An opportunity to boost nurse impact on global health

Professor Lisa Bayliss-Pratt told Nursing Times she hoped one of the legacies of the Nightingale Challenge 2020 would be that nurses were “taken seriously” as practitioners and leaders, not just by their colleagues but by key decision-makers in every corner of the world.

It was announced in June that Professor Bayliss-Pratt, chief nurse at Health Education England, had been appointed to head up the initiative, which aims to give young nurses and midwives the skills they need to play a more influential role in global health.

By signing up to the challenge, employers agree to provide leadership and development training for at least 20 of their staff during 2020, which has been assigned the International Year of the Nurse and Midwife by the World Health Organisation (WHO). The goal is to get 1,000 employers taking part in order to benefit 20,000 nurses and midwives.

While the project has an expiry date, Professor Bayliss-Pratt said she wanted positive lasting changes from it that would benefit the nursing profession and the public well into the future.

Describing what she hoped would be the programme’s long-term legacy, she said: “First and foremost, [I hope] this doesn’t just end in December 2020, that actually the world has woken up and identified nurses and midwives as key agents in delivering better healthcare for everybody across the world.”

”We’ve got the volume, we’ve got the ability and we’ve got the potential”

Lisa Bayliss-Pratt

At present, she thought some nurses around the world were being held back from being leaders, because their “true value” was not always understood.

“I think a big, big element for some countries is that nurses just aren’t taken seriously enough, and they are not listened to by influencers and decision-makers that aren’t nurses,” she said.

“This [programme] is about influencing the influencers that aren’t nurses. We know we can sell our story to each other really well and we get it, but can we sell it to, for example, the Bill Gates Foundation, can we sell it to donors and investors to seriously contribute to developing this workforce. There’s something about that which I think holds us back, people not really understanding our true value.”

She stressed the “value” that was being missed was nurses’ ability to help the United Nations achieve its goal of delivering universal health coverage (UHC) – where all individuals and communities around the world have access to affordable, high quality healthcare services – by 2030.

“There’s no way any other profession is in a position to ever do that”

Lisa Bayliss-Pratt

With around 20 million nurses around the globe, Professor Bayliss-Pratt said she believed there was no other profession better equipped to be able to bring this vision to life.

“With 20 million, imagine if they were all developed and enabled to be the global leaders and deliverers of UHC for everyone,” she said. “There’s no way any other profession is in a position to ever do that.

”We’ve got the volume, we’ve got the ability and we’ve got the potential, we just need the capability and capacity building. For me, that’s what holds us back, the capacity and the capability building.”

The Nightingale Challenge is a major part of Nursing Now, a three-year international campaign to raise the status of nurses and midwives led by the WHO and the International Council of Nurses, with support from the Burdett Trust for Nursing.

Highlighting what was possible when leaders backed nurses, Professor Bayliss-Pratt noted that Nursing Now had the support of former NHS chief executive and health policy expert Lord Nigel Crisp, who she said saw the potential of nursing to improve health globally.

A key part of the Nightingale Challenge is around forging international links between the different countries and staff taking part, and Professor Bayliss-Pratt said early work had already revealed a “real appetite” among nurses and midwives to connect and become “global citizens”.

She said she hoped that, through the programme, a “global network” of young nurses and midwives would be formed with the “passion and tenacity” to keep it going beyond 2020.

“For the workforce to be able to be more mobile without it being really burdensome would be fantastic”

Lisa Bayliss-Pratt

Suggesting other “spin-offs” that could occur from the campaign, Professor Bayliss-Pratt said it would be “brilliant” if leaders recognised the desire in nurses to be international and put new systems in place that allowed them to move around countries more easily, such as an “electronic passport” that included a common set of competencies accepted around the world.

“For the workforce to be able to be more mobile without it being really burdensome would be fantastic, because there are the nurses out there but they are not all in the right place. And they are not probably doing all they want to do and they are not able to develop in the way that they want to, so if we can crack some of those issues, then I think it would be just brilliant,” she said.

While the programme is open to nurses and midwives of all ages, it is targeted at those aged 35 and under. Professor Bayliss-Pratt said one of the motivators behind this decision was to smash hierarchies in nursing that told younger staff that leadership was not for them.

“I think in some countries… there are perceptions out there that you have to do a job for a lot of years before you can become a leader and that leadership is for older people, but leadership is for everyone,” she said.

The project could help improve retention of young nurses because they would see they were valued by their employer, she suggested, while also encouraging them to continue their “leadership journey”.

“There are perceptions out there that you have to do a job for a lot of years before you can become a leader”

Lisa Bayliss-Pratt

She said she hoped the programme would give them “energy and enthusiasm and commitment to stay with the profession and use those leadership and development skills to take the profession and themselves, and the patients they look after, to the next level really”.

Professor Bayliss-Pratt said she had been pleasantly surprised about how well the challenge had taken off. In the first three weeks since its launch, 95 employers had signed up across 21 countries, agreeing to provide training for almost 5,000 nurses and midwives.

The expectation is for employers in high- and most middle-income countries to fund their own parts of the programmes, while financial support is on offer for less well-off nations. Professor Bayliss-Pratt said places showing interest so far included Uganda, Cambodia, Tonga, Israel and the UK.

The content of the training opportunities will be set locally by each employer, but Professor Bayliss-Pratt said they should focus on three areas – leadership, patient advocacy and practitioner skills. “I think if you get them right then you get brilliant care,” she noted.

Nursing Now was launched in 2018 in response to a report by the UK All-Party Parliamentary Group on Global Health – chaired by Lord Crisp – which determined that UHC would not be possible without strengthening nursing globally. Marking the bicentenary of Florence Nightingale’s birth, the campaign is due to culminate in 2020, set to be one of the most significant years for nursing to date.

As well as hosting the Nightingale Challenge, 2020 will see the publication of a major report by the WHO on the state of the world’s nursing and Professor Bayliss-Pratt said this could a “watershed moment” for the profession.

“It’s going to show what we’ve got, what the differences are, the different levels of investment, the numbers, and how that relates to population-based healthcare,” she said. “It’s got such potential and I think the fact that they have announced that it is going to be the year of the nurse and the midwife in 2020, it feels like we have got real game-changers here.”

“It’s got such potential and it feels like we have got real game-changers here”

Lisa Bayliss-Pratt

Leading the Nightingale Challenge on a part-time basis, Professor Bayliss-Pratt will continue to work as Health Education England’s chief nurse at the same time. She said overseeing the programme was a “once-in-a-lifetime” opportunity to learn more about the global nursing agenda and would equip her with new knowledge and expertise to bring back to her national role.

She said: “Working with the partners, such as WHO, ICN and the Burdett Trust for Nursing… and being connected to all these employers across the world, is just going to give me such insight into the commonalities and differences that we all face – in terms of recruiting the right people, retaining our nurses and midwifery workforce, giving them career development opportunities, and finding ways to put the spotlight on what they do that’s not about nurses and midwives talking to themselves.”

Reflecting on how education had been a “key enabler” in her own career, allowing her to climb to one of the most senior nursing posts in England, Professor Bayliss-Pratt said she would have “jumped at” the chance to take part in the Nightingale Challenge when she was a young nurse.

“I am truly grateful to all the people who have helped me along the way”

Lisa Bayliss-Pratt

After converting from a diploma in nursing to a bachelor’s degree in 1996, she went on to do a master’s in health sciences and then a doctorate in clinical practice.

“That gave me the confidence and the competence, that capacity and capability building, to be able to put myself forward for exciting roles and challenges opportunities,” she said.

Professor Bayliss-Pratt noted she had been lucky during her career because she had “champions” who opened doors for her – and, crucially, she had not been afraid to walk through them. “For me, those have been the things that have been blessings to enable me to do what I am doing now,” she said.

“It’s a privilege to do the Nightingale Challenge, it’s a privilege to be HEE’s chief nurse. I never underestimate that, and I am truly grateful to all the people who have helped me along the way.”

World Health Assembly

Lisa Bayliss-Pratt

Global young nurse event in Geneva, World Health Assembly, with Lisa Bayliss-Pratt (front row, second from left)

What is Nursing Now?

Nursing Now is a three-year global campaign, running from 2018 to 2020, to improve health by raising the profile and status of nursing worldwide.

Run in collaboration with the World Health Organization and the International Council of Nurses, it seeks to empower nurses to “take their place at the heart of tackling 21st century health challenges and maximize their contribution to achieving universal health coverage”.

It will focus on five core areas: ensuring that nurses and midwives have a more prominent voice in health policy-making; encouraging greater investment in the nursing workforce; recruiting more nurses into leadership positions; conducting research that helps determine where nurses can have the greatest impact; and sharing of best nursing practices.

The campaign is being run as a programme of the Burdett Trust for Nursing, an independent charitable trust based in the UK. The campaign board includes individuals from 16 countries.