This research project, funded by East Suffolk and North Essex NHS Foundation Trust (ESNEFT) is evaluating how the roles of the Professional Nurse Advocate (PNA) and the Professional Midwifery Advocate (PMA) can help with staff wellbeing and staff retention.
The purpose of this research is to explore how the role of professional advocacy is embedded in nursing and midwifery in one NHS acute trust.
Professional advocacy, using the A-EQUIP model, was introduced in midwifery in 2017 following the restructuring of statutory processes for supervision. In response to the COVID-19 pandemic, the Chief Nurse for England directed nurses to use the same structured, supervisory model.
However, little is known about the impact of advocacy on the day-to-day experiences of the nursing and midwifery workforce. This research seeks to explore the role of the PNA/PMA in ESNEFT, with a focus on staff retention and wellbeing.
The PNA/PMA role places nurses and midwives at the centre of workforce transformation. It does this by advancing personal and professional accountability via professional development and strengthening personal wellbeing.
The need for the PNA/PMA role is clear. In the UK, there are approximately 50,000 nursing and midwifery vacancies and the number of registrants leaving the Nursing and Midwifery Council register is increasing. The two main reasons for leaving tend to be retirement and work-life balance.
The PNA/PMA combines professional nursing leadership and clinical supervision through the Advocating for Education and Quality Improvement (A-EQUIP) model, which in turn is based on Leading change and driving improvement (Proctor, 1986; NHS England, 2017, NHS England, 2021).
The initiatives of PMA/PNA provide useful preconditions for service improvement, yet there is little evidence that informs how best the role can be developed and applied in local organisations. It is not clear how PNA/PMAs themselves implement the role, how the role may be used by advocees, nor if it does impact QiP, staff retention and sense of professional wellbeing.
This research project seeks to explore the PNA/PMA role in ESNEFT, with the outcomes being to provide an evidence base as to how the role is used; and how it can be developed.
The study design is multimethod case study, with four workstreams and one PhD.
Engward, H., Goldspink, S., van Veggel, N., Abdulmohdi, N., Tuckwell, A. and Alexander, M. (2025) ‘Advocating for Professional Advocates in Nursing and Midwifery’, Policy, Politics, & Nursing Practice, 26(3), pp. 208–218. Available at: https://doi.org/10.1177/15271544251331052
Goldspink, S., Engward, H., Alexander, M., Abdulmohdi, N., van Veggel, N., Tuckwell, A. and White, M. (2025) ‘Developing sustainable knowledge partnerships: Joining the DOTS between inter-organisational research’, International Journal of Collaborative-Dialogic Practices, 14(1), pp. 42-51.
Goldspink, S., Tuckwell, A., van Veggel, N., Engward, H., Abdulmohdi, N. and Alexander, M. (2025) ‘Professionals in-place: the role of the practice-based research coordinator’, Nurse Researcher. Available at: https://doi.org/10.7748/nr.2025.e1964
Goldspink, S., van Veggel, N. Engward, H., Abdulmohdi, N., Tuckwell, A. and Alexander, M. (2025) ‘Beneficent Disruptors: A qualitative descriptive study of professional advocacy in healthcare’, F1000Research, 14, pp. 647. Available at: https://doi.org/10.12688/f1000research.166551.1
van Veggel, N., Goldspink, S., Engward, H., Abdulmohdi, N., Tuckwell, A. and Alexander, M. (2025) ‘Professional Advocacy in Focus: A Qualitative Descriptive Study of Nurses and Midwives Perceptions in one UK NHS Trust’, Research Square. Available at: https://doi.org/10.21203/rs.3.rs-7374915/v1
van Veggel, N., Goldspink, S., Engward, H., Tuckwell, A., Abdulmohdi, N. and Alexander, M. (2025) ‘Revisiting Advocacy in Midwifery’, MIDIRS Midwifery Digest, 25(3), pp. 241–244.
Engward, H., Goldspink, S., Abdulmohdi, N., Alexander, M., van Veggel, N. and Tuckwell, A. (2024) ‘Understanding Professional Advocacy: A protocol for a mixed method project to explore professional nurse advocacy and professional midwifery advocacy in one NHS trust’, SocArXiv. Available at: https://doi.org/10.31235/osf.io/9zr7n
Buaki-Sogo, M., Goldspink, S. and Engward, H. (2023) ‘Workforce assets: recognising the value of long-serving nurses and midwives’, Nursing Times, 119(11).
Abdulmohdi, N., Tuckwell, A., Goldspink,, S. and Engward, H. (2023) 'Exploring the integration and impact of nurse and midwifery advocate roles on staff well-being and retention: a cross sectional survey study', RCN Education Forum and National Conference 2024.
Flack, L. and Abdulmohdi, N. (2023) 'Designing and delivering a professional nurse advocate training module', Nursing Times [online], 119, pp. 11.
Engward, H., Goldspink, S., Abdulmohdi, N. and Alexander, M. (2023) 'Understanding Professional Advocacy: A Mixed Method Protocol to Explore Professional Nurse Advocacy and Professional Midwifery Advocacy in one UK NHS Trust', JMIR Research Protocols. Available at: http://doi.org/10.2196/preprints.48397
Qualifications and training
1997: RMN Dip(HE)
2001: BA(Hons) Health Studies
2011: MSc Advanced Practitioner
2018: Athena Leadership Programme, Kingsfund
September 2022: enrolled on Professional Doctorate with University of Essex.
Marie qualified as a mental health nurse in Ipswich in 1997. She has worked in a number of hospital, community and clinical education roles, including two years with Health Education England in the regional senior nursing team from 2019-2021.
Since March 2022 Marie has been the Associate Chief Nurse for Education and Research at East Suffolk and North Essex NHS Foundation Trust with a portfolio that includes all pre and post-registration nurse, midwifery and allied health professional education, advanced clinical practice and the development of clinical academic roles.
Andrea has worked in the NHS & the private sector for 28 years. She is dual qualified as a nurse and a midwife and has undertaken post graduate studies to enhance her knowledge, skills, and personal development.
Her professional background includes working as a Ward Sister, Supervisor of Midwives, Professional Midwifery Advocate (PMA), Crisis Pregnancy Counsellor, Birth Trauma Debrief Clinic & Antenatal Team Lead, Maternity Bleep holder, Vaccination hub nurse, Governance/Audit midwife & Maternal Medicine Specialist Midwife.
Andrea remains committed to women’s health is a Specialist Midwifery Sister, supporting pregnant women with underlying complex health conditions and has facilitated learning and additional skill acquisition for midwives in this area.
As a PMA, Andrea has been actively involved in pastoral welfare and engaging in supportive conversations in the workplace. She will use her knowledge and experience in her role as the project Research Co-ordinator to build links between academic and practice colleagues and promote the research throughout the Trust.
Associate Professor, Health & Social Care Director, Professional Doctorate Health & Social Care
Professor in Applied Social Science
Senior Lecturer
Senior Lecturer in Animal Health
