Dr Simon Eccles talks to Stuart Shepherd about his path from medical school to a variety of roles in NHS management

I do not think I knew what kind of doctor I wanted to be when I started at the London Hospital Medical College in 1989. That became clearer, so I thought, during my house officer days in East London, when orthopaedics - which brought together my love of medicine and engineering - looked a very attractive option.

At medical school, I was the one who got involved with committees. That gave me an insight into the glacial pace at which big organisations work and the merits of a well-chaired, productive meeting.

I also got to write some book reviews for Oxford University Press. As a result, I was invited to co-edit the Oxford medical careers guide So You Want To Be A Brain Surgeon. Writing a book seemed terrifying and time management was not my strong point, but it was around this period, in the mid 1990s, that I realised that if I put my mind to something I could do it.

Embracing variety

I also got involved in the British Medical Association junior doctors' committee contract negotiations. I did not like the contract plans but found you could not influence anything shouting from the touchlines. In 2003, I was elected chair of the committee.

At the same time, I was seconded to the Depatment of Health a few days a week to work on the hospital at night project. I consider it one of my biggest successes. The project set out principles of good team-working to help junior doctors do tasks most appropriate to their training and these have been adopted as far away as Australia and the US.

At the end of 2004, I was asked to become national clinical lead for hospital doctors for Connecting for Health. A lot of people said that while it would be prestigious, I would be mad to take it on. So I did.

By April 2005, I was a full-time specialist registrar in emergency medicine at the Homerton Hospital, chairing a BMA committee, working on Connecting for Health, writing the first edition of the Oxford Handbook for the Foundation Programme and revising for my fellowship in emergency medicine exam. Once the book and the exam - which I passed - were out of the way, I went to bed for a week.

Later that year, I got a consultant's post at the Homerton, which keeps me sane two days of the week. I have recently been appointed national clinical director at Connecting for Health and that takes up the rest of my time.

Make it happen

I thought I would be in full-time clinical healthcare. But even if I were the best accident and emergency consultant in the country - and I am decidedly average - it would mean 330,000 people could, if they came into the department, get looked after well.

If, however, Connecting for Health succeeds in the way I hope it does, the difference it makes to healthcare will be hundreds or thousands of times greater. We will have doctors using the same clinical information as hospital managers, commissioners, public health directors and the Department of Health. That is so different from where we are now and is a prize worthy of a lot of effort.

The challenge is getting clinicians interested in making it work at a point where they cannot yet touch it, see it and feel it. On top of that, at the moment, people unconnected with health are trying to ruin my life by losing data or leaving laptops in the back of their car. It has nothing to do with our security systems, but it is the first thing that gets brought up at the next morning's meeting.

I am still writing and am also an adviser to the national workforce project, the national clinical assessment team and a number of publishers. When Connecting for Health ends, I would like to stay in some sort of healthcare management role. The ethics and equality of access of the NHS are perhaps the best in the world. Issues like the efficiency of care delivery, however, could be better. I think the answers lay with clinicians from across the professions feeling able to make a difference, something I want to help happen.

My colleagues tell me I am tediously optimistic, but I believe if you want a career that suits you, you should go for it. Make it happen.

Working at the BMA

One of the more distinct features of Dr Eccles' early career, and something that has clearly helped him carve out a diverse and rewarding working life, was his time spent on BMA committees. For medics looking to do likewise, the BMA has the following advice:

"Most doctors get involved with the BMA locally by attending BMA divisional meetings or regional branch of practice committees. Involvement at this level allows doctors to put forward motions to the annual representative meeting, where if accepted by the members will be adopted as BMA policy. Doctors on local or regional committees can also stand for election to national committees if they are interested in national issues.

"National committee meetings are held throughout the year to develop BMA policies and to work towards their implementation. BMA policies cover public health issues, medical ethics, science, medical education, the state of the NHS, and doctors' contracts."