/care systems leaders, researchers and practitioners in the theory and practice of transformative leadership in nursing, and beyond in each UK country who will be invited to participate in a one day workshop in each country (Phase 2).


Phase 2 the national leaders will focus on a data generation understanding of the processes of leadership in nursing and identify what works to encourage its growth and spread its insights. It will aim to generate fresh insights by combining knowledge and experience from across research, policy and practice drawing on policy and practitioner knowledge by actively engaging participants from these backgrounds. The focus will be to:

-examine and reflect on the results of Phase 1.

-explore the conditions that will enable a successful culture of transformative leadership in nursing.

-present and discuss examples of transformative innovation in practice.

-link local and global expertise in relation to transformative innovation.

-determine process and outcome indicators to assess effectiveness and impact for a culture of transformative leadership practice in nursing. (O2-4)


Phase 3: Five participants from each of the 4 UK countries will be invited to a one-day follow-up in central UK to focus on synthesising findings from Phases 1 & 2 supported by research leads and collaborators. Also, to identify priorities for policy, practice, education and research, as well as, preparing the way for developing a social movement and community of practice (CoP) for sustaining ongoing interest and development. (O3-4)


Data from the workshops/CoP inquiry group will be subjected to systematic and iterative inductive analysis using the constant comparative method (Glaser and Strauss, 1967)

What will the project generate?

The project will generate:

1) A framework that identities and explains the relationships between different contexts, processes, outcomes, impact and indicators.

2) A self-assessment tool that can be used to support formal programmes of leadership development, individual professional development, revalidation and academic accreditation

3) A set of impact indicators that can be used by individual nurses to demonstrate and or evaluate investment in nurse leadership

4) A bank of leadership stories that will be shared through Social Media etc

5) A series of twitter events around Nursing Leadership drawing on experts from WeCommunities, WhyWeDoResearch, FONS, Burdett, Florence Nightingale Network, Q Fellows etc for ongoing support of nurse leaders across the UK


Uptake and engagement will be measured through engagement analytics that will demonstrate

  • -The number of nurses across the UK engaged in contributing to the project
  • -The number of nurses participating in SoMed discussions and debate informing the establishment of WeCommunities.

Project Partners: Professor Kim Manley and Carrie Jackson, England Centre for Practice Development, Canterbury Christ Church University; Professor Belinda Dewar and Dr Belinda Young, Institute for Health Care Policy and Practice University of West of Scotland; Professor Assumpta Ryan, School of Nursing,  Ulster University; Professor Debbie Roberts, School of Health Care Sciences, Bangor University


@KimManley8, @ECPDCarolyn, @EC4PD


NMAHP Leadership Twitter Chat Flyer July 2018