As I change roles from the Department of Health to frontline primary care trust and local government, I've been reflecting on transformational leadership within organisations.
Working at the DoH gave me some fantastic opportunities and the support I received from colleagues was second to none. For that I am really grateful.
I am pleased to see that health secretary Alan Johnson has included health inequalities in his top priorities. Effective ministerial support is also a key to success and I was extremely lucky to work with two excellent public health ministers − Caroline Flint and Dawn Primarolo.
While good public health skills provide credibility and direction in transforming a key government policy area such as health inequalities, you also need a compelling story. People need to engage, and once this happens you are halfway there.
You can have all the facts and figures in the world, but if it cannot be transformed into a story with some human element, it's an uphill struggle. Add in a clear understanding of how others can contribute and that is a pretty good recipe for success.
Can some of these experiences be of any use at local level? Any skills and experiences have some relevance in a local context and there is no doubt the high pressure on delivery evident at national level is expected locally.
A briefing request from the Treasury or health secretary still sends a chill down your spine; just as a summons to a local meeting about primary care services does.
What I think makes a difference to organisations is where leaders demonstrate knowledge and passion about their responsibilities. It needs a maturity that does not allow the organisation to go into freefall every time the going gets tough. A steadying hand is key. There needs to be a sense of balance about what is going well and what needs to be improved.
And, most importantly, we must avoid picking on the weak link. Identify it, deal with it and strengthen it. Most organisations have at least one area where there is a spoken or unspoken sense of failure. By recognising it, and the fact that organisations are only as good as their weakest link, encouraging a team to strengthen that link can lead to an amazing transformation. It all imbues the whole organisation with a 'can do' attitude.
So, whichever end of the telescope you are looking from, it may seem that the language and approach are totally different. But it ain't necessarily so, and the problems are similar and the skills needed to change them are not that different either. It just goes to show the importance of listening − or getting a good translator.