Careering ahead

For six years, Sam Jones worked as a nurse, and realised it was not the career for her. But when she tried to get a place on the MTS, she found 'it was like trying to join Equity - you couldn't join unless you had management experience, and you couldn't get that without being on the scheme'. After getting the grounding she needed at Anglia and Oxford regional office, she got onto the scheme and is now nearing the end of her second year. 'Looking around, there are very few jobs on offer, particularly at our level, ' she says. 'It is not like five years ago when there were lots of new business manager posts.' Now based at Ealing, Hammersmith and Hounslow health authority, she says she wants to get experience in mental health, where she has not yet worked, but adds: 'I am at heart an acute provider person. That's where I trained and that's what I am comfortable with.'

Brett Bousfield joined the MTS from a nursing background and is now assistant commissioning manager at Leeds HA. 'In the past there have been traditional career routes. But with primary care groups, things are looking very different, ' he says. 'There is a degree of uncertainty. If you move to primary care, will you be able to get back into the acute side?' Unconcerned by the high turnover of people in management jobs, he says: 'I have seen too many people sit in jobs for too long. The challenge is to maintain your skills.' The MTS is 'an excellent scheme', he says. And despite the complaints of some trainees in the past that support and mentorship were weak, he says: 'I think it comes down to individuals. If your line manager or mentor is not doing a good job, you have to sort it out.'

Kate Middlemiss was a medical secretary, 'but when I worked in a hospital I always thought I could manage better than some of the people there', she says. She left to run her own antiques business instead, but was drawn back to the NHS and, after studying for a law degree, found herself on the MTS. Based at South Staffordshire HA, she is looking for a job when she leaves the scheme in June. 'I think this is a really exciting time - the best for four or five years.'

She finds the prospect of 'facilitating' the setting up of PCGs exciting. 'There will always be jobs for good managers, ' she says.

Richard Renaud applied for the MTS 'on the university milk round' after studying modern history. 'Sandy Macara says historians make the best managers, so that's my claim to credibility with clinicians, ' he says. Based at North West Anglia HA, and currently seconded to Peterborough Hospitals trust managing ophthalmology services, he is coming to the end of his first year on the MTS. He hopes to help set up PCGs in his next post. 'It is going to be fascinating, ' he says.

Demelza Penberth is continuum of care manager at Guy's and St Thomas' Hospital trust. Now needing to find her first permanent post, she says: 'My concern is that the support provided by the scheme will stop when we come off it. You become aware as you approach the end that the emphasis is on recruiting new people and supporting those still going through. You don't just want to find yourself in a job, and that's it, no more training. It's like a driving test - you only really start learning once you have passed.' She is also concerned that jobs in which new managers can develop their skills may simply not be available. 'Employers want people with immediate skills.' But she says there are opportunities - not least in primary care. 'I think GPs in particular are looking for help.

They have trained to be GPs - they want management support. We are trained to be facilitators.'

Lucy Peregrine has just returned from New Zealand where she spent her elective working at the Ministry of Health. A biochemist by background, NHS management was the only career she considered, and she eventually joined the Welsh management development scheme. 'My last placement was as GP liaison officer, and I worked really closely with GPs and practice managers, ' she says. 'Primary care is a huge management job and it is a new area for the future. Working in primary care groups is going to be just as challenging as running acute services.' Her interests lie in public health. 'I want to be closer to the population level, ' she says. But she admits: 'With the Welsh Assembly coming along, no one really knows how things will work out.'

Deepak Puri spent nine years in public sector management before joining the MTS, and for half that time he was commissioning and developing health services for black communities. 'I was managing in the ghetto and I wanted to bring those skills out into the mainstream, ' he says. The problem he found was that people did not believe his skills were transferable. 'I was going to a lot of interviews and coming second.' Now working at Barnsley Community trust he believes The New NHS 'offers opportunities to creative and innovative people. It says a lot about what it would like, but not very much about how it should be done. That's down to people like us.'