Nursing and midwifery at Imperial’s journey on the Pathway to Excellence

Sue Burgis, Deputy Chief Nurse at Imperial College Healthcare NHS Trust, reflects on the Trust's journey so far on the Pathway to Excellence programme at Charing Cross Hospital.


When Imperial College Healthcare NHS Trust was nominated by NHS England’s Chief Nursing Officer to be one of fourteen NHS Trusts in England to take part in the Pathway to Excellence programme, it was a moment of pride and excitement for the journey to come.

Three years on, with activity having been paused during the Covid-19 pandemic, the Trust is now firmly on its way towards accreditation, integrating the programme’s core standards into our working culture and empowering our nursing staff.

Pathway to Excellence at Charing Cross Hospital

Pathway to Excellence was chosen by NHS England's Chief Nursing Officer to underpin her vision of nursing and midwifery excellence. Successful designation represents global recognition of organisations that cultivate an empowering and positive practice environment for nurses and midwives, and drive exceptional standards of practice. The US-designed programme is pursued by healthcare providers around the world and is a prestigious marker of nursing excellence.

The nursing-specific scheme is initially being run at Charing Cross Hospital, with the learnings and behaviours it develops informing our approach to nursing and midwifery across the Trust. The key underlying principles of the programme are around staff engagement, excellent patient care and continuous improvement. These principles will also prove important across the Trust’s other sites at St Mary’s Hospital, Hammersmith Hospital, Queen Charlotte’s and Chelsea Hospital and the Western Eye Hospital.

The journey towards Pathway to Excellence accreditation is a rigorous undertaking, underpinned by an evaluation process focused on six standards for nursing excellence: shared decision-making, leadership, safety, quality, wellbeing and professional development.

These standards are central to our vision for nursing at the Trust and have formed the backbone for engaging staff on the journey towards recognised nursing excellence.

A recent staff survey at Charing Cross has shown an exceptional commitment by nursing colleagues to safety and quality in care, alongside a desire to more fully engage with the Trust’s professional development opportunities, such as research and training. There was also a clear appetite for having a greater role in decisions that affect them.   

Shared decision-making at all levels of nursing

At the heart of the Pathway to Excellence standards lies the concept of shared governance and shared decision-making. Adopting this approach empowers direct care nurses to drive improvements and transformative change across wards and promotes a working culture of continuous improvement. 

This is brought to life through the establishment of ward-based Shared Decision-Making Councils, a platform that encourages nurses at all levels to actively participate in decisions that directly impact their work and to be instigators of positive change for patients and colleagues alike. This gives staff more agency in change that affect them and means frontline experience and transparency is rightly treated as key in decision-making.

Charing Cross Hospital is proud to have established a network of more than 25 shared decision-making councils to date, with the majority operating at the ward level. The latest cohort includes councils focusing on student nurses, internationally educated nurses and clinical managers. By coming together across wards, nurses at Charing Cross can more effectively bring about change and improvements in their workplace and in patient care. 

These councils have already led the implementation of numerous improvements, including enhanced staff recognition, facility upgrades, streamlined stock and medication management, optimised shared spaces and an elevated focus on nurse wellbeing.

Each council has the opportunity to regularly share their insights and best practices through a monthly Leadership Council, where shared decision-making council members converge to showcase their work to colleagues, the Chief Nurse and other senior leaders across the organisation.

Nurses at Charing Cross Hospital involved in the Pathway to Excellence programme, including Professor Janice Sigsworth, Chief Nurse

Continuous improvement in nursing at Imperial

As we continue on the Pathway to Excellence journey and further embed these standards, we are focused on the lasting legacy the programme will have for the Trust.

To make sure the standards and behaviours encouraged by the programme have a positive impact on the working environment and culture for both current and future nurses and midwives at the Trust, we have focused our approach around three key areas: 

  • Leading and empowering
  • Supporting, growing and sustaining
  • Delivering the best care

We are encouraging our staff to engage with shared decision-making and drive change, as well as supporting them to pursue professional development such as training and research opportunities. Through this we are committed to fostering future leaders and a network of empowered, engaged nursing colleagues.

We are equally focused on prioritising wellbeing, embracing diversity and recognising excellence through schemes such as the Daisy Award . The Daisy Award programme provides the opportunity for relatives, carers and significant others to nominate nurses and midwives they have interacted with. We are invested in our staff and committed to a working culture that brings out the best in them.

All of this goes towards our core drive and commitment to delivering the best care for our patients. We believe we can do this best through empowered, engaged and excellent staff.

Pathway to Excellence is the latest exciting step in our journey of continuous improvement and nursing standards and I am looking forward to see its development at the Trust across all our hospitals. We will continue to share updates from along the journey.

To find out more about Pathway to Excellence at Imperial, or to get involved, contact