Bright young staff swapped ideas with today’s top managers at HSJ’s Rising Stars seminar, with topics raised including the need for unrelenting patient focus and the honour of being an NHS leader. By Claire Read
On beginning her career in nursing, Samantha Jones headed straight to her senior manager to share a realisation. “I went to see the chief nurse at Great Ormond Street Hospital, and said I wanted to be a manager,” reports Ms Jones, now director of the new care models programme for NHS England.
“I said, ‘I don’t know why I want to be a manager, but I’ve got four brothers, I’m too stroppy, I have to stand by my beds while the consultant does his ward round and I’m not allowed to speak until I’m spoken to, and I’m not having any of that.’”
More from the Rising Stars seminar
The response was simple but profound. “She said, ‘Finish your training and come and see me every three months.’ She was amazing. Every three months, she gave me tea and air time as a student nurse and then as a qualified nurse. [She enabled me] to see what a true leader is like. A true leader listens, and a true leader gives time for people coming through.”
‘A true leader listens and gives time for people coming through’
A few years later, now on the graduate management training scheme, Ms Jones once again got in touch with a senior figure. “I wrote to Sir Alan Langlands, the then chief executive of the NHS, and asked him if I could come and shadow him for a week. No one had told me I could, no one had told me I couldn’t, and so I did it. So I spent a week with him, and for half an hour after every meeting he said, ‘What do you think, Sam? Tell me what your view is.’”
Ms Jones shared both these formative experiences at HSJ’s second annual Rising Stars seminar, held in association with Celesio UK. “The point I’m trying to make,” she explained, “is that my responsibility is to support people coming through, to give them air time.”
In many ways the event offered an opportunity to do just that. It united many of the 25 individuals named in the second list of Rising Stars – judged to be the healthcare influencers of today and the healthcare leaders of tomorrow – with those currently holding senior posts in healthcare. The aim was to explore the challenges, opportunities and responsibilities facing the up and coming leaders of the NHS.
Ms Jones’ presentation opened proceedings. A theme that quickly emerged was that each generation must support the next. “You’re described as the rising stars of the future. Take that as the honour it is, [and remember] that what you do with it and how you behave for people coming through sets the tone for them for life,” she said.
‘Each generation must support the next’
It was a point firmly endorsed by Cormac Tobin, managing director of Celesio UK. He urged the young leaders in the room to realise that they should actually be focusing on the people coming up behind them. “When you’re a leader, it’s not about you: it’s about you creating the next generation of leaders. Being a leader is the loneliest job, it’s the greatest job, it’s the worst job. But when you lavish praise on others and see the success they achieve, see rising stars take their position, it’s the most satisfying job.”
Cormac Tobin on driving real transformation
This is the second year that Celesio UK has supported the HSJ Rising Stars. I’m extremely proud to continue our involvement in such an inspirational initiative: one that I believe will drive real change.
Taking place amid a general election campaign, the Rising Stars seminar showed me that the outstanding talent needed to make the NHS Five Year Forward View a reality is already there. The stars who shared their stories humbled me with the work delivered through innovation, collaboration and incredible personal drive. The task of rethinking care models for the benefit of patients is not to be underestimated. But as I’ve seen through the success of our pilot LloydsPharmacy accident and emergency based first care clinic, it is within our reach through innovative thinking. Fergus Jepson - the Clinical Leader of the Year at the HSJ Awards 2014 and who spoke at the event - put it well. He said we need to step up and emulate what we see in our patients: courage.
The Health Pledge campaign, which 2014 Rising Star Amir Hannan, presented to this year’s audience, is another fantastic example. The concept is that ordinary people are inspired to take small steps to change their lifestyle and improve their health.
However, innovative thinking is not enough. Sustainable leadership is needed. Change in the NHS will not happen overnight - nor indeed should we always want it to be immediate.
As Samantha Jones noted, space and time is paramount to delivering new models of care. Involving everyone in leadership is not only crucial to fostering respect across an organisation, but it means that the next generation of leaders is constantly being cultivated.
Another aspect of sustainable leadership is, simply, being human: having empathy, humility and trust. It was truly heartening to see these qualities in abundance throughout this year’s Rising Stars seminar.
One common theme in all the speeches was putting the patient first. David Bull’s account of the training offered by the National Ambulance Resilience Unit particularly highlighted this - this training has been built around meeting the needs of a patient, even in a high threat environment.
As we enter a period of change in the NHS, sharing ideas with leaders who prioritise the patient was invaluable and inspiring. Theirs is a mindset that will serve us all well for the future.
Cormac Tobin is managing director, Celesio UK
He too remembered a senior figure at the beginning of his career who had moulded his view of what it meant to lead. “I started work at 13, sweeping floors in a supermarket, and the leader of that business always met the new employees – he made a point of it.
“He came and he met me one day in his store, 600 people worked there, and he said, ‘Welcome Cormac, what do you do for me?’ And I said, ‘Mr Quinn, I sweep your floors, I’m a great floor sweeper.’ He said, ‘No, what do you do for me?’ I said, ‘I sweep your floors, look, they’re all clean.’ He said, ‘No, what do you do for me?’ I thought he was stupid; he owned a big company, I was a floor sweeper. I said, ‘I sweep your floors.’ He said, ‘No you don’t, you are very important to this company. You give our customers compelling reasons to come back, time and time again, you are as important as everybody else.’
‘Create more leaders and make them feel good’
“The lesson he taught me that day was that leadership was about everybody, it was about treating people with dignity and respect and inspiring them, and that everybody in the business contributed, right across the line, right to the cleaners in the stores, to the people on the checkouts, to those on the phones, to the top management. And that has stayed in my brain to this day. That’s what defined me going forward.
“Create more leaders and make them feel good,” he urged the audience, “no matter how small what they did.”
Not least, of course, because in healthcare small changes can have an incredible impact. Ms Jones was keen to ensure that the Rising Stars never forget the privilege and power of working in healthcare. “Whether you’re a chief executive or not, every interaction you have makes a difference to staff and the population that we serve,” she emphasised.
Ms Jones once again drew on a personal story to underscore the point. “My mum died in my first two weeks of the management training scheme. She was 48, she had a pulmonary embolism, she was here one day and she wasn’t here the next.
“So I can honestly tell you that the training scheme for me was the best and worst two years of my life. Because after my mum died, my father then had an acute psychotic reaction and was sectioned. So we went from being a nice, middle class family with my brother doing law, my younger brother doing A-levels, to our whole world being turned upside down.
“I remember phoning my mentor from the garden outside our house – bearing in mind I was two weeks into the training scheme – saying I won’t be in tomorrow, my father’s barricaded in the house and he won’t let us in because he thinks that we’re going to come and take him away. My mentor at the time was the most amazing person, who just said, ‘OK Sam, just let us know when you’re coming back,’ as if it was the most normal thing in the world.
‘Never, ever forget the honour that we have’
“And I saw the best and the worst type of care that the NHS and social care could provide. I saw the most amazing care from the paramedics when my mum arrested – I saw how hard they fought for her, and I saw the most amazing critical care at the John Radcliffe Hospital.
“I then saw the most fractured care provided for both my father and also my family at a time when we were grieving. There was no care or support for any of us. The most infamous story is me ringing the mental health unit and saying how is my father, and them saying he’s absolutely fine – he was on 15 minute observations because he was under self-harm observation – as he ran into the house. He’d run seven miles back to our house, and he was naked because he’d decided that was the way he wanted to come back. He’s OK with me sharing this story and my family’s OK with me sharing this story, because I absolutely learnt then the value of good care, and of what care –when not so good and fractured – can do.”
She continued: “Remember the honour we have in providing and leading health and social care services. I tweeted this morning and asked people to tell me what I should say to you, and the thing for me that stood out was never, ever forget the honour that we have. We are here solely for one purpose, and that’s to provide health and social care for the population that we serve. Nothing else.
The day we forget that is the day we forget the honour we’ve
Fergus Jepson, head of the specialist mobility rehabilitation centre for Lancashire Teaching Hospitals Foundation Trust, also said he drew inspiration from this honour. “It’s my patients who inspire me on a daily basis,” said Dr Jepson, who was named Clinical Leader of the Year at the 2014 HSJ Awards.
He was keen to urge the next generation of leaders to centre on patients. “What I enjoy most is really looking after patients and supporting their needs. Having a very patient centred approach is really what we’re all about [at our unit],” he said.
“For instance, we had a patient with a quadruple amputation who came to us because he wasn’t getting good care. He had two privately purchased limbs because the local NHS couldn’t provide him with limbs he could walk on. We got him moving, and got him to where he should be. He’s now a world class Paralympic swimmer. I try to look to emulate some of the things we see in our patients in how courageous they are, and in how we can push forward.”
He argued supporting patients means looking at the individual as a whole, including their family. “When an adult has an amputation, their children often really find it extremely difficult to cope with this. This was highlighted when I was referred a patient from another centre because the child had developed anorexia. The psychiatric team who were looking after him felt the anorexia was directly caused by lack of progress and concern that the son had for his mother who had had the amputation.”
‘Supporting patients means looking at the individual as a whole, including their family’
Dr Jepson explained that he responded by inviting the whole family into the unit, showing the children that it was a welcoming place and helping to remove their concerns about the way their mother was being treated. “She’s now walking, has gone back to education, and her son’s anorexia was contained within eight months and he’s now been discharged fully.”
The idea of an unrelenting focus on the patient continued as the event moved from speeches by established leaders to presentations from this year’s Rising Stars. David Bull is head of education and training for the National Ambulance Resilience Unit, which prepares paramedics and others to deal with major incidents such as terrorist attacks or pandemics. He explained that “the centre of our ethos of every single course we deliver is that it’s patient focused”. He said: “It’s about enabling the responders, who come to us as paramedics, to do their day job regardless of the environment. We refer to ourselves as one hand away from the patient.”
Many spoke of the need for healthcare leaders of the future to see patients as key partners. Chief among them was Anya de longh, another of this year’s Rising Stars. A former medical student, forced to give up her studies due to the diagnosis of several long term neurological conditions, she encouraged clinicians to understand the value of patients’ experience.
“I never finished medical school, but I did end up with a degree, and since becoming a patient I’m far more proud of the qualification I’ve got from the ‘university of life’ than I am of my actual degree.
“Although the knowledge and skills and expertise I’ve learnt as a patient means I don’t have half the alphabet after my name and I haven’t got a royal college or anything like that, it’s not to say it’s any less valuable than the experience people gain from a clinical or professional background.
“It’s not about undermining any of the skills that anyone has from clinical perspective, but likewise not undermining any of the skills and experiences that patients and carers bring to the table as well,” she argued. “We all have different knowledge and experience and the fact that it comes from different places actually means that, when it’s combined, it’s going to be a lot better than one half or the other half working in isolation.”
‘It’s about not undermining the skills and experiences that patients and carers bring to the table’
She also urged up and coming leaders not to be tempted into the view of patient and public involvement as a simple tick box exercise. “It’s all very well having a nice smart boardroom and making sure one person in one of those chairs is a patient, but if that individual hasn’t got the confidence, skills and knowledge to contribute to the conversations that are happening around that table, they’re not actually doing anything meaningful by
“One of the things that’s helped me most is doing some coaching in terms of being a patient leader, so that when I am asked to sit around tables like that, [I] have got the confidence and the skills to be able to contribute in the same way that everybody else does.”
What of the skills that will be needed among the clinicians of the future? Anita Jayadev, a respiratory specialist registrar who won the Rising Star category at last year’s HSJ Awards, spoke of the Enabling Doctors in Quality Improvement and Patient Safety programme she had helped devise.
“The course is now in its fourth year, and it started when morale was pretty low,” she told the audience. “It was post the Francis report. We were looking at the literature, and there was lots published on [the] value of clinical leadership in driving improvement in the NHS and also quite a bit on the barriers to engaging clinicians – some as simple as [clinicians] not knowing what’s going on, and not knowing who to contact.
“So we devised a programme – the idea being that, if you’d noticed a concern, you’d bring your problem and then get some training around improvement methodology and some coaching and then that problem hopefully turns into a quality improvement project.”
‘Common themes were: passion, innovation, determination to make change’
She explained that those who had completed the course in its first year were followed up two years later to gauge the impact.
“Everybody reported they felt much more valued and empowered to make changes within their department to improve care. There were lots of projects that didn’t complete, that were wicked problems that couldn’t complete, but even those people found the course useful. What we were unravelling were concerns that people didn’t know where to take or know how to challenge. So they felt empowered that they could do something about it.”
Dr Jayadev continued: “Everybody who went through the programme had said they’d gone on to change their practice – I think that was the biggest achievement, so they’d gone on to either lead a service improvement project or gone on to a different trust and started up similar training
programmes in their trust for junior doctors, and I think that was really valuable.”
In drawing the event to a close, Andrew Willetts – public sector and healthcare services director for Celesio UK – centred on that desire for change.
He suggested it was a uniting factor among the people in the room.
“Despite everyone coming from disparate backgrounds, I think there have been some common themes: passion, innovation, determination to make change and to drive for a better NHS.” As we look to the future, that can surely only be encouraging.
Rising Stars 2015: United by a desire for change
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Rising Stars 2015: United by a desire for change