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Tough times in the health sector are not the times to disinvest in quality nurse leadership, says recently resigned chief nurse Mark Jones. Jones told Nursing Review that embedding nursing leadership more deeply in the sector was one of the unfinished pieces of work from his time as chief nurse.

“Whilst the nursing leadership is much more embedded than it was… I don’t think it is bolted down and we need to keep watching that space,” he said noting the issue was particularly important given tightening budgets in district health boards and beyond.

“When you’ve got financial constraints and often increasing requirements for practice and performance targets to be hit, you need quality nursing leadership,” Jones said. “And if you disinvest I would suggest you are not going to get the best out of your nursing workforce.”

Jones resigned late last year after joining the Ministry of Health as chief nursing advisor in 2005 and leaving it as chief nurse four years later after deciding to pursue new directions.

Applications for his replacement were due to close on February 24 with an unknown number of applicants as Nursing Review went to press.

Jones said the second major area of work remaining was for “new and exciting roles” like nurse practitioners and other advanced practise roles to be used more widely.

He noted recent commentary on the low number of specialist physicians in New Zealand compared to other OECD countries and Des Gorman of Health Workforce NZ’s response that he was more concerned about the lack of GPs.

Jones said he would add that we needed to develop more NP roles in primary health and these could complement the skills of the GP workforce. He also hoped the expressions of interest currently being considered for “better, sooner, more convenient” primary care would include wider nursing roles and the “big nettle” of reforming funding of primary health would be grasped to allow multi-disciplinary teams to work to their full potential.

“I think for some policy makers nursing is an afterthought – not out of malice but out of ignorance in the proper sense – people just don’t appreciate what nursing can do.”

Jones said he was encouraged that Health Workforce New Zealand (the name for the Clinical Training Agency board set up last year) was looking at wider roles for nursing – including prescribing for non-NPs – “quite seriously now” as initiatives needed to be on a national, systematic level rather than ad hoc.

Building strategic relationships with emerging national bodies like Health Workforce New Zealand, the National Health Board and the new quality commission would also be a major role for the new chief nurse, believed Jones.

During his own time in the role he took pride in re-establishing the role as “chief nurse” rather than simply chief advisor – a move he believes as “incredibly important” for New Zealand nursing as a chief nurse role created a professional reference point for nursing within the ministry and for the wider health sector.

Another push of his had been to work with directors of nursing around the country to build them into a national health leadership team which he said had not only strengthened their role but also saw them having a stronger influence on policy. “You now hear ‘we need to consult with the DoNs on this’… which when I started I never heard.”

He said the chief nurse role would always be attractive to the right person wanting a challenge. Part of that challenge for his replacement would be the major re-organisation of the ministry and the establishment of new bodies requiring the chief nurse to build a whole new set of relationships to keep nursing at the policy forefront.

“It’s a crucial role.”