Ignoring her school’s advice that “you’ll never make a nurse”, in 1967 Elizabeth Fradd applied to train at Westminster hospital in London. Graduating top of her class, Fradd, who has died aged 75, rose to the height of the profession, becoming assistant chief nursing officer for England (1999-2000), and made key improvements in children’s and community care.
Appalled by the case of Beverley Allitt, the nurse convicted in 1993 of murdering four babies and attempting to murder or seriously harm another nine, in 2000 Fradd helped set up the Commission for Health Improvement (now the Care Quality Commission) to investigate major system failures in hospitals, and then became its lead director for review and inspection.
In the 1970s Fradd, who had specialised as a children’s nurse, was a ward sister at Westminster children’s hospital, caring for children with bone marrow transplants. One of her patients was Anthony Nolan. Following his death in 1979 Fradd helped his mother Shirley set up a charity in his name, which has saved thousands of lives through its stem cell register programme.
Between 1983 and 1999 Fradd held increasingly senior children’s nursing positions in Nottingham and the West Midlands, which gave her scope to implement her ideas. One was to set up an overnight unit where parents could stay. “Families coming into hospital,” she said “are guests in our house and we should make them welcome.” She also instigated “negotiated care” – parents were asked what they would like, and could participate in tasks such as feeding. She even allowed pets to visit on the wards.
While at Nottingham, Fradd started a children’s community nursing service, so that children at the end of life, or with diabetes or cystic fibrosis, could leave hospital and be nursed at home. Her colleague Dr Sheila Marriott said Fradd had immense energy and worked incredibly hard to organise this service. Community nursing was extremely important to Fradd, and she worked with the Nursing and Midwifery Council in the 90s to create a set of standards for community nursing and a postgraduate programme.
Fradd’s toughest challenge, however, was managing the children’s nursing service in Grantham, Lincolnshire, in the aftermath of the Beverley Allitt scandal at Grantham and Kesteven hospital in 1993. Staff at the hospital’s children’s unit were horrified and demoralised, and Marriott described Fradd’s leadership at this time as “extremely kind and intuitive in an awful situation”.
The experience took her career down a new path. Fradd said: “You can’t be involved in something like that without asking over and over ‘How could this have happened?’”
She had a talent for problem-solving and wanted to prevent further such failures in the NHS. In 2000 she was instrumental in setting up the Commission for Health Improvement; as its lead director for review and inspection (2000-04), she oversaw 700 reviews of NHS hospitals and investigations into failures.
From 2004 to 2016, Fradd served as an independent health adviser and was involved in many Department of Health projects, including chairing the Health Visitor Taskforce in 2011, with a brief to rejuvenate the service, and contributing to the report Front Line Care (2010) on the future of nursing and midwifery.
She also helped set up the children’s charity Together for Short Lives, becoming its vice-president in 2011, and was a trustee or patron of many other charities, including Sue Ryder Care and Rainbows Hospice. In 2009 Fradd was made a dame.
One of the four children of Harriet (nee Abey), a former teacher, and the Rev Allen Birtwhistle, a Methodist minister, Elizabeth was born in Worcester Park, Surrey. She attended Farringtons, a Methodist boarding school in Kent, where she was unhappy and yearned for her father’s visits (he was the school’s minister). Despite the school’s downbeat assessment of her prospects (they said she had only “manipulative skills”, meaning in needlework and cookery), she applied to study nursing, encouraged by a surgeon friend of her parents, and qualified in 1971.
Shortly after qualifying, she met the actor Glenda Jackson in a London art gallery. Jackson was due to start filming in Spain and needed a nanny for her son, Daniel. Elizabeth jumped at the chance, not least because it gave her the opportunity to look after a child who was not ill and was developing normally. It was the start of a long friendship and Jackson’s quiet confidence and unstarry integrity impressed Elizabeth.
She returned to London with new confidence, and six months later rose to become a ward sister. She studied throughout her career, qualifying as a health visitor and midwife, and received an MSc in healthcare policy in 1994.
In 1976 Elizabeth married Dr Simon Fradd. They divorced in 1998 but remained on good terms. She enjoyed keeping active and skiing into her 70s as well as playing an important part in Nottingham civic life: in 2020-21 she was the city’s high sheriff. She lived in the village of Tollerton, to the south-east, for 30 years, opening her beautifully kept garden to the public in 2002-04 as part of the National Gardens Scheme to raise money for nursing charities.
She is survived by her brothers, John and David, and her sister, Rachel.
• Elizabeth Harriet Fradd, nurse and health adviser, born 12 May 1949; died 12 May 2024
