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With a prestigious academic reputation and a current role as professor of modelling (working on the modelling of health care systems), the RCN deputy president鈥檚 background may come as a surprise to some.

Alison Leary grew up on a council estate in south-east London and spent 10 years as an engineer before she went into nursing. She鈥檚 presented at World Health Organization conferences, served on the National Cancer Action Team, been a trustee of several charities and was Chief Nurse at St John Ambulance for three years. She鈥檚 also been a commercial modeller and mathematician.

鈥淚 was into science at school,鈥� she recalls. 鈥淲hen I left, I got an engineering apprenticeship and worked in safety critical industries before moving to biomedical engineering in the NHS.

鈥淭here鈥檚 more crossover to nursing than many realise. It鈥檚 about the application of theoretical knowledge to a real-world problem which matters to people.鈥�

A standing ovation from football fans

Alison says her most memorable achievement was when she worked as clinical lead at Millwall Football Club.

鈥淔or 23 years I worked with a great team, and we had an opportunity to influence national policy,鈥� she says.

Following the tragic events that took place at Hillsborough Stadium in 1989, every English Football League team was required to have a medical service. Many assumed these were put in place to manage major incidents, but Alison and her team made changes that would have an impact on lives throughout England.

We tailored the service we provided to meet the needs of the population we served

鈥淲e did an analysis that found that people who present at football grounds typically don鈥檛 go to medical practitioners or practices. There were a lot of men at our games who were self-employed, for example, and didn鈥檛 have time to see their GPs. So, we got more proactive about public health.

鈥淲e saw a lot of people with long-term conditions, so we started to offer services such as blood pressure checks before and after games and worked with charities such as Prostate Cancer UK to raise awareness of symptoms.

鈥淎s a team we worked with paid staff and volunteers to design the required staffing for the service. We had to get the mix right. We hired GPs instead of only emergency response staff. We tailored the service we provided to meet the needs of the population we served.鈥�

Alison says the support of the club, who wanted the service to be great, made the difference.

鈥淪taff from other clubs came to see what we were doing, and our model was picked up by the Sports Ground Safety Authority. It鈥檚 now used in the English Football League in the Guide to Safety at Sports Grounds [also known as the Green Guide].鈥�

It鈥檚 a 90-minute game but we鈥檇 be there for four hours

The team鈥檚 work started way before kick-off, sometimes with popular health promotion stands in the car park.

鈥淚t鈥檚 a 90-minute game but we鈥檇 be there for four hours. Every season I worked there we picked up at least one person with an undiagnosed cancer, and many others with serious illness. We had the time to take their history, which you don鈥檛 always have in the NHS.鈥�

In 2019, Alison was appointed Member of the Order of the British Empire (MBE) for services to spectator safety and medical care, but she's quick to credit the team she worked with, recognising their range of skills and experiences.

鈥淪ome of the volunteers were quite young but have gone on to have careers in health and social care. Many are still in contact with me today; it鈥檚 a lovely legacy to have.鈥� 

She also remembers the crowd showing their appreciation after she resuscitated a supporter in the stands the previous week. 

鈥淚 was one person in the team, and I didn鈥檛 want applause. But our team getting a standing ovation from Millwall supporters is my biggest career achievement. They鈥檙e a hard bunch to please," she says. 

The work ahead in nursing 

Now a professor of modelling, Alison uses her skills, experience, and more recently her election as RCN deputy president, to influence key nursing discussions. 

鈥淥ne of the biggest issues in nursing is the retention of the skilled frontline workforce,鈥� she says. 

鈥淕overnments promise to recruit more nursing staff, but they鈥檙e still leaving. We need to focus not just on numbers but also consider experience and qualifications. If we don鈥檛 get this right, we鈥檙e not supporting the next generation properly.

"Many newly registered nurses who faced the challenge of learning through COVID-19 are not staying in the profession. 

鈥淣ursing pay, working conditions and cultural issues like bullying and not feeling valued, need to be addressed. 

鈥淚t鈥檚 not enough for these policies to simply exist; they need to be implemented. Too many nursing staff are still being denied their flexible working requests. We have a profession dominated by women 鈥� a sandwiched generation who are looking after their older relatives and their own children. Without flexibility, they鈥檙e looking elsewhere.鈥�

Invest in the profession 

Valuing nursing is also an issue Alison is passionate about. 

鈥淗ealth and social care managers and politicians need to see that nursing gives you a great return on your investment,鈥� she says.  

We鈥檙e not a two-week holiday in the sun, we鈥檙e the loft extension in your house

鈥淐urrently they鈥檙e taking huge risks. When budgets are cut, the workforce is the first place they look to save money. We鈥檙e seen as an expensive burden but elsewhere 鈥� in the commercial sector, we鈥檇 be seen as a great return on investment. We add value. We鈥檙e not a two-week holiday in the sun, we鈥檙e the loft extension in your house. 

鈥淭his short-termism in health care compromises safety. In our profession, workforce and safety issues are in opposite corners. Elsewhere, it鈥檚 so intertwined and organisations work hard to keep an experienced workforce.

"There鈥檚 no overarching safety regulator in health care in the UK 鈥� as there is in aviation, for example 鈥� so employers are more likely to take risks and make questionable decisions in terms of safety to meet cost improvements.鈥� 

Getting our message out there

Now Alison is using her voice as RCN deputy president to ensure politicians and the public understand the value of nursing.

鈥淣ursing is the lowest-paid graduate profession in health care and the most dominated by women. Time after time we鈥檙e voted the most trusted profession, but we need to emphasise how safety-critical we are.  

Better outcomes come from better investment

鈥淢embers of the public care that their relative is dying in the corridor. They are right to care about it. But better outcomes come from better investment, so we need to help the public understand the role of nursing in better outcomes. 

鈥淲e talk about lack of beds in health care, we often mean lack of registered nurses. We don鈥檛 emphasise how important nursing staff are. To survive your surgery, you need access to good nursing care.鈥� 

Looking forward to her RCN tenure ahead she concludes: 鈥淚 hope to bring my career experiences in industry and public sector to this role. We have minimum staffing at a football ground but not in a hospital. Don鈥檛 tell me that鈥檚 right.鈥�