Clinical leadership case study: midwife and chief nurse


Pippa Nightingale, Chief Nurse, Chelsea and Westminster NHS Foundation Trust, on becoming a clinical leader.

My journey

My journey into senior leadership began as a clinical midwife for over 10 years and then as a consultant midwife. From here I progressed to Head of Midwifery, then Director of Midwifery. Following this I became the Clinical Director for Women’s Services and then was successfully appointed Chief Nurse, along with my role at the sustainability and transformation partnership (STP) as senior responsible officer (SRO) for maternity services. 

The turning point

Personally, I naturally progressed through the various clinical roles. I was fortunate to have leadership training and development outside the organisation. I also had a supportive mentor and coach who helped me along my leadership journey.

It’s important to recognise the importance of networking and having a wide-reaching clinical professional community. Management/leadership can be a lonely, challenging place sometimes; external networks are essential. It’s also important to understand the balance of leadership and management and to identify your followers.

Having a professional voice at the board is essential, I am a firm believer if you are not contributing you should not be there, choosing your battles well as not all battles can be won!

Key barriers/challenges and how I worked through these

Self-belief and professional identity was a challenge I had to work through. This was helped by leading multiprofessional groups of nurses, midwives and AHPs.

Other challenges I have had to navigate have included:

  • work-life balance
  • board and non-executive director politics and practices
  • self-conflict of not being directly clinical and having patient contact but understanding you can still influence care
  • maintaining clinical credibility

Organisational support to make this happen

All the organisations I have worked for have supported me to grow my leadership potential by supporting me to have leadership training. The organisation also supports talent spotting/management and role shadowing.

My top tips

  • Be yourself and be authentic, open and honest as well as passionate.
  • Keep your professional network close: we all need support at times.

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