Past work

Your education and research partner

We all aspire to achieve better health outcomes, but the models of primary care are changing around the world. Is your organisation up to speed?

Healthcare leaders face a variety of challenges today to meet the changing needs of their communities and the role of technology in health services. Professionals need a strategic vision of how to plan and deliver healthcare to meet the demands of future local challenges. Competencies in leaders must be developed to meet the needs of patients and take health services into the future, and leaders should be involved in the process. Working in an uncertain environment, developing skills to work in these circumstances is key for leaders to influence positive outcomes.

Organisations need support to run efficiently, to develop and implement policies; to research, monitor and evaluate with a clear focus on patient outcomes; to create and evaluate health-related programmes across organisations, communities and countries; and to maintain training for medical staff and improve knowledge.

Using proven methodologies, a customised approach and adopting the best practice, Quality Education & Research empower individuals and communities across the world to develop the skills and evidence needed to achieve their potential. We improve health, knowledge, skills and care through the delivery of education and research programmes to the health sector.

How we can help you

Quality and evaluation

• Improve the quality and safety of your services by providing person-centred care.
• Evaluate your current programmes, assess short-term impact and recommend improvements.
• Design and deliver evidence-based and academically sound programmes with immediate practical results.
• Undertake assessments to identify gaps in quality care at national, organisational or community-facility level, and develop priorities for interventions.
• Leadership development and tools for quality improvement.
• Facilitate learning sets or one-to-one coaching to maximise the benefit of time and investment.
• Undertake evidence reviews to establish best practice and possible projects needed to deliver an organisation's objectives.

Clinical professional education

• Masterclasses and programmes of action learning.
• Community-wide interventions and public health development programmes.
• Bespoke, evidence-based education programmes to address health inequalities, global health and key clinical priorities, with immediate practical results.
• Developing public health interventions that promote health and wellbeing.

System strengthening

• Co-design and perform countrywide, organisation- wide or team-wide health system strengthening programmes based on WHO or local frameworks.
• Engage with ministries, commissioners, communities and service users around quality improvement (QI)

initiatives, including large-scale stakeholder analysis and small-scale focus group or semi-structured interview work.

We have the energy, expertise and experience needed to make what seems impossible, possible. If your Plan A is to improve equity, social justice, child and maternal health, mental health - or just health - please get in touch.

I lead QER Ltd. I am a nurse and global health consultant specialising in public health, nursing, creative health, system strengthening, quality and clinical leadership.

As a proud nurse for 40 years I have taken my nursing expertise into senior and global roles in health care, as a nurse, public health specialist and Associate Dean. From 2000 to 2020 I held senior leadership positions in NHSE and HEE, including national roles, and worked internationally too.

During COVID-19 in 2020 I went back into clinical leadership and education at the London Nightingale Hospital, and joined my local COVID vaccination teams. I also worked with global-reach charities to support education and grants across the world.

In 2024 King Charles awarded me the British Empire Medal (BEM) for services to women and children in Africa. The Foreign, Commonwealth and Development Office put me forward for this medal in recognition of my work as a female leader in health, equity and social justice.

My international roles have included strategy development and stakeholder work with the Ministry of Health Zambia; health system strengthening and leadership teaching in China; Clinical Associate with Primary Care International (Jordan); COVID Technical Advisor and Honorary Nursing Advisor with the global health charity Tropical Health and Education Trust (THET); and curriculum development with the University of Global Health Equity (UGHE), Rwanda.

I am Visiting Professor at the University of West London, an academic lecturer, and an award-winning expert in global health and creative health. I was part of the global delegation in New York for the 2024 Arts for the Future Festival.

I am a Trustee of Paintings in Hospitals, the Foundation for Nursing Studies and Human Story Theatre. I am also

Director of the charity Fiona Foundation for Kids, which I set up in memory of my sister to provide help for children who need it most.

In 2024 I headed to the United Nations Action Days as part of the Summit of the Future in New York as a health expert, an advocate for gender equity and an innovator in creative health. My panel session featured artists and health system contributors to my forthcoming book linking arts, nurses and the SDGs.

From 2024, Eleanor Reynolds joins as Senior Researcher and Project Manager to coordinate the global projects and publications.

Leading complex change

I have experience in leading and delivering complex change and strategy development in a politically sensitive and complex environment. This ranges from leading a whole-country approach to developing strategy and health quality in Zambia, to providing policy support to regional leads in the NHS, to whole-systems and stakeholder work to redesign the workforce in Frimley Integrated Care System.

Such work required me to analyse complex issues in changing contexts where evidence was limited and time was short. I can process evidence from all sources and present recommendations or make autonomous decisions on investment and action, depending on the project. My research interest is in the retention and recruitment of the nursing workforce and how image and identity influence this, and I am working with colleagues across Europe to explore it.

Recent work, 2021 onwards

• Working with the University of Global Health Equity to develop the MSc Nursing Leadership for launch 2022.
• Working on a grant from the Burdett Trust to develop an arts- and image-based resource for nurses' wellbeing.
• Working with Experience Led Care to evaluate implementation of video group clinics across health settings: what works, where and why?
• Clinical Lead at a vaccination centre; ECG training.
• Volunteer medic and mate with the Ellen MacArthur Cancer Trust throughout the summer.

2020-2021

• Developing the principles needed to move international volunteering from face-to-face to digital (publication pending, BMJ Global Health).
• Defining criteria for 'second victim' COVID grants to support health partnerships across the global north and south.
• Working with WHO colleagues to develop thinking on quality and compassion across post-COVID work.
• Working with nurse colleagues in African universities to explore approaches to nurse leadership programmes.
• Working with European colleagues via Sigma Nursing on a research project to collate experiences of nurses during COVID and compare across Europe (publication pending).

2019-2020

Improving Global Health Fellowship with the Ministry of Health in Zambia (February - August 2019). Objective: to provide a process through which the quality of health care could be coordinated and improved across the country, introducing the WHO Framework for Quality:

• Identified the top six no-cost/low-cost interventions across the life course and care continuum.
• Built a bank of evidence for investment and action.
• Identified stakeholder perceptions of quality (200 stakeholders) and a network of clinicians to sustain improvements and education.

Outcomes were presented as:

• Government Cabinet Papers for decision (May 2019).
• National Conference on Quality (June 2019).
• WHO Pan-Africa presentation for discussion (August 2019).
• Strategy completed and published in June 2020.
• Ongoing support for the Ministry of Health Zambia and work on a second conference, September 2020.

Primary Care International: Clinical Associate (November 2019 onwards). Worked with WHO and the Ministry of Health Jordan to establish management of the national non-communicable diseases strategy and an operational plan for stratification of hypertension care and healthcare staff training in the use of risk charts (WHO HEARTS Programme).

April 2020. Co-wrote e-learning modules on COVID-19 in low-resource countries, leading on the mental health of healthcare staff.

Senior roles

Deputy Medical Director, NHSE South Central (2013 - February 2020, three days a week). Health system workforce lead for NHSE South Central, leading the development of workforce strategy and engagement with national priorities and local needs in line with the long-term plan and the new architecture of health services. Strategic lead for doctors' appraisal and revalidation and standards of care; designed and led the introduction of governance systems and public engagement processes, and managed teams. Led research with Oxford University Department of Primary Care to establish the appropriate role of the public in professional regulation, and worked collaboratively with the NHS England Quality Team, Academic Health Science Networks and Clinical Senates to link service improvement with patient needs. Designed and delivered the NHS@2030 leadership programme for senior health system leaders across the South of England, and delivered 'developing positive organisational culture and positive behaviours' workshops.

NHS Leadership Academy - Organisation Development and Programme Director, Patient Leadership (2008 - February 2020, one day a week). Designed and delivered master's-level clinical fellowship programmes for quality improvement (more than 200 projects). Led Patient Leadership programmes, including harnessing the role of the arts in health and health system leadership. Designed and delivered masterclasses on organisational development, system innovation and strategic planning for health system leaders across the South of England.

Associated positions

• Visiting Professor, University of West London - Dementia (January 2018 onwards). Teaching includes frameworks informing health, health systems and health academia; policies and systems in dementia care across the world; and individuals' perspectives - philosophical approaches to person-centred care.
• Reviewer: Nursing Open (2019 onwards); Permanente Journal (2011 onwards); Nursing Education Journal (2014 onwards); Arts & Health (2012 onwards).
• Associate Lecturer, Warwick Business School (2018 onwards).
• Visiting Lecturer, Global Health and personal project support, Buckingham Medical School (2018 onwards).
• CQC Specialist Adviser (2017 onwards).
• Company Director of Quality Education and Research Ltd (established 2012).

External voluntary roles

• Sigma Nursing, European Communications Committee, UK Representative; Sigma Nursing Phi Mu, Communications Committee, UK.
• Charity Founder and Director of Fiona Foundation for Kids, providing education for communities and care for children across the world (Charity Number 1176655).
• Adviser and health expert to Human Story Theatre Company, Oxford (2016 onwards).
• Health Adviser to Tushinde Children's Trust, Nairobi, Kenya (2016 onwards).
• Charity Trustee for Paintings in Hospitals (UK charity, 2018 onwards).
• Dementia Drama Alzheimer's Cafe Adviser, Isle of Wight (2010 onwards).
• Ellen MacArthur Cancer Trust volunteer, trip medic and boat mate - providing sailing adventures for children recovering from or living with cancer (2017 onwards).
• Nursing Now Ambassador, UK NHS.

Keynes.

Former positions

• Researcher and project lead, Collaborating for Health (June - December 2019): a six-month contract to address non-communicable diseases and support nurse health, resulting in a film to support conversations on nurses' health.
• Associate GP Dean / Academic Lead, Health Education England Thames Valley - guiding research (2004-2016).
• Director of the GP Leadership Fellows Programme (2004-2016).
• Fellowship Programme Director, Thames Valley and Wessex Leadership Academy (2008-2016), designing and delivering master's-level multi-professional programmes for clinicians and social care leads working in the community; clinicians leading simulation education and curriculum mapping; and clinicians leading on quality improvement and leadership in health.

Awards

• Zambia Minister of Health Award (2019): personal presentation and public acknowledgement for having 'the head of a lion and saving many lives'.
• International Health Improvement (IHI) Kaiser Permanente International Award (2010) for QI education.
• Healthy Prisons Award (DoH, 1994) for education work with young offenders.

Current academic work

• European nurses' experiences of COVID-19 care: comparing and contrasting, and looking at the 'capital' nurses hold.
• Identity formation of nurses: how image and identity in nursing inform recruitment, role and relationships with patients and professionals.
• Writing and delivering a teaching programme for a Kenya charity: addiction and domestic violence in slums in LMICs, and how to help families cope.
• Book publication pending: Developing Quality Healthcare Systems in Low- and Middle-Income Countries (ISBN 978-1-9162452-0-4).
• Screenplay in development: Dementia and the Law - who is the victim?

Academic qualifications

• Postgraduate Certificate (Pg.Cert.) in Leadership and Management (2013); Accredited Healthcare Manager Level 7, IHM (2013).
• Professional Doctorate in Health Sciences, Staffordshire University (2003-2010). Thesis: Challenging the Epistemological Underpinning of Medical Education.
• Pg.Cert. in Strategic Commissioning (2008), Thames Valley University.
• M.Sc. Primary Care Development (2004), Nene University Northampton: Why do GPs Study for Higher Degrees?
• Pg.Cert. in Medical Education (2002), Staffordshire University.
• M.Sc. Health Promotion and Health Education (Public Health), University of Wales College of Medicine (1992-1993), full-time programme.
• ENB clinical accredited courses: HIV/AIDS, Family Planning/Sexual Health (1993-96).
• Registered Mental Nurse (RMN) (1985-1988), Surrey.
• Registered General Nurse (RGN) (1982-1985), Oxford.

Previous academic, national and professional roles

• Nye Bevan Executive Leaders Programme, NHS Leadership Academy (2014-2015).
• Harvard Disruptive Innovation Programme (2012).
• GMC Quality Assurance Visits: Regional Assessor (2014-2016).
• External Examiner, M.Med.Ed., De Montfort University (2012-14).
• CHAI Reviewer, Department of Health (2003-2009).
• HEI External Examiner, SSM Medicine: Literature and Medicine, Leicester (2002-2006).
• Professional Coach, SC SHA and Thames Valley and Wessex Leadership Academy (2005 onwards).

Approximately 50 articles, book chapters and conference presentations are available on request.

Sporting life

• Transatlantic Sailing Race, August 2011: Southampton to Brazil as part of the Round the World Race; the world circumnavigation crew was awarded the Seamanship Safety Award. Medical support and crew diary writer.
• Qualification: Yachtmaster, 5,000 miles.
• Fastnet, August 2013: the Fastnet endurance sailing race - finished, and survived to tell the tale.
• Cowes Week and Round the Island Boat Race: competitive sailing, 2014-2019.

2023. The results and recommendations from the evaluation work in Zambia in 2022 resulted in national funding being secured for the whole child and maternal health programme. Thrilled to have played a small part in the large result.

2023. The design and delivery of the MBA Global Health Leadership and Management in London brought much content and contentment - and a lot of PowerPoints! All of this will help with the book.

2023. Presentations at conferences in New York, Canada and (virtually) Australia brought the SDGs, social justice, maternal health and nurse wellbeing to a wider audience.

2022. The publication in BMJ Global Health brought together the guiding principles for working virtually, in partnership, globally.

Zambia: national quality strategy, 2019

A six-month Ministry role supporting the Ministry of Health, Zambia, to develop the National Quality Improvement and Performance Management Strategy.

• Analysed international data on quality of care and population health; aligned Zambian national policies to international evidence and contributed to the World Bank funding and focus presentation, clarifying the current problem and securing the World Bank loan needed to co-design solutions.
• Undertook health data analysis and horizon scanning to identify the top six low-cost/no-cost health interventions for the highest return on quality of life and human capital development. Presented as a Cabinet paper to inform national priorities.
• Sense-checked the proposed approach and recommendations with 200 stakeholders, ranging from national heads of non-governmental organisations to civil society representatives and health workers.
• Produced an outline strategy for a pan-Africa World Health Organization event, ensuring Zambia was the first African country to use the WHO framework for planning this new strategy.
• The Zambian National Strategy launched in June 2020; I am named as a contributor.

I have also authored a book on quality of healthcare in low- and middle-income countries for free use (in press).

Jordan: Ministry of Health and WHO, 2019

• Worked alongside WHO and the Ministry of Health to facilitate a panel of experts from government and healthcare to identify the need, gain insights into WHO approaches to care (the HEARTS Programme) and decide on a national approach to non-communicable disease management.
• Summarised findings and gained consensus to present to WHO and the Jordanian Government as recommendations for the level of care to be offered, the risks associated with this, and the actions needed to implement the plan.

COVID-19 management in resource-poor settings, March 2020

• Worked with Primary Care International colleagues to swiftly produce educational resources requested by resource-poor countries.
• Analysed WHO resources to write, within seven days, an evidence-based educational resource.
• Led the content to support the management of mental health during the COVID pandemic - a four-day turnaround, while in lockdown in New Zealand.

Summit of the Future, New York 2024

Thrilled to be invited once again to take part in the Action Days informing the Summit of the Future in New York in September 2024.

Arts for the Future Festival 2024, New York and global

Honoured to be one of the 100-strong global artist delegation invited to take part in the Global Arts for the Future Festival, running alongside the Summit of the Future in New York. Our work is to curate the contributions of artists who are using the arts to improve health and deliver all SDGs. All SDGs lead to health.

One moment changed me not through policy but through art: standing ankle-deep in the Hudson River beside artist Sarah Cameron Sunde, taking part in her tidal performance 36.5 / A Durational Performance with the Sea. Matching my breathing to the waves as the tide rose and fell, I understood the UN's lofty ideals not through policy, but through art.

The SDG book: published by Springer, 2026

Nurses and Allies Harnessing the Arts to Deliver the Sustainable Development Goals is the culmination of two decades of research and projects on the arts in health, in health professional education and in nursing. I edited the book and wrote or co-wrote seven of its chapters - from how nursing and the arts can deliver the SDGs to my days as an artist, nurse and gender activist at the United Nations. The contributors are artists, writers, actors, nurses, OTs and drama therapists, all with a lifetime of expertise and experience.

WHO 2023: climate crisis, health and how the arts can help

Thrilled to be invited to be part of the round-table discussions in New York in 2023 exploring how the arts can be part of the work to address the impact on health of the climate crisis. Follow-up now includes stakeholder work to create recommendations and tools.

Gates Foundation Goalkeepers, United Nations SDG Summit, New York, September 2023

Honoured to be invited back as a Gates Foundation Goalkeeper to the event running alongside the United

Nations General Assembly. A photo from the work in Zambia appeared on the main screen behind the jazz band: mixing with 200 other global disrupters and developing cunning plans to deliver the SDGs. I was first nominated as a Goalkeeper in 2022 - one of only two hundred people a year, worldwide, invited by the Bill & Melinda Gates Foundation to their New York event. Sitting with the world's disrupters and activists, I was asked by Richard Curtis: what will you do? So I gathered colleagues working in health and in the arts, and created my SDG book. At that first event I met Afghan journalist Zahra Joya - a conversation that led to a joint Global Health 50/50 project (2023) making sure the women of Afghanistan were seen and heard.

International Council of Nurses, Montreal 2023

A women's health poster and a nurse wellbeing presentation made a visit to Canada possible. Thrilled to mix with 6,000 nurses from across the world, all wanting to improve the quality of health care and the work of nurses. Presenting both the Menopause Circles research and the I'm Fine Project resource made for a great balance - with more to come when I'm Fine went to the US in November.

Speaking at the United Nations

My own contribution at the Summit was to speak about gender equity in nursing, on behalf of Art of Nursing CIC and as a female nurse. The adrenaline surge on hearing my name followed by 'United Kingdom' stays with me still. I watched world leaders adopt the Pact for the Future - and witnessed the fights behind it: the fossil fuel commitment battled to the wire and lost, and words like 'LGBTQI+' pushed out of formal documents only hours before signing. Listening to Mary Robinson, former President of Ireland and UN High Commissioner for Human Rights, I learnt that evidence and being right are sometimes not enough: strength comes from collective leadership, standing together and starting again. Language matters. Visibility matters.

“I had come to the Summit expecting resolutions. What I left with were revelations.”

Climate, gender and the SDGs: the work goes on

In 2023 I sat at the round table with WHO leads, artists, health people and researchers to shape the questions for the Jameel Arts and Health Lab's work on how the arts can address the health impacts of climate change - the report is now published. With Global Health 50/50 I co-led a 2023 arts competition to breathe life into their annual reports on inequality. Entries came from across the world, with women and art from Afghanistan included, and 272 images now sit in an online exhibition and in international reports, visualising the data and humanising it.

Using data and evidence to make decisions and influence runs through every programme in this book. The method is constant: analyse the evidence, test it with the people who will live with the decision, and present it so that action follows.

Relevant skills

• Analysing, selecting and presenting evidence to support prioritising investment of finance and education to deliver health policies and interventions.
• Building partnerships within ministries, professional associations, NGOs and civic groups.
• Producing government policy briefs, director and organisation reports, and academic articles; assessing research and reports.
• Developing stakeholder engagement and co- production of health education programmes.
• Developing implementation networks and 'social movement' approaches to health.
• Developing educational support materials and delivering workshops (thematic deep dives or generic horizon scanning); designing and delivering quality improvement masterclasses and individual mentoring.
• Analysing and presenting the context and culture of health interventions or health institutions, to make the invisible visible and then to improve the culture and the care provided.
• Developing innovative approaches to health improvement using the arts and culture to raise awareness and change behaviour (work to date includes three programmes: alcoholism, dementia and domestic violence).

Building and managing relationships and partnerships: the arts health programme, 2001 onwards

• Using innovative methods to harness customer and patient insight to develop high-quality and effective services.
• Utilised the arts to create dramas that enable stakeholders' voices to be heard by the most senior decision-makers.
• Worked with the health sector, the arts sector, service users and system leaders to make visible the invisible health challenges.
• Built trusting and collaborative partnerships to articulate and address the issues too hidden to deal with or too difficult to say: to date, dementia, depression, isolation, cancer, middle-class middle-aged middle England, alcoholism and domestic violence.
• 2018: presented at the All-Party Parliamentary Group to challenge current approaches and share research findings.
• 2020: presented a play on hidden alcoholism at the House of Lords to influence thinking on current priorities and approaches to alcohol policy and alcohol use.
• 2020: interview as part of the arts in health programme published as a podcast by Human Story Theatre, explaining why the arts in health work, how and why the play DRY was commissioned, and the impact this has had on people's awareness, health behaviour and service provision.

Project and programme leadership: NHS England South, 2013-2020

• Defined need, designed the intervention and led a programme of work to introduce medical revalidation for 3,000 GPs and 16 health systems.
• Utilised implementation science and lean project methodology to motivate the team and monitor processes and outcomes.
• This programme was identified nationally as an exemplar, delivered within budget and on time, and exceeded national targets for patient engagement, clinical leadership and clinical engagement in appraisal.
• 2016: revisited the project cycle and reviewed processes, bringing together an expert panel of patients, academics, clinicians and managers; the review of evidence and recommendations informed change in the national approach.

2019 Zambia: national conference organisation and management

• Conference to identify best practice (led the initial academic abstract committee) and wrote summary speeches for Directors and the Minister of Health.
• Created multi-professional, cross-sector and cross- country networks and a 'community of practice' for quality.
• Received a personal accolade and an award from the Minister of Health for innovation and contribution to health ('the head of a lion, and can lift elephants').

Capability building

NHS@2030 programme for senior leaders of new models of care, 2019. Designed and delivered a development programme to enable others to lead the redesign of primary care; led a diverse team to identify evidence (statistical analysis) and articulate their own experiences (storytelling) to build capability and new models of care. A 30-minute interview was published nationally as part of the programme for innovations in healthcare, outlining the design and delivery of the Leadership 2030 programme.

Master's educational programmes, 2006-2017. Designed and delivered programmes to enable senior clinical leaders to horizon scan, analyse data and build teams to improve health services and outcomes. More than 200 senior leaders participated and are now in leadership posts across the health system. Evaluation of one programme resulted in an international award and follow-up publication.

• Professor at the University of West London, delivering master's teaching on health policy and system design (2017 onwards).
• Accredited Coach on the NHS Leadership Academy Register (2009-2020).

Communication and interpersonal skills

• Experienced and confident communicator with excellent written, public-speaking and teaching skills, working at national level and across stakeholder groups, organisational sectors and health systems.
• Wrote General Practitioner training curricula content used by all GPs in the UK (2000-2020).
• Authored chapters in medical education books and published articles, plus multiple international conference presentations (2002 onwards).
• Led the development of innovative approaches using the arts to improve policy and improve health.
• Interviewed as part of European horizon scanning on health policy, challenging how policy is created and what is used to inform it.

A selection of previous research programmes and projects delivered by QER and me:

• Evaluation of the NHS South England Quality Improvement and Leadership Programme, 2011-2012.
• Design and delivery of a programme to improve patient care in Emergency Departments across six trusts on the South Coast of England.
• Design and delivery of the Francis Fellows Programme, a six-month educational programme supporting healthcare professionals to design and deliver changes that will support the Francis recommendations in secondary and primary care.
• Workshops for Local Professional Committees to explore vision, values and leadership skills and to develop a strategy for future ways of working.
• Developing approaches, models, projects and processes enabling health professionals across Wessex and Thames Valley to innovate and evaluate improvements in patient care and health systems.
• Building on the 2023 challenge by working with junior doctors and other junior healthcare professionals to develop the 2024 Challenge.
• Developing an evidence base for the inclusion of improvement science approaches in the clinical curriculum and continuing professional development.
• One-day workshops for Local Professional Committees.
• Joint working with NHSIQ to support people working in Clinical Commissioning Groups.
• Joint working with the RES Consortium to deliver master's-level education programmes for NHS leaders.

The NHS@2030 Programme

Around 85 clinicians completed the first cohort of this innovative clinical leadership programme, developed under the auspices of NHS England, the Thames Valley Strategic Clinical Network and the Thames Valley and Wessex Leadership Academy, with the intention 'to grow individual confidence, courage and the conviction to transform care, and establish a system of continuous quality improvement for patients and primary care teams alike'. The content of the programme was a co-production with its participants.

These clinicians came together from a wide geographical area - from Gloucester in the south-west to Slough in the east and right down to Southampton - to develop competencies and connect leaders, current and future, across this large geography, learning new leadership skills from national experts and each other.

Benefits of the programme design included:

• An opportunity to develop facilitated networks.
• A safe space to share concerns and anxieties, both personal and professional.
• Support for leaders to help them navigate a complex working environment.
• An opportunity to discuss and explore succession planning: what might the role of CCG chairs be going forward, and what skills will we need to deliver these roles?
• Strong and independent professional facilitation for leaders.
• Access to a personal coach and 360-degree feedback.
• Access to a wide range of national and international leaders and influencers, with experience and examples of how they have tackled challenges.

This approach enabled delegates to hear what was being developed and used elsewhere, learn from the best in the world, and then discuss amongst themselves how these skills and attributes could help locally with the challenges they face.

The participants were deliberately chosen for their mix of experience, from experienced chairs of CCGs to newly qualified GPs, as well as people just starting out on their leadership career. This mix was an ideal opportunity for all to learn and share experiences and skills, and was well received by participants.

The programme consisted of five full-day events and two half-day learning sets where delegates came together to learn from specialists in different aspects of the NHS world, share experiences, and develop and hone leadership skills. The days covered a wide range of topics including change management and improvement, examples of other organisations going through change, generative listening skills, a RightCare introduction and information, as well as talks from international leads on primary care and senior military personnel.

The participants are continuing to lead system changes and mentor colleagues to become leaders in the future.

Featured work

Practices and experiences of European frontline nurses under the shadow of COVID-19. Semyon Melnikov RN PhD, Ilya Kagan RN MA MBA PhD, Helena Felizardo RN MA, Marion Lynch RN PhD, Charlotte Jakab-Hall RN and colleagues. First published 3 March 2022. Read the research article

NHS@2030 Leadership Podcast. Ben talks to me and former CCG Chief Executive Alan Webb about the innovative initiative to develop the next generation of primary care leaders, and how the programme's co-production process works.

Human Story Theatre podcast, April 2020. Why I commissioned and contributed to DRY - a play exploring alcoholism and contributing to changes in drinking behaviour and service provision.

Oxford University personalised medicine interview. 'Personalised Medicine: the promise, the hype and the pitfalls' - a short interview with me.

Medical Humanities and Narratives. Part of the Knowledge Exchange project (Compassion and Healthcare): 'Medical Humanities and Narratives', an interview with me.

Publications and conference presentations

• May 2020. Blog, Paintings in Hospitals: 'Nurses heard and seen with 2020 vision' - the images of nurses and nursing.
• February 2020. Blog on the NHSE website, as Leadership Consultant and Deputy Medical Director, NHSE South East.
• January 2020. 'A Nurse to the World', feature article, Island Life magazine.
• 2019. Blog, Paintings in Hospitals: 'Going with the Flo - or changing the future', on nurses' image problem.
• 2019. Presentations, Ministry of Health QI National Conference, Zambia.
• 2018 (first edition 2014). GP e-module, Holistic Approach, Lynch M.
• 2018. GMC Impact of CPD, Case Study 16. Lynch M and McFetridge N.
• 2018. Isle of Wight Trust Board Papers: report on design and delivery of a multi-professional culture and leadership programme for health, social and third sector.
• 2018. New Horizons presentation, Strategic Clinical Networks conference.
• 2018. Patient feedback in revalidation: contribution to theory and workshops.
• 2018. Contribution to the Parliamentary Review on the nursing workforce.
• 2017. 'Six thought leaders give their thoughts on the future of primary care' - Dr Lynch (NAPC).
• 2017. Safer care patient checklist: a co-designed intervention to promote safe, high-quality practice and improved outcomes, University Hospital Southampton (project lead mentor).
• 2017. Improving the reporting, learning and sharing of patient safety incidents in primary care (project mentor), DEMEC poster.
• 2017. Improving colorectal cancer referrals (project mentor, acknowledged).
• 2017. Conference presentation: 'The art of caring', Thames Valley SCN.
• 2015. Developing dementia-friendly GP surgeries (project mentor), RCGP.
• 2014. Assessment: review of Sheffield Medical School, as GMC Assessor.
• 2013. Lynch M, Verner E. 'Building a clinical leadership community to drive improvement: a multi-case educational study to inform 21st-century clinical commissioning, professional capability and patient care.' Education for Primary Care, special edition on leadership.
• 2012. Commentary on competency and leadership.

Education for Primary Care.

• 2012. Keynote speech: 'Positive asset approach to motivating people through appraisal; recognising value and values.' National Appraisal and Revalidation Conference.
• 2012. 'Action research to improve GP education and spread best practice.' Poster, National Society for Academic Primary Care Conference, Scotland.
• 2012. 'Leadership education for the minority of GP trainees or the majority?' Poster, RCGP Conference.
• 2012. 'NHS Leadership Academy: Engaging GPs in Leadership.' Poster, RCGP Conference.
• 2012. 'Using the Creative Arts to Teach: The Arts, Literature and the Narrative.' The GP Educators Handbook, Radcliffe Press, Oxford.
• 2012. 'Leadership: additional web resources', Chapter 30, The GP Educators Handbook, Radcliffe Press, Oxford.
• 2011. Lynch M, Young E. 'Moving GPs towards Commissioning': Buckinghamshire Pathfinder, patient and public engagement pilot, 'What keeps you well?' and Citizens' Jury.
• 2011. Lynch M, McFetridge N. 'Practice Leaders Programme: Entrusting and Enabling General Practitioners to Lead Change to Improve Patient Experience.' Permanente Journal, USA (IHI conference insert, award winner 2010).
• 2011. 'Revalidation: The Patients' Voice is missing' - report of discourse analysis. Presentation, Academy of Medical Educators Conference.
• 2011. 'Challenging the Epistemology of Medical Education: The Patients' Voice in Medical Education.' Academy of Medical Educators Conference.
• 2011. Lynch M, Siddique T. 'The Buckingham Project: The Public Voice in GP Commissioning.' Academy of Medical Educators.
• 2010. Commentary: 'Responsible Officer: Revalidation.'

Journal of Evaluation in Clinical Practice, Vol. 16, no. 2.

• 2010. 'Revalidation: Wisdom and Professionalism or a Passive Pedestrian Process?' Keynote, Revalidation Conference, Oxford.
• 2009. RCGP Curriculum: 'Holistic Approach, Person- Centred Care' - assessed e-module for the RCGP licensing exam, Domain Six, for all UK GP trainees.
• 2009. Pitts J, Lynch M, Mulholland M, Curtis A, Simpson J, Meacham J. 'Disaster planning: using an evolving scenario approach for pandemic influenza with primary care doctors in training.' Education for Primary Care, Vol. 20, no. 5.
• 2009. Lynch M, McFetridge N. 'Improving the Quality of Care through Education.' Hi-Quality in Healthcare Conference, Orlando, USA. Poster (awarded International Service Quality Award for Narrative Medicine).
• 2009. Lynch M, Mulholland M. 'Disaster planning' and 'It's a bit GPish: using whitespace narrative and complexity to improve GP registrars' understanding of the person and change mindsets.' RCGP Conference.
• 2009. Lynch M, McFetridge N. 'Practice Leaders Programme: Education for service improvement - changing thinking to change culture.' RCGP Conference.
• 2009. 'Leadership and Complexity.' WONCA Conference, Basel, Switzerland.
• 2009. Lynch M, Turner N. 'It's a Nightmare: Experienced GP Appraiser Competency Assessments.' RCGP Conference.
• 2009. Key speaker: 'How to Motivate Learners.'

National Primary Care Education Conference.

• 2009. Book chapter, Essential GP Training Book.
• 2009. Clinical Leadership Fellowships presentation, Oxford Deanery.
• 2008. 'Using Poetry and Prose to Teach - on or off the GP curriculum?' International AMEE Conference, Prague.
• 2008. 'Other Ways of Seeing.' Australian Journal of Radiology.
• 2008. 'Teaching Trainees about Dementia in a Person- Centred Way.' Teaching Exchange, Education for Primary Care.
• 2008. 'How and Why do GP Trainers use Poetry and Prose to Teach? Challenging the Epistemological Underpinning of Medical Education.' Ottawa International Conference on Clinical Competence, Melbourne, Australia.
• 2008. Buckle G, Lynch M. 'Educating the Educators: Developing a University Accredited Course Suitable for all Healthcare Professionals Involved in Education.' Ottawa Conference poster, Melbourne.
• 2008. 'Using Film to Teach.' GP Update Journal, educational article.
• 2007. 'How to Teach Medicine Using the Arts.' UKCEA Conference, Brighton.
• 2007. Gallen D, Lynch M, Buckle G. 'Addressing Leadership and Management Competencies in Foundation Year Two.' Clinician in Management, Vol. 15, no. 2.
• 2005. 'Higher Degrees for General Practitioners.' AMEE presentation, Amsterdam.
• 2005. Lynch M, Gallen D. 'Higher Degrees for GPs: Supporting a Modern Prometheus or Being Complicit in a Brave New World?' Education for Primary Care, Vol. 16, no. 6.
• 2004. 'First Steps to Higher Degrees for General Practice Registrars.' AMEE Conference paper, Barcelona.

Conference presentations, 2016- 2017

• Lynch M. (2017). 'Using mime and drama workshops to support non-verbal skills development. Could it work?' International Alzheimer's Conference, London.
• Bennett M, Lynch M. (2017). 'Using innovative ways to support communication.' Poster, International Alzheimer's Association Conference, Kyoto, Japan.
• Lynch M. (2017). Keynote speech: 'Looking to the Future and learning from the past. Making Primary Care fit for the 21st Century.' Practice Managers Conference, York.
• Lynch M, Bennett M. (2016). 'Making the most out of games to make the most out of safeguarding.' Poster, Oxford University TORCH Conference, Oxford.

Acknowledgements in others' work

• Gilbert A, Hockey P, Vaithianathan R, Curzen N, Lees P (2012). 'Perceptions of junior doctors in the NHS about their training: results of a regional questionnaire.' BMJ Quality & Safety.
• Riley B, Haynes J, Field S (2007). Condensed Curriculum Guide. Royal College of General Practitioners, London.

• Eleanor Reynolds joins as Senior Researcher and Project Manager for programmes and publications.
• Commissioned to work with mental health nurses to establish 'what mental health nurses do?' and to co-produce a creative piece showing the invisible skills and processes that aid joy in work and quality of care.
• Invited back to New York to contribute to the United Nations Action Days.
• Part of the delegation in New York for the Arts for the Future Festival, hosting a panel contributing to the whole event.
• Founding curriculum writers and teaching faculty with the University of Global Health Equity M.Sc. Global Nursing Leadership - and part of the assessment team in December 2024.
• Awarded the British Empire Medal from the Foreign, Commonwealth and Development Office for services to women and children in Africa.
• Became a Trustee of the Foundation for Nursing Studies.
• Became a Trustee of Human Story Theatre.
• Worked with THET to conduct the evaluation of the Nursing Now projects through the lens of power and equity.
• Worked with Global Health 50/50 to lead the international gender equity work: identifying the criteria for, and running, the competition for inclusion of art images in the Inequity Report, and facilitating an online exhibition.
• Spoke at the United Nations Summit and was invited to be part of the Gates Foundation Goalkeepers event again.
• Completed the work for Experience Led Care and presented the evaluation of menopause circles at the International Council of Nurses Conference in Canada.
• Researched, wrote and evaluated the nurses'

wellbeing resource, the I'm Fine Project (funded by Burdett and in partnership with Paintings in Hospitals), and presented it at the ICN Conference.

• Worked with the Zambian Ministry of Health to evaluate the impact of Quality Improvement Education Programmes: in-person visits to 20 rural health outposts, analysis of interviews and a final report. This work helped secure the Global Fund monies needed to support the Child and Maternal Health Programme across the country.
• Worked with Experience Led Care to evaluate and provide recommendations on how and why group consultations in outpatient services in Wales work.
• November: made an Honorary Advisor with THET, working more closely on programmes to improve health and develop the health workforce internationally.
• November: presented two pieces of work to more than 6,000 people at the ICN Conference 2021 - the Sigma work on nurses' experiences across Europe during COVID, and the design of the MSc in Nursing Leadership.
• October: presented the work on nursing and international leadership at the THET Challenges Conference.
• June: part of the volunteer global catalyst team for quality with WHO, leading the discussion 'what is quality?'
• April: presented the European research on nurses'

experiences of caring during COVID to a North American academic audience.

• Led the THET COVID conference theme on compassion and quality, bringing evidence and experience together from across the world.
• Received a Burdett Trust grant to develop an arts- and image-based resource to support nurse wellbeing - reflection and recovery - with Paintings in Hospitals.
• Evaluating how and why video group consultations work, and what is needed to help them spread and sustain behaviour change.
• Working with Sigma colleagues to explore the experiences of COVID from nurses across Europe, building a legacy as well as learning from each other.
• Experiences of European Nurses During COVID: the study, jointly written, published and recognising the amazing work of nurses across Europe.
• Presented a keynote speech at the THET conference 'Health For All, a Decade to Deliver' (20 February 2020), focusing on COVID, the climate crisis and technology - and took forward the work as COVID Technical Advisor for International Health Partnerships.
• Google Arts & Culture: me, as former Deputy Medical Director at NHS England South East, in conversation with Thomas Walshaw, Communications Manager at Paintings in Hospitals.
• Presented research and experience in clinical education at the All-Party Parliamentary Group on health and the arts.
• Crossing Boundaries 3 Conference on Global Health Systems: showcasing opportunities for collaboration.
• Fiona Foundation for Kids: founded in memory of my sister, a teacher of young people with special needs, to help children everywhere - particularly where life is really hard, where a little help can help mums and children stay together and help themselves.
• 'An Anthology of Poetry and Medicine', edited by Corinna Wagner and Andy Brown (Bloomsbury, 2016).

Nurse wellbeing: the I'm Fine Project

The I'm Fine Project brings art and nurse wellbeing together, and can be useful in teaching, in reflection, or simply as inspiration. Developed with Paintings in Hospitals and funded by the Burdett Trust for Nursing. Explore the I’m Fine Project

Nurses' role in Virtual Group Consultations (VGC)

Context. The coronavirus pandemic can be viewed as a disruptive change characterising the complex VUCA world our healthcare exists in. This shift, alongside the challenges of the decrease in the nursing and health workforce (WHO 2020) and the increase in the demand for care workload, requires a rethink on who does what and how.

More than 20 years ago, Jason Hwang and Clayton M. Christensen (2008) explored the need to shift how we see health work and the workforce: 'Legacy institutions of health care delivery are jumbled mixtures of multiple business models struggling to deliver value out of chaos.'

Our VGC and nurses approach is underpinned by the ideas of disruptive innovation (Christensen et al., 2009), which outlined the health system workforce changes and challenges to such innovation and described the layers of workload - stratifying the complexity, and so the clinical competency needed - and outlining solutions to the crisis.

The rethinking of the healthcare model has now led to rethinking of the health workforce model, which has in turn brought us to the development of advanced practitioners, the introduction of technology-based healthcare, competency-based education and, for this work, the work of the 21st-century nurse and their role in VGCs.

The approach is that we shift our view and move from looking at the task or service we have historically seen towards what Christensen describes as the 'job to be done'. This job, not the task, is the end point through the patient's eyes. Our approach therefore sees VGC outcomes:

• through the patient's eyes (person-centred);
• with economic system's eyes for sustainability (cost and future focused); and
• delivered by 'poly-professionals' (competency-based, not defined by traditional professional boundaries) - who may be nurses delivering new work using traditional nursing values.

Additionally, the place of the patient and of technology in the future has been explored for Europe to 2035, highlighting the rise of information held by patients and the use of technology in healthcare.

“Marion is an inspirational and passionate professional who is held in high regard nationally and internationally. She has a track record of innovative, community-focused interventions based on sound evidence. Her international work has been exceptional. Marion has extensive experience of running highly complex programmes of work related to health and care. She combines her academic knowledge with excellent communication skills to make her work impactful and successful. She is highly regarded in health education circles as someone who is up to date with current thinking and also able to horizon scan and provide thought leadership and innovative research.”

Maggie Woods, Associate Dean, Health Education Thames Valley, NHS

“It has been my privilege to know Marion professionally for over 20 years. I have experienced her working in a number of different roles in primary care education and service development. She brings to her work some strong theoretical perspectives as well as compassionate insights into how colleagues can be nurtured and helped to improve their performance. She is very well placed to help individuals and organisations undertaking change management.”

Ed Pelle, Emeritus Professor of Medical Education, University of Warwick

“He said I have the head of a lion and can lift elephants.”

- Zambia Minister of Health, 2019

What next

The next decade is already taking shape. In his Lancet Public Health Viewpoint 'Reimagining the aspirations of public health for the coming decade' (2026), Sandro Galea maps where health is heading and what public health must aspire to. His five trends and five aspirations name the work of my career.

The five trends shaping health (Galea, 2026)

• Population ageing
• Urbanisation
• Climate change
• Changing relationships with institutions
• Transformative technology The five aspirations for the coming decade
• Longer, healthier lives
• Confronting the commercial determinants of health
• Better health systems
• Embracing new technologies
• Reimagining how our field thinks, talks, acts and communicates These are the challenges Art of Nursing CIC exists to meet. As a community interest company, we reinvest in the work: making nurses and nursing visible, bringing the arts into health, and turning evidence into action with partners from Zambia to New York. The aspirations running through this book - quality education, gender equity, climate-conscious care, the SDGs - are our plan for the coming decade.

The Artful Intelligence™ revolution is how we deliver it: the irreplaceable human art of nursing working in partnership with artificial intelligence - person centred, never replaced. My personal creative health mission is to make twenty-first century health care person centred in partnership with AI, and this is how we get there.

“All SDGs lead to health - and the next decade is ours to shape.”

If these are your aspirations too, come and work with us.