1. Know your worth
Even if others don’t recognise it, understand what it is that you contribute to your service and team. If you find this difficult to articulate or are unsure what you are actually good at, why not ask for a 360° review. For a small fee, you can use the tool from the NHS Leadership Academy. Your organisation may already have a licence for this. If you want to try to understand yourself better, there is also the NHS Leadership Academy’s self-assessment tool.
2. Take your appraisal seriously, even if your appraiser does not
Be prepared, ask for constructive criticism, go in with examples of what you would like to discuss. Appraisals and your Nursing and Midwifery Council review process are often seen as tick box exercises and just another thing to do. However, when it is used well, an appraisal can really help strengthen your visibility and position. Your appraisal is an opportunity to reflect on your current role including workload and responsibilities, where you want to be and how you might get there.
A well-structured appraisal should not only focus on your individual key performance indicators (KPIs), but also seek to understand broader elements of your role and how or where you may wish to develop in addition to areas where you may need support. It is your opportunity to display your strengths, as well as seek support with areas where you may feel you need to develop and ensure that these are clearly recorded with achievable action points.
3. Use data: In God we trust – everyone else bring data
Even if you have not been set organisational KPIs, it is worth considering what you feel they should be. This gives you something to measure yourself and your service against and also facilitates a conversation about what your role should be. Guidance or examples on what could be measured and how to link this into current national strategy can be found in the NHS England Core Component Descriptors (NHS England, 2026b), much of which is also applicable to sectors other than community care.
Data provides evidence of what you do, don’t do and what you cannot do. Use it wisely, always consider the ‘so what’ of the information you are presenting. Remember not everyone likes Excel sheets or bar charts, so consider the visual appeal of what you are presenting and how it may contribute to the narrative. Have your data ready. You can guarantee you will be asked for it with far less notice than is reasonable.
4. Recognise your strengths and weaknesses
Recognising your strengths and weaknesses is important. However, it is not a reason to delegate (or dump) the things you do not like on others. If you are not a data person, hate speaking in public or feel your writing is not great, then there is nothing wrong with deferring to others who love doing those things – but build your own abilities and capabilities. You are not expected to be A* at everything, but you should be able to demonstrate ability across all of your role descriptors. Being a team player is a great strength, but you need to be able to step in across every element, if and when needed.
5. Take every opportunity to grow and develop
This builds from all the previous points. Importantly, be creative in what you see as growth and development. Attending university or a conference definitely has benefits, but so does asking another team if you can shadow them or if they will evaluate your service.
Sometimes stepping out of a specialist role for a period of time can be one of the greatest things to do. Whether you chose to work with industry, move to academia or research, set yourself up to work independently or even leave tissue viability for a while, you will always learn something new. Learning also comes from activities outside work and often from chance encounters, so always take time to reflect on new skills and where they may be applicable.
It is also worth remembering that all the coaching gurus will tell you that the biggest learning comes from failure. Understanding what went wrong and recognising what you could do differently may be painful – but there is always learning in there.
Ask if you can do things. If you have never spoken at a conference, pick one, contact them and offer them a session, a case study (they are good if you are nervous because you know the patient better than anyone), work that you did for academic study, or even ask if they need someone to chair. They may say no in the first instance, usually because the programme is already planned, but they will often get back to you for the next conference. If you have never written but want to, the same applies. Pick your journal and email to ask about submitting an article. Journals love new authors, so are always supportive.
6. Be brave, strong or creative – but realise that these character traits are not always valued or liked
Change is rarely popular, and doing things that are ‘a bit different’ is even worse. Being the one who leads a change of direction, whether small or large, can be personally challenging so you will need to prepare yourself for challenge and criticism. It can feel very personal – but it rarely is and it is usually more of a reflection of other people’s insecurities than your own. Always listen – there may be something in it that you did not think about or underestimated – but if you genuinely have a good idea or a passion, then go for it. Also be prepared for others to claim your ideas as their own. It is hurtful and frustrating, but it happens a lot. Think carefully about what the benefits are and what there is to lose before you challenge anything.
7. Know what is within your control
Much of what happens within a work environment is not within our control. We can not magic up new staff or more budget, we cannot get our projects prioritised against things that are on the national agenda. But we can use resources well, we can stop doing things that do not make a difference and focus on those that do. We can make significant cost savings by being evidence based and healing wounds – but generally we make far less significant savings by changing from dressing A to dressing B.
Where factors are not within your control, be vocal about what they are, present your data to those who may be in control (or at least able to escalate). Present the risks of the current direction or inaction and make sure these are well documented in risk registers, your appraisal, email or meeting notes. Be solutions focused. What can you do? What can you achieve? How can you do things differently? Are the community standards a burden – or an opportunity?
8. Network
Network, network, network. Even if you hate chit chat or are uncomfortable with new people, push yourself a little. Send an email, comment on someone’s social media, approach someone and simply ask them a question. It generally pays off. Most people are kind and helpful. I have yet to ever have anyone email me back saying ‘well, that’s a stupid question’ – and believe me I’ve asked a few! Do recognise body language. If someone is clearly in the middle of something, it’s OK to just say hello, but maybe have a note ready and say, ‘I can see you are busy but when you have a moment could you…’ Always remember not everyone is good at remembering names so try to reintroduce yourself if you have met someone before and you can see them desperately trying to read your badge or searching for context in your conversation.
9. Use social media wisely. Every post, repost or like colours how people see you – and your team and organisation
Make sure that you know what your organisation’s policy is on the use of social media. They can be quite draconian even if you are communicating in a personal capacity about something that may be deemed to be politically sensitive.
Try to have a plan for how you use social media. Iit can be a great way of communicating, raising your profile and getting feedback if you do it carefully and with a clear objective. Be clear about how much of your time it is consuming and what the return on that investment is. Like journals or conferences, be clear about who your audience is and use the right platform to reach them.
Know who your friends are – use them wisely – they are far more use than social media.
10. Take time out, do not burn out
Book regular leave, take time with your family and friends – they are far more important than any job.
If you are struggling, tell someone. It will help. It may not change anything, but it will allow you to give voice to your situation. You may be reluctant to access help at work, but it is there and accessible to all. Try looking at Supporting you through change (NHS England, undated). Most importantly, recognise when to walk away – realise that walking away is not a failure, but a strength. You chose to do it because you valued yourself.
I am not a big advocate of management speak and life coach quotes, but when I am really, really stressed, I always remember this which was given to me way back in the 1990s – and it’s absolutely true. On reflection, when you look back at things that were truly awful:
- You got through them.
- They seemed much worse when you were in them than when you were out the other side.
- You always learn something.
Seven questions to help you SUMO (shut up and move on; SUMO, undated)
1. Where is this on a scale of 1–10?
2. How important will this be in 6 months’ time?
3. Is my response appropriate and effective?
4. How can I influence or improve the situation?
5. What can I learn from this?
6. What will I do differently next time?
7. What can I find that is positive in this situation?
