TopicsProfessionalMaria McIlgorm: a vision for change

Maria McIlgorm: a vision for change

Northern Ireland CNO Maria McIlgorm outlines some of the positive steps she is taking to improve the country’s health, despite the challenges faced.

Although it’s an integral part of the UK, Northern Ireland faces some distinct issues when it comes to delivering health and social care. It means that anybody taking on a senior leadership role in the Department for Health must have a deep understanding of both national and UK-wide issues.

To that end, Maria McIlgorm, Northern Ireland’s chief nursing officer (CNO), is ideally placed. Belfast-born Maria started out as a nurse in the Irish republic (training, then working, at Our Lady of Lourdes Hospital, Co. Louth) before moving to London to become a midwife. She spent the bulk of her NHS career in Scotland, culminating in her appointment as a professional adviser to the Scottish Government. All this experience has been put to good use in her CNO post, which she has now held for two years.

‘It has been an extremely difficult time for the health service here in Northern Ireland,’ says Maria. ‘We are facing significant budgetary pressures and what until very recently has been a challenging political situation, which has caused quite significant challenges and constraints. When I first came into post, we were also emerging from the Covid-19 pandemic and trying to rebuild our integrated health and social system.’

The pandemic has
shown us that we are
perhaps one of the most
innovative, adaptable and
resilient professions
in the world

So how did she begin to address the issues faced? ‘In the first six months in post, I learned about the health and social care system here in Northern Ireland,’ says Maria. ‘And while there are similarities to Scotland and England (in that we are all part of a universal healthcare system that provides the best possible care to some of the most vulnerable in our society), there are also differences. ‘For example, Northern Ireland has an integrated health and social care system with one budget for health and social care. The population here is around 1.9 million and while there are urban areas it is also very rural, and it maintains a very strong sense of community. We know there are opportunities for us within health and social care in to be even more integrated and work better together.’


At the core of Maria’s plan to help improve the provision of nursing and midwifery services is her Shaping our Future A Vision for Nursing and Midwifery in Northern Ireland: 2023-2028 blueprint, which she launched last May.

‘In developing that vision, I listened to the views of nurses and midwives – including health visitors, school nurses and other stakeholders – to gain an understanding of what the current issues are, and also the concerns across our health and social care. I also aligned the vision with the Nursing and Midwifery Task Group: Report and Recommendations and the Nursing and Midwifery Retention Report, which were both done before I started in post,’ Maria says.

‘In the [Shaping our Future] five-year Vision I identified four key priorities: the first is workforce and workload planning; the second is education and training, including pre- and post-registration education; the third is improving career pathways; and, finally, the fourth is producing a quality assurance framework for nursing and midwifery, with our allied health professionals also included in that.’

Despite the significant challenges and constraints, Maria believes there are already encouraging signs. ‘Under The New Decade, New Approach Deal agreement in 2020, the health department here committed to, and delivered, an extra 900 nursing and midwifery undergraduate students over a three-year period – that is a significant step,’ Maria says.

‘We have also established a new framework for the supply of agency nurses and midwives and healthcare support workers, with the goal of eliminating the use of “off-contract” agency workers. This will also put agency workers on a firmer footing and help to develop and retain a sustainable workforce to deliver safe and effective care.’


In other areas of progress, community practitioners are playing a key role, Maria explains. ‘I am very aware of the valuable contribution that our midwives, health visitors and school nurses are making to the public health agenda,’ says Maria.

‘The need for early intervention to address inequalities is fundamental to ensure every child has the best start in life. We are making good progress in this area. For example, I am really delighted that every teenage mother here in Northern Ireland is offered a place in our Family Nurse Partnership programme.’

‘Earlier this year, I was also pleased to launch the Continuity of Midwifery Carer framework, an evidence-based framework that provides integrated and seamless care by the same midwife or small teams of midwives during pregnancy, birth and the early parenting period. That will ensure better outcomes for mums and babies, as well as strengthening communication between the main midwife and the main health visitor, to ensure that every mother gets good continuity of care, particularly at that time when they are handed over to their health visitor.’


Naturally, less than a year into Maria’s five-year strategic vision, there is still much to do. Not least, Maria says, is the need to help health visitors and school nurses deal with the much more complex health and social care issues that children and families are facing post-pandemic.

‘A review of our Healthy Child, Healthy Future policy has highlighted some of the key regional issues. Without a doubt, social isolation during the pandemic had a great negative impact on children, particularly around mental health and development. I see health visitors and school nurses as key players in ensuring that the younger members of our community are supported.’

Maria continues: ‘There has been significant investment here in Northern Ireland across the early years – £2.4 million has been invested – but we know we need to continue to grow our workforces. I think getting it right for children and young people, and ensuring every child has the best start in life, has to be our priority, and I see midwives, health visitors and school nurses as having a fundamental role in improving the health and wellbeing of our children, families and communities.’

What’s perhaps most clear in Maria’s future vision, beyond any formal plans, is the value of the professions. ‘What I have learned throughout my career is that nurses and midwives have a wealth of transferrable skills and the pandemic has shown us that we are perhaps one of the most innovative, adaptable and resilient professions in the world.’


What drives you? Having the opportunity to make a difference and influence the changes that need to happen for nursing and midwifery in Northern Ireland.

What do you enjoy most about your work? I’ve always been really proud to be a nurse and a midwife, helping to make difference to people’s lives. I have had great opportunities throughout my career, and I have welcomed each opportunity.

What is your greatest achievement? Becoming the CNO for NI, which is an honour and great privilege – and bringing up my two gorgeous children.

What are the biggest lessons you have learned during your career? The importance of creating conditions and opportunities for others to thrive; the importance of involvement and engagement, especially with the people we care for and their families; and the importance of taking time to look after yourself and spend time with your family and friends.

What would people be most surprised to learn about you? Perhaps my sense of fun. I have always found laughter to be a great medicine.

How do you unwind? Spending time with my family and friends. l love to cook, I love long walks with my dogs, and spending time pottering in my garden – I love all the different seasons in the garden.

Audio Exclusive! Click here to hear more from Maria in our exclusive audio interview, including the importance of lifelong learning, the value of mentors, and her commitment to CPs.

Image | Maria McIlgorm


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