Is the NHS overlooking an important resource by making limited use of mentors? Janet Snell reports

When Odysseus set out on his legendary journey, he left his son in the care of a local wise man called Mentor, who offered guidance to the young prince and whose name has entered the language as meaning 'a wise and trusted advisor'.

Mentorship is now an established personal development and support system. Over the past decade or so it has proliferated in all walks of life, including the NHS.

In some sections of the health service, such as the management training scheme, the concept of mentorship has become very much part of the culture, but enthusiasm is by no means universal.

Management consultant Julia Pokora, who is due to speak at a major conference on mentoring and clinical governance in York this week, believes that NHS managers are more receptive to the idea of mentoring than clinicians, particularly medics.

'I think some doctors still see mentoring as something rather soft and 'g irlie' and just for sad people on their way out. When I do leadership development with managers they either say they currently have a mentor or they have already been there and done that.

'But it's much more foreign territory for the doctors, particularly those in hospitals. Things are starting to change - it's just progress is a bit slower than we might like.'

But Dr Nancy Redfern, an anaesthetist and associate postgraduate dean for the northern deanery who runs courses on mentoring and will be speaking at this week's conference, believes that some managers are just as resistant to the idea as hospital doctors.

'I think the NHS as a whole is rather schizophrenic about mentoring. We still have a big problem about recognition by managers at the more macho end of the spectrum.

There's a perception that mentoring is weak and is solely for people with problems, when of course that is clearly not the case.'

She believes that only a handful of chief executives fully understand the concept and its benefits. 'People will say it all sounds jolly good, but when it comes to the crunch and you ask them if it's something they could implement in their organisation, they say no because they don't see it as a priority.

'Good quality personnel management seems to always come a distant second to coming in on budget. There's a huge tension between the need to develop staff and the need to just push the customers through.'

Management consultant Dr David Clutterbuck, director of the European Mentoring Centre, shares the concern about mentorship in the NHS. 'I think the problem is that the NHS lacks a co-ordinated approach to mentoring.

There are scattered initiatives all over the place and some are very good. But they suffer from the fact that the picture is so fragmented.'

Dr Clutterbuck says some believe in an informal approach to mentoring, allowing people to find themselves a mentor if they want to.

'But under this sort of arrangement, those who get involved are the ones who would have found themselves a mentor anyway and it tends to exclude ethnic minorities and women. Having a formal mentoring system opens the whole thing up to people who would otherwise have been left out.'

He says the classic mistake is failure to train people for mentoring which leads to lack of clarity about what can be achieved.

'Without training, only three out of 10 mentoring relationships will have a positive result. With training you can double that, and if you train both the mentor and the mentee you can get that success rate up to nine out of 10.

But some will inevitably fail because the personalities are incompatible.'

Dr Clutterbuck believes the NHS now has enough experience of mentoring to develop a clear notion of what amounts to good practice.

'It's about time the health service really pulled this work together. There's a good case right now for a proper review of the whole management of mentoring in the service. The Department for Education and Employment has already done it and now they are working on a database of people, plus an accredited training scheme. The NHS could learn a lot from that sort of co-ordinated approach.'

Tessa Brooks, director of leadership and management development at the NHS Executive, accepts that better coordination is needed if mentorship is to flour ish in the health service, but she says work on this is in hand.

'The creation of the NHS centre for leadership and management development, which is now under my wing, is partly about that.

'We want to build links, which is why we have brought the management training scheme and the chief executive programme under the same umbrella. Once we have the right standards in place we can start pushing the whole thing out across other managerial grades.'

The NHS Executive is producing a booklet on mentoring, coaching and development, to be published after Christmas.

Meanwhile, copies are available of a draft contract that can be used when two people enter a mentoring arrangement.

Ms Brooks says that take-up of the mentoring scheme for chief executives 'has not been enormous', so there are plans to relaunch it and possibly extend it to other professional groups.

It may be appropriate to have mentors for primary care trust chief executives drawn from the existing chief executive community or for mentors to be made more widely available for those who want to make the transition to chief executive.

'These are some of the ideas we are playing with, but I believe that when it comes to addressing the issue of mentoring in the health service we are building on a firm foundation, ' says Ms Brooks. 'What I would say is perhaps the time has come to give it a bit of a boost.'

European Mentoring Centre, Burnham House, Burnham, Buckinghamshire SL1 7JZ. 01628-661 667.

What is a mentor?

sounding board

joint problem solver


mirror coach

repository - for dumping 'baggage'

referee devil's advocate - to find the weak spot in your proposal or argument

connector and networker empathiser guide

Getting support: 'Life is never all plain sailing' Gill Collinson, former assistant regional nurse for Anglia and Oxford, is being mentored by commissioner for public appointments Dame Rennie Fritchie, who is also visiting professor of leadership at York University and chair of council and pro-chancel lor of Southampton University.

Gill Collinson says: 'I was working part-time at the NHS Executive with a view to making a move into consultancy. I had been an admirer of Rennie Fritchie's for some time, and while working with her I shared my aspirations about becoming self-employed.

She was very generous with her advice. Over time I came to realise that her way of working was the way I wanted to work, so about a year ago I asked her if she would be prepared to be my mentor during the transition period while I set up as a development consultant and qualified counsellor.

I've had mentors in the past, both formal and informal.

Sometimes I've had more than one at the same time. I wanted to be a mentee of Rennie's because I found her so authentic. She brings her whole self to her work - you don't get an act. Also, she owns her own business and she has experience beyond the health sector.

Becoming self-employed is a whole life transition and Rennie helped me with that. She is someone you can talk to about everything, not just work but how the change has impacted on other parts of my life.

We tend to meet at her flat in London because that's mutually convenient. We don't have a formal agenda, but I do go in with an idea of the sort of things I want to talk through and we have a very wide-ranging and relaxed conversation.

Often I'll talk about something that's come up and she will recount a similar experience of hers and describe how she handled it. Sometimes she'll challenge me over something I've done or said, but it's always in a very positive way. She makes suggestions and, like everybody, I tend to procrastinate, but she'll always pick me up on it next time and ask me what I've done about it.

Often things crop up days and weeks later and I can think back to what she said and reflect on it. I respect and admire her and she has been a role model to me.

At the beginning I had to pluck up the courage to ask her to mentor me. But I think having a good mentor is one of the most important things you can do for your own development.

It's particularly useful when you're self-employed because it can get lonely. The important thing is to choose carefully.

You have to connect as human beings and, though you set clear boundaries, you can't put up barriers - you have to be prepared to disclose something of yourself.

Someone who was my mentor 10 years ago is now one of my best friends.

Life is never all plain sailing, so it's good to have some support. When you see managers stressed out and constantly thinking about the next thing, you realise that having some time and space to consider the right course of action is vital.

If somebody offered me the choice between getting a mentor or going on a really expensive training programme, I'd choose mentoring every time.

Having somebody to talk things over with who's been there, done that and has the video and the T-shirt has been an invaluable experience.

'Dame Rennie Fritchie says: 'As with all my mentees, Gill and I began by drawing up a contract so we were clear what she wanted to achieve, how we were going to evaluate it, how long each session would take, where we would meet and how long the process would last.

It has to be approached in a business-like way, even though the meetings may be informal and quite personal, because then everyone knows where they are.

Gill and I agreed to review the whole process at the end of a year. We're just coming up to that and we'll either decide that we're done or that we w i l l carry on in some way. One opt ion may be to meet twice a year and still keep in contact, but at a distance.

By the end of 12 months you know people much better than you did at the beginning but it's still a functional relationship. What you aim for is healthy respect on both sides with no element of patronage.

Often people who want to be mentored are moving to another job and maybe feel a bit out of their depth. Or perhaps someone is at a crossroads, or feels stuck and wishes they were at a crossroads with options open to them.

Sometimes, like Gill, they're starting up a new venture.

When changes happen you don't just flick a switch. Gill needed someone to look at her situation strategically and say: 'Let's view the whole picture and decide what's desirable and what's sensible.'

When we meet I usually start off by asking what's been going on in her life and I might mention anything interesting that has happened to me.

Then I ask what we ought to have discussed by the end of the session and what needs to have been resolved or explored if the meeting is going to serve her purpose.

It might be: 'Should I sell my house?' You talk about personal things because that's part of the package, but you have to be clear about the boundaries and what your limits as a mentor are. It varies from individual to individual as to the mix of personal and professional.

Confidentiality is very important and that must be clear from the very start.

I've mentored more than 20 people over the years, a mix of men and women. Sometimes I'm paid for it, sometimes I do it as gift work.

At the moment I have four people on the go and I see them for half a day every six to eight weeks. I like to see good people doing a good job and I'm happy to help where I can.

It's about making sure the right people are in good heart to lead the service. That may sound like motherhood and apple pie but I mean it.

People approach me for various reasons. One man asked me to be his mentor because he wanted to learn more about the different way women approached issues, which I thought was interesting.

I did have one person who would ring me on the way to meetings and I had to explain that wasn't a mentoring relationship - they needed technical support and perhaps weren't ready for mentoring.

In another case someone said they were looking for a friend. I didn't take them on because I think you have to find your friends elsewhere. It's important that people going into it understand what mentoring is all about.

Guiding light: 'It's helped me be more focused' Gill Vass, deputy general manager for the directorate of surgical services and site co-ordinator at the Queen Elizabeth the Queen Mother Hospital, Margate, Kent, is being mentored by Peter Catchpole, chief executive of West Sussex health authority.

Gill Vass says: 'I was given my mentor as part of the Institute of Healthcare Management continuing professional development scheme. I asked to have someone more senior than me and was given Peter Catchpole, so I considered myself quite lucky. We began by swapping profiles so we could look at each other's background. I didn't really have any preconceived notions of what it was going to be like - I went in with a completely open mind.

He asked me to do an action plan and we talked through where I saw myself in the future and how I could create opportunities for myself. We talked over some problems I was having with my diploma in management studies.

You get so bogged down with the day-to-day work of the organisation it's great to spend time with a senior manager away from the organisation.

We have an hour, or just over, together and the time flies by.

I then have a two-and-a-quarter hour drive back from Worthing to Margate, which gives me time to reflect on what we've discussed, though the distance is a nuisance. Because of pressures at work I sometimes wonder if I'm being selfish taking virtually a whole day out - but then I say to myself that I'm worth it.

It's helped me to be more focused about my strengths and weaknesses, what I want and where I'm going with my career.

You have to be prepared to do some work because otherwise it would be easy to lose the momentum. Peter says I can ring him any time and he's never cancelled on me. I suppose the key thing is to choose a person who is simpatico and prepared to give you some time.

'Peter Catchpole adds: 'We started just over a year ago and at the beginning we focused on Gill's needs, what opportunities there were and what blocks existed to stop her achieving them. She made a list of her objectives and that helped to steer the conversation in the direction she wanted to achieve her priorities.

Initially the process was oriented towards career pathways but, as it's evolved, the discussion has become more general.

We didn't set a time limit. When Gill feels she is no longer getting anything out of it, then we'll stop.

It's been an opportunity to find out things that otherwise I wouldn't have done. Gill works in accident and emergency and her unit was going through a merger process similar to one I'm overseeing here. She gave me some contacts to talk to there about their perspective on the change process. I found this very valuable.

Being a mentor has given me an insight into the aspirations and expectations of middle managers which I wouldn't have had otherwise.

Sometimes it has been difficult arranging meetings. We don't always meet face to face, but thanks to modern technology it's still possible to keep in touch.

My advice to anyone thinking of being a mentor is you'll find it rewarding as long as you can put enough energy into it.

Once you make the commitment then you'll probably see it through - and the value increases over time as a relationship of trust builds up. But one of the most important things is the chemistry between the two of you - get that right and the rest should follow.