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Interview: Janet Davies, new chief of the Royal College of Nursing

It was a unanimous decision to appoint her into the role after nine years as The Royal College of Nursing (RCN) director, and her predecessor Peter Carter describes her as “an inspiring and energetic colleague, who has put nursing at the forefront of everything she does”.

In terms of the government's current plans, she says: “Seven-day care will only be successful if we have investment in nursing. Yes we can change rotas and move people around, but then it's extra work, it's not the same work being done at different times.”

Similarly she says that the plan to move care into the community is “absolutely the right thing” however, “the reality isn't connecting to the rhetoric at the moment… We've seen some areas where we've got vertical integration and then staffing levels in the community are being reduced, which seems quite strange when actually we're meant to be investing in community services to make this happen”.

From 1 October 2015, the responsibility for commissioning health visiting services will transfer from NHS England to local authorities. In response, the chief exec says: “In some ways it's a very positive move because its about basing health visiting in the community where it belongs. It will also allow much more integration with children's services.” However, she cautiously warns that “we know local authorities are really struggling with their budgets, and we are nervous that they will look at health visiting as something they might wish to dilute, but we don't know that yet”.

In order to highlight these issues to government and policy makers, and hopefully resolve them, she says her number one priority is getting the college 425,000 nurses, midwives, health visitors, nursing students, cadets and health care assistants more engaged. “The real experts of nursing are in our membership so it's really important we enable their voice to be heard,” the nursing leader of 20 years' says.

In terms of current problems she feels that nurses are “the solution to many of the issues we're facing in health” and says that it is really important to her that nursing is “seen for the valuable profession it is”. One way of articulating the value that nurses provide is through revalidation, a measure she says thinks is “really positive”.

“We know that nurses are really keen to get further education, further training, further opportunities for development, and we're hopeful that revalidation will enable that… But reflective practice isn't something that we do everyday and is perhaps something that we have to learn better. It enables us to articulate the value that we provide,” she adds.

However, she recognises that nurses' pay doesn't reflect their value either - due to the five-year pay restraints - which she says has forced many nurses to use foodbanks or tax credits. “For a professional who's working in such a valuable job I think its pretty significant that they're having to resort to that level of support.”

Similarly, whereas nurses used to do agency work occasionally, to fund a holiday for example, now many turn to agency work and second jobs to pay the bills or childcare costs, she explained.

“Interestingly, with the new immigration rules the salary that was set by the government for a professional was £35,000 a year, nurses are way off that! And it's fascinating that that is the value that the government put on a professional that should be able to stay in this country because they are so valuable, and yet we've got nurses working in the community with some of our most vulnerable people who are never going to earn that much. It says a lot about how we value nurses in the fact that the salary doesn't even reach what's been set by the government themselves,” she adds passionately.

According to NHS Careers, a fully qualified NHS nurse will start their career paid at band 5 (from £21,478 to £27,901) of the 2014/15 Agenda for Change rates. A practice nurse should expect at least a salary starting at band 5. However, even a specialist nurse working in GP practices or schools would not hit the £35,000 target, and would expect a salary at band 6 (from £25,783 to £34,530).

Despite this problem, at the moment Davies feels that
the “number one pressure” on nurses is staffing levels, and says: “I think we need to look way into the long term… We seem to do things in the short term but that creates problems later. We do need to have that long term vision, because I think that's one of the biggest issues.”

Thinking about the future of nursing, she predicts “in five years we will still be leading clinical care. We'll be using data more and working with technology in different ways”.

As a fan of technology she says that this is changing the relationship between nurse and patient. Whereas it used to be that nurses “were the ones making the decisions,” now she feels that “we're much more in partnership and that's absolutely right. Patients are more empowered”. In November 2014 the report Personalised Health and Care 2020: Using Data and Technology to Transform detailed the importance of using it to help people use care services less. Branding it “key to helping our NHS meet the efficiency, as well as quality, challenges it faces”. Currently NHS England is looking at rolling out free wi-fi across all of its estate, and telephone, email and video appointments are becoming more common across the country.

However, Davies does not want nurses to forget that this type of care would not suit all patients. “We can work much smarter, and that includes using technology for remote working, but never forgetting that with nursing it is that human contact that makes the biggest difference. It isn't about us being technicians, we mustn't forget that care and compassion, which should be essential.”

In fact, her most memorable experiences of nursing were working directly with the elderly and people with dementia. “I worked for a long time with older people and it really was about people with complex needs. It was the nursing that makes a massive difference in getting people home, people that perhaps didn't think they were going to go home.”

After starting nurse training at just 17 - after one year working in a mail order company “to gain some life experience” - she says that in her current role there is still something every week that makes her feel proud of being a nurse. “Not necessarily of what I've done but of what nurses have done… nurses are doing some really incredible things, they're making a huge difference to patient care and I think that needs to be recognised.” In the future Davies also thinks that nurses will be taking on even more roles, “I think we will be enhancing our practice, working very much in a multi-professional way.  I'd like to hope that we'd be being valued more too, that's my hope.