Nursing Studies

Strengthening the Executive Nurse Director Role in the UK: a qualitative interview study

The project will generate new evidence and make recommendations to strengthen the Executive Nurse Director role; and to highlight challenges and opportunities that impact the role across the different administrations of the United Kingdom.

Evidence given during the Francis Inquiry (2013) revealed serious shortcomings in the care provided to the most vulnerable. In the immediate period after this study, there was a need not only to learn from the Inquiry but also to research the factors that led to this situation. In light of the criticism and concerns aimed at senior nurse managers when such events occur, as well as the need to question other factors such as high vacancy and turnover rates for Executive Nurse Director (ENDs) in some parts of the UK (Nursing Standard 2016) this study will explore the experiences of those responsible for leading nursing services in the NHS at executive board level. This is in line with the overall aim to strengthen senior nursing leadership by reviewing experiences through in-depth interviews about the role generally, as well as highlighting current training and support needs of post-holders. Importantly, there is a need to learn from success as well as challenges for ENDs during this project. We will explore the END role in the 4 countries of the UK.

Despite the importance of these roles in this regard, remarkably little evidence exists about their workplace experiences, how they are prepared for the role or how the END function is viewed by those sharing board responsibility. This is a nurse-led study and our objective is to offer a deeper understanding of the contemporary END as well as suggest ways to improve training, recruitment, career planning, support and retention of those in these key leadership roles in the future. We anticipate this study will improve our understanding of the constraints and future potential of the END role across the UK.

The project aims to produce empirical evidence identifying the distinctive contemporary challenges, barriers and opportunities facing ENDs and provide recommendations for strengthening the role in the future. The objectives are:


Royal College of Nursing (RCN)

A photo of the project team
Professor Aisha Holloway, Professor Sharon Hamilton, Professor Daniel Kelly, Professor Pam Smith, Professor Joanne Reid, Zoe Horseman, Professor Ruth Harris, Dr Aled Jones

Project Team 

Professor Daniel Kelly: PI, Cardiff University & Visiting Professor, University of Edinburgh

Professor Pam Smith: Co-PI, University of Edinburgh

Professor Aisha Holloway: co-applicant, University of Edinburgh

Dr Aled Jones: co-applicant, Cardiff University

Professor Anne Marie Rafferty: co-applicant, King's College London

Professor Ruth Harris: co-applicant, King's College London

Dr Helen Noble: co-applicant, Queen’s University Belfast

Professor Joanne Reid: co-applicant, Queen’s University Belfast

Professor Sharon Hamilton: co-applicant, Teesside University

Zoe Horseman: Research Assistant, University of Edinburgh