RCN Congress 2026 & RCN North West Multicultural Group (NWMG)

England's North West is certainly in the news at present, on two counts:

1. The current Labour party machinations in the Makerfield ward;
2. and RCN Congress in Liverpool.

 As I attend Congress a key focus is the debates and how I can relate these to Hodges'model - (with some links to previous posts):

1. Nursing as a STEM profession
Matter for discussion submitted by the Eastern Board
That this meeting of RCN Congress discusses the recognition of nursing as a STEM (Science, Technology, Engineering, and Mathematics) profession, valuing the scientific, technical and analytical expertise of nurses.

STEM - science : technology : engineering : mathematics

2. Safe, ethical, person‑centred nursing
Resolution submitted by the Cheshire Branch
That this meeting of RCN Congress calls on RCN Council to urgently develop and implement a UK‑wide framework for realistic person‑centred care, ensuring that nursing practice is safe and ethical.

safe : ethics : person-centred 

3. Regular redeployment
Matter for discussion submitted by the Wiltshire Branch
That this meeting of RCN Congress discusses the impact of the daily redeployment of nursing staff on morale, team work and patient safety.

re- deployment

4. Unpaid hours
Matter for discussion submitted by the North East London Inner Branch
That this meeting of RCN Congress discusses the culture of nursing staff missing breaks and working beyond their contracted hours.

work

5. National safety standards for lone working
Resolution submitted by the Health and Safety Reps Committee
That this meeting of RCN Congress calls on RCN Council to lobby for the implementation of national safety standards for lone working, ensuring access to appropriate safety equipment, technology and protocols to protect staff across all care settings.

lone working

6. Accountable, compassionate and psychologically safe leadership
Matter for discussion submitted by the Cheshire Branch
That this meeting of RCN Congress discusses how the RCN can help create a culture where accountability, compassion, and psychological safety coexist, enabling managers to lead effectively while ensuring all staff feel respected and protected.

accountability : compassion : leadership 

7. Misinformation in health care
Matter for discussion submitted by the Women's Health Forum
That this meeting of RCN Congress discusses misinformation in health care and the impact this has on the nursing workforce.

misinformation : information disorder

8. Confidence to address racism
Matter for discussion submitted by the South West London Outer Branch
That this meeting of RCN Congress discusses how to build the confidence of nursing staff in addressing racism.

confidence : racism

Once again the North West Multicultural Group will have a stand:

The RCN North West Multicultural Group (NWMG) creates a community for members across the region from multicultural ethnic backgrounds to connect with each other, share their lived experience, knowledge and diverse ideas that help drive change around racism to ensure that their various organisations is the best place to work.

Membership is open to RCN members of Royal College of Nursing from multicultural backgrounds and their allies.

Mission statement: 

The aim of the North West Multicultural Group is to stand against racism and discrimination by using members lived experiences, encouraging organisations to be anti-racist and with the support of allies.  

Aims and objectives: 

• To raise the issues around race, discrimination and equality in the workplace and to find potential solutions. 
• To challenge misconceptions about people from different ethnic backgrounds.
• To recognise the skills and contribution to care for people from all backgrounds make.
• To acknowledge that racism is a social construct that needs to be eradicated together.  Together we are stronger.
• To be a platform for black, Asian and minority ethnic staff and allies to work collaboratively to address racism in practice.
• To help amplify the voice black, Asian and minority ethnic staff.
• To be role models, set examples as allies and develop confidence.
• To provide training and support about anti-racist practice.
• To work with the RCN to support campaigns to make sure communication is fit for purpose and acknowledges any cultural differences. 

Your executive team:

Chair: Olanike Babalola
Vice Chair: Susan Owen-Naz
Communications Officer: Mark Anthony

9. Advanced nursing practice
Resolution submitted by RCN Council
That this meeting of RCN Congress agrees that the RCN will act upon attempts to undermine advanced nursing practice.

advanced : practice : theory

10. Protecting nurse education
Resolution submitted by the Education Forum
That this meeting of RCN Congress asks RCN Council to lobby UK governments to protect nurse education from university sector economic pressures.

protect

11. Quality of clinical placements
Matter for discussion submitted by the Students Committee
That this meeting of RCN Congress discusses ways in which the quality of clinical placements can be ensured and consistent across all 4 countries.

quality : placement

12. Bank rates
Resolution submitted by the South Yorkshire Branch
That this meeting of RCN Congress demands that employers pay nursing staff bank shifts at their substantive rate.

pay

13. Are external reviews meaningful?
Matter for discussion submitted by the Midwifery Forum
That this meeting of RCN Congress discusses whether external reviews and inquiries are genuinely driving meaningful improvements in safety across health and social care.

inquiry : review

14. Improving acute mental health crisis services for children and young people
Resolution submitted by the London Board
That this meeting of RCN Congress calls on RCN Council to lobby UK governments to improve the provision of services to children and young people presenting in acute mental health crisis.

children : mental health

15. Access to specialist pain services
Matter for discussion submitted by the Pain and Palliative Care Forum
That this meeting of RCN Congress discusses access to specialist pain services and the role of the registered nurse in caring for those in pain.

pain

16. Palliative and end-of-life care
Resolution submitted by the Pain and Palliative Care Forum
That this meeting of RCN Congress calls on RCN Council to lobby UK governments to ensure everyone living across all 4 nations has access to specialist palliative and end-of-life care.

palliative

17. Accessible and affordable travel
Matter for discussion submitted by the North Central London Inner Branch
That this meeting of RCN Congress discusses what accessible and affordable travel means for the nursing workforce.

18. Uptake of physical health checks
Resolution submitted by the Public Health Forum
That this meeting of RCN Congress requests RCN Council to lobby UK governments to improve the uptake of physical health checks for people with learning disabilities and serious mental illnesses (SMI).

serious mental illness (SMI)

19. Eye donation
Matter for discussion submitted by the Greater Glasgow Branch
That this meeting of RCN Congress discusses the role nursing has in eye donation in end-of-life care planning.

eye : vision

20. 35-hour week
Resolution submitted by the Lothian and Borders Branch
That this meeting of RCN Congress calls on RCN Council to instigate a campaign for a maximum 35 hour working week for the nursing workforce.

21. Inappropriate delegation
Matter for discussion submitted by the Berkshire Branch
That this meeting of RCN Congress discusses the delegation of health care tasks to school staff and non-health care professionals.

22. Access to medicinal cannabis
Matter for discussion submitted by the Cheshire Branch
That this meeting of RCN Congress discusses the impact of current NHS prescribing practice on access to medicinal cannabis.

medicinal cannabis

23. SPA time
Resolution submitted by the Wiltshire Branch
That this meeting of RCN Congress calls on RCN Council to lobby for the inclusion of Supporting Professional Activities (SPA) time in all nursing job-plans.

See: https://www.rcn.org.uk/Congress/Agenda 

Are there any lessons from this exercise? Well, I have no posts tagged 'donor', or 'medicinal cannabis' - to make an important distinction. Something to correct and try to follow this week. 

See you there ...?

(I may need to reduce the link-count here.) 

Reflections: "Reimagining the nursing workload: Finding time to close the workforce gap"

Redesigning care models through intentional delegation and

potential tech enablement can free up nurses’ time.

I learned of this study through twitter (see below) and ongoing awareness of the work, contribution and debate regards management consultants over the years. The research study was conducted in USA and I have no work experience there. As stated many times on W2tQ: my context is UK-based and public sector - NHS. I have been seconded in the past to a project which engaged management consultancy companies, the work involving IT and communications. The latter was focussed upon (much needed) IT engagement and being 'on message'. 

If employed long enough in the UK public health sector, you will come across consultancy employees eventually (whoever is in government too). Through news, media, consultants (friendly, with wide experience, eager to engage and deliver) will be introduced to the team, on placement for several weeks to collect data through a series of meetings, and conduct a presentation about impending change. The management consultancy sector  often have a bad press, with ongoing critique and debate regards their role, across the Atlantic and globally. More on that to follow.

McKinsey: LinkedIn

A brief introduction to the study follows:

"We conducted a survey of 310 registered nurses across the United States from February 8 to March 22, 2023. Our goal was to understand nurses’ perception of time spent throughout the course of a shift and to identify existing and desired resources to help nurses provide high-quality care. Our sample focused on nurses in roles that predominantly provide direct patient care in the intensive-care unit, step-down, general medical surgical, or emergency department settings. Insights were weighted by length of shift (the minimum shift time included was six hours)." p.2.

To begin, I like 'reimaging' in the title. Healthcare should always be about imagination, envisioning, and action - on an individual and collective basis. Organisational reimaging is also what management consultancy is predicated upon. 'Care model' here, appears to refer to the care environment (and experience?) as found. Gap, also in the title is another positive. Gaps must be seen, to see how we might close, bridge and span them.

 

Over several decades a preoccupation with 'process' has been apparent: the nursing process and processes as events and sequential series in project management. But what is this? No 'process' but one instance of processes. While this was encouraging, as presented, emphasis is placed on activities and tech - both of which can engender reductive and task-based perspectives. Allied with tech, improved delegation is the stated aim of the study. 'What do you expect?' - might be the rejoinder. As per the twitter replies the study conforms to type, brief and 'message':

"Achieving this may require health systems to invest heavily in technology, change management, and workflow redesign.

Realizing these changes will require bold departures from healthcare organizations’ current state of processes. It will be critical for hospitals to bring both discipline and creativity to redesigning care delivery in order to effectively scale change and see meaningful time savings. Close collaboration beyond nursing is also paramount to ensure alignment across the care team and hospital functions including administration, IT, informatics, facilities, and operations." p.8.

Technology is often described as the catalyst, but the impact (and risks - safety?) are often missed - a case of 'wag the dog'?

 

There is a global shortfall in the nursing workforce. National governments take a local perspective tempered (we hope) with international agreements on overseas recruitment. From the shortage in the USA listed (below), to the potential time saving equivalence is a significant outcome:

"When we translate the net amount of time freed up to the projected amount of nursing time needed, we estimate the potential to close the workforce gap by up to 300,000 nurses." p.2.

I am a technology enthusiast outside of work, but a technology realist at work (I do enthuse with students and enjoy hearing their views and experiences - personally, at university, on placement). I've used two electronic health record systems in mental health over the past four years. It is usable, but - as ever - could be improved. Thoughts re. tech are currently clouded by the UK use of telecoms and IT as the access point for primary care. Unfortunately this acts as a 'gate'. More tech is not necessarily better. Can it be argued that the pace of technical change (hardware and software - cloud, devices, decision support ...) is so fast that it is constantly contested? New systems need to be re-evaluated for patient benefits, improvements in care, safety, fit for purpose and other desiderata. Many consultants and advisors point to the existence of disciplinary and (hence) knowledge silos. What is key, is how IT can disrupt existing practice through these silos, especially in the form of AI. 

To return to the study(!), it is primarily in-patient hence hospital based. Perhaps hospitals are the biggest silos of all? These management studies flow, forming a series, a work-stream that includes:

How ‘Care at Home’ ecosystems can reshape patient care

Virtual hospitals could offer respite to overwhelmed health systems

Nursing in 2023: How hospitals are confronting shortages

 

These are cross-referenced online, but what price integrated care - and person-centred care at home?

Prof Alison Leary's tweet highlights research that has demonstrated the improved patient outcomes when care is delivered by Registered Nurses. The importance of training, registration and need to study the 'work' of nurses and their workload is not new:

Robb, I. H. (1903). The Quality of Thoroughness in Nurses’ Work. The American Journal of Nursing, 4(3), 168–177. https://doi.org/10.2307/3401722

Plus, 

"One of the new applications for decision analysis derives from the realization that if physicians are to become effective advocates for quality health care delivery under the incentives engendered by the newer cost-containment strategies, a common language is required to permit communication between physicians, regulators, policy makers and patients relative to what comprises effective care and why physicians do what they do." Preface, v. (my emphasis)

Knoebel, S.B. (1986). Perspectives on Clinical Decision-Making. New York: Futura Publishing Co., Inc., Mt. Kisco.

Whether 'physician', 'doctor' is cited as the user - an electronic health record should cohere across disciplines including nurses - the multi-disciplinary team; even as disciplinary system use may have its own signature (subsets). We are still seeking a language. For me this remains SOCIO-technical.

Innovations are mentioned in the study, but the specifics are not stated in explicit nursing terms, but related to the role of technology, electronic health records (yes, a care record is critical), building on existing tools and reducing implementation risk. Sadly, the informational environment (body politic?) appears to place constraints on the nursing 'care models' referred to here.

On delegation, the following makes a lot of sense: "While nurses report wanting to spend more time overall on direct patient care, there are specific tasks that could be delegated both vertically and horizontally to ensure that the work nurses perform is at the top of their license and promotes professional satisfaction." p.5. (my emphasis)

INDIVIDUAL

|

INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

Nurses thinking of leaving - reasons include: "not feeling valued by their organization and not having a manageable workload." with additional settings inc. home care and long-term care facilities. This is a common expressed wish by nurses: "spend more time with their patients" but how often is it qualified psycho-socially?	310 subjects - nurses ".. estimates still suggest a potential shortage of 200,000 to 450,000 nurses in the United States, with acute-care settings likely to be most affected." Settings include: intensive-care unit, step-down, general medical surgical, or emergency department.
Direct patient care - relationship building, empathy and rapport?	effectiveness, efficiency and equity* The politics of health systems and health service delivery globally.

In the 1990s organisational hierarchies were flattened, middle management roles were reduced. Technology played its part, but there are many other factors:

https://www.nber.org/system/files/working_papers/w9633/w9633.pdf

At a time when applied AI is increasing, nursing is open to innovation, but synergy and assurance of high quality, safe, person-centred care is essential. 

Socially we also need to preserve forms of work that have a role in well-being and community health - care of older people. Hierarchies and the services they 'deliver' will be flattened further and rationalised - if as nurses we are sufficiently passive. Consider the thoughts of Prof. Acemoglu, Economist, MIT:

"He [Acemoglu] imagines a day when teachers could use AI to create individual lesson plans for every student, or nurses might be able to take on much greater roles in, for example, diagnosing disease. 'Why is it that nurses cannot prescribe medications? Why must everything go through this very hierarchical approach where you have to call a doctor [to do that]?' As it is today, the people who spend the most time with patients - nurses, not doctors - are those who are paid and valued the least." p.3.

Foroohar, R. 'When mistakes involve powerful technologies, you're going to have trouble', Lunch with the FT: Daron Acemoglu, FT Weekend, Life&Arts, 20-21 May, 2023, p.3.

There is most likely a 'corporate' signature common to these reports as there will be to the posts here (2006 ... ). For nursing's sake - vested in the sustainable development goals, the determinants of health, and climate change - we need to preserve 'models of / for care' defined, applied and refined by nurses, the profession and professionalism, registration and holistic bandwidth.

See also:

Moisoglou, I., Galanis, P., Meimeti, E., Dreliozi, A., Kolovos, P. and Prezerakos, P. (2019), "Nursing staff and patients’ length of stay", International Journal of Health Care Quality Assurance, Vol. 32 No. 6, pp. 1004-1012. https://doi.org/10.1108/IJHCQA-09-2018-0215 (I have accessed the abstract only).

Kim, J., Lee, J.Y., Lee, E. Risk factors for newly acquired pressure ulcer and the impact of nurse staffing on pressure ulcer incidence. J. Nurs Manag. 2022 Jul;30(5):O1-O9. doi: 10.1111/jonm.12928. Epub 2020 Feb 25. PMID: 31811735; PMCID: PMC9545092.

[ Thanks to Phil Wilson: https://twitter.com/ph_wilson1/status/1667869284305977346?s=20 ].

By one of the big four. It does try to look at workload redistribution but seems to conveniently ignore the evidence regarding the improved outcomes of RN delivered care & bad tech. #Nursing
Big 4 really need to dump the Christmas tree models. https://t.co/2zrylhTZOo @McKinsey

— Prof Alison Leary 💙#ProtectNurse (@alisonleary1) June 1, 2023

*Apply the 3Es across the domains of Hodges' model.

Reimagining the nursing workload: Finding time to close the workforce gap

https://www.mckinsey.com/industries/healthcare/our-insights/reimagining-the-nursing-workload-finding-time-to-close-the-workforce-gap