Episode Summary: Chris Pointon and the Hello, My Name Is Campaign

In this episode, Matthew Winn sits down face to face with Chris Pointon — partnership manager by profession, and co-founder of the landmark “Hello, My Name Is” campaign alongside his late wife, Dr Kate Granger. With 2026 marking ten years since Kate’s death, Chris reflects on how a single hospital conversation became a global movement that transformed the culture of compassionate care.

The Origin Story

The campaign was born in 2013 from a conversation between Chris and Kate in her hospital side room, where Kate was being treated for a desmoplastic small round cell tumour — a rare and aggressive sarcoma. Despite being given just 12 months to live in 2011, Kate survived until 2016.

On one particular day, the couple noticed a simple but striking failure: healthcare staff were not introducing themselves. Kate, a doctor herself and prolific on social media, decided to act.

“It was born way back 13 years ago between one conversation between a terminally ill lady who was also a doctor and her non-medical husband.”

Chris, coming from a commercial background, was struck by the contrast: “We used to hold meetings with customers, with suppliers, and you would always have that introduction as part of that meeting structure… But obviously got into a medical setting and we could tell that it doesn’t happen in every situation.”

A Campaign That Grew Beyond Expectation

What Chris and Kate initially thought might gain brief traction quickly grew into something far bigger. “The first couple of weeks, we probably thought that maybe something that would get a little bit of traction and we got a lot of responses, but then it would fizzle out because surely introducing yourself was not something that was required as a reminder… but it just grew arms and legs.”

Senior NHS leaders began asking how they could help. Chris leveraged his professional networks to get figures from the business and celebrity world photographed with the campaign logo, spreading the message across social media:

“It doesn’t matter if you’re the Prime Minister or if you have those goal blogs walking on the street — we’re all human beings and that human interaction is the first interaction you may have with an individual.”

Kate’s Values and What Made the Campaign Last

Beyond the campaign logo, Kate developed a set of personal values that became central to its ethos: effective and timely communication; seeing the patient as an individual rather than a bed number; putting the patient at the heart of every decision; and recognising that little things make a difference.

“She always said if it made a difference to one other interaction anywhere in healthcare, anywhere in the world, then she was happy because she knew she’d made a difference for that interaction.”

Chris describes Kate as someone who, despite her illness, gave everything: “She often said she was only running on 50% gas because of the chemotherapy or because of the side effects or because of the cancer, but 50% of what she was running out was probably double what I was running out or double what a lot of people would have been running out.”

The Double Act

Matthew presses Chris on his own contribution — the networking, the logistics, the sheer determination. Chris is characteristically modest, framing it through Kate’s example: “Kate’s terminally ill, she’s doing all this speaking at events, she’s really driving her book sales forward, she’s continuing to work… What have I got to moan about? I should be there doing as much as I can.”

Carrying the Legacy Forward

After Kate’s death, Chris took a year-long unpaid career break and delivered over 200 talks across the UK, Australia, New Zealand, and Europe. “It helped me come to terms with what had happened… It meant that I could carry on Kate’s legacy and the campaign in other countries around the world.”

Today, the campaign lives on through ambassadors worldwide, branded merchandise that raises funds for charity, a touring play about Kate and Chris’s story, and awards named in Kate’s honour for compassionate care.

Observations on Leadership

Drawing on years of visiting NHS organisations, Chris shares a clear observation: “Those organisations that really embrace the campaign from the start reap the benefits in their patient surveys and in staff morale.”

He notes that the best leaders are those who understand and share the campaign’s backstory rather than treating it as a top-down directive: “I talk at a lot of organisations and when you speak to the staff afterwards, they’ll say, I didn’t know the story — I just thought it was something that we were told we have to do.”

On leadership more broadly: “A sign of a great leader is hopefully admit to being wrong and hopefully admit to making mistakes as long as we learn from them.”

Looking Ahead — 10th Anniversary

The International Hello, My Name Is Day falls on 23 July - the anniversary of Kate’s death and the couple’s wedding anniversary. Chris encourages organisations to hold relaunch events, run selfie campaigns, adopt the logo on staff badges, and reflect on what compassionate care means in practice.

“Everyone that works in healthcare makes a difference. You might not think you do, but you certainly do to the people that you’re looking after.”

Get involved:Visit the Hello, My Name Is website to contact Chris, order campaign merchandise, or plan events for International Hello, My Name Is Day on 23 July.

https://www.officialhellomynameisbadges.co.uk/?gad_source=1&gad_campaignid=21038657475&gbraid=0AAAAAD3cZDbTm2XPEN9cclGiREc_9YoXq&gclid=CjwKCAjw1tLOBhAMEiwAiPkRHmwgcWicdDRN87hls3Y7UNwnDjGBHWbhsvIUlQRGNz8sv9k8GCHN-xoCAaQQAvD_BwE

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Professor Dhesi begins by reflecting on her personal and professional journey into geriatric medicine. Raised in Essex by first-generation immigrant parents, she trained in Leicester before initially considering careers in neurology or endocrinology. A period of time away from training proved pivotal, allowing her to step back and reflect on what she valued most in medicine. This led to a clear realisation that her interests lay in whole-person care, multimorbidity, polypharmacy, and the interface between physical health, mental health, and social care—core principles of geriatric medicine. This insight prompted a move to London to train in a unit with strong clinical and academic pedigree, laying the foundation for her later leadership roles.

The discussion then turns to Professor Dhesi’s role as President of the British Geriatrics Society. She describes the BGS as one of the UK’s largest medical specialty associations, with a multidisciplinary membership across the four nations, united by a single mission: improving healthcare for older people. As President, her role extends far beyond ceremonial responsibilities. It involves setting strategic direction, working closely with vice presidents responsible for policy, workforce, education, clinical quality, and research, and motivating clinicians who undertake national leadership roles on a voluntary basis alongside demanding clinical jobs. Central to her leadership is maintaining focus on the needs of older people amid an increasingly complex and pressured health and social care landscape.

Professor Dhesi reflects on the long-recognised but insufficiently acted-upon challenge of population ageing. Despite decades of warnings, health systems remain largely organised around single organs or conditions, rather than around the needs of the population that uses healthcare most—older people living with frailty and multiple long-term conditions. She discusses how geriatric medicine has historically struggled to be heard at national policy tables, and how the COVID-19 pandemic acted as a catalyst for the specialty to step forward and assert its voice. Through sustained advocacy, evidence generation, and collaboration, she describes how the BGS has increasingly influenced national conversations about service design, workforce planning, and value-based care.

A significant part of the episode focuses on Professor Dhesi’s work in perioperative care and the development of the POPS (Perioperative care for Older People undergoing Surgery) model. Drawing on her experience as a medical registrar witnessing preventable complications on surgical wards, she explains how better pre-operative assessment, optimisation, and shared decision-making can transform outcomes for older patients. She emphasises the importance of embedding research alongside clinical innovation, enabling services to demonstrate both clinical and cost effectiveness. Evidence from POPS programmes shows that when geriatricians, surgeons, and anaesthetists work together, a substantial proportion of patients choose not to proceed with surgery because it does not align with their goals or offer meaningful benefit—an outcome that reflects better, more personalised care.

The conversation then turns to shared decision-making, realistic choice, and the ethical responsibility to support patients in choosing not to pursue interventions when the risks outweigh the benefits. Professor Dhesi highlights that “doing nothing” can sometimes be the most appropriate and compassionate option, particularly later in life. She argues that these conversations, while often described as difficult, are essential and require honesty, clarity, and strong clinical leadership.

Looking to the future, Professor Dhesi expresses cautious optimism. She sees opportunity in the emerging long-term planning agenda for the NHS and in a renewed willingness to rethink how care is delivered. She stresses the importance of clinical leaders who retain credibility through ongoing practice, bringing frontline experience into national decision-making. She also speaks passionately about diversity, inclusion, and the need to support leadership development for people from different socio-economic, cultural, and geographical backgrounds, ensuring that national leadership does not become London-centric.

The episode concludes with a powerful call to action around public awareness and advocacy for older people. Professor Dhesi challenges the accepted norm that older people often lack a dedicated specialist overseeing their care, arguing that just as children expect paediatric leadership, older people deserve coordinated, specialist-led care—delivered by the most appropriate professional within a multidisciplinary team. As she approaches the end of her tenure as President of the BGS, she reflects on the Society’s growing visibility, influence, and membership, and her confidence that geriatric medicine will continue to play a central role in shaping a more person-centred, integrated, and sustainable healthcare system.

Quotes from the episode:

1. Clinical Leadership & Influence
   • “It’s very much giving direction for the overall team, ensuring that we are delivering against our vision and our strategy, but also trying to inspire and motivate people during very challenging times.”
   • “You have to have credibility as a clinician back at your home base—it gives you the platform to speak with authority when influencing change nationally.”
   • “Clinical leaders need to bring shop floor experience into decision-making; that’s how we make policy meaningful and effective.”

2. Journey into Geriatric Medicine
   • “I realised I liked looking at the whole person, managing multiple long-term conditions, polypharmacy, and the interface between physical and mental health—not just a single condition. That led me to geriatric medicine.”
   • “Having a bit of distance from training gave me the opportunity to reflect on what I really enjoyed about medicine—it was a real epiphany.”

3. Advocacy for Older People
   • “We often organise healthcare around organs or conditions, not around the needs of the biggest users of healthcare—older people. That has to change.”
   • “Just as we expect children to have a paediatrician overseeing their care, older people deserve coordinated, specialist-led care. That’s what we’re championing.”
   • “Part of my role is making sure the issues facing older people are heard and informing how services and the workforce develop for the future.”

4. Shared Decision-Making & Patient Choice
   • “Sometimes ‘doing nothing’ is the right thing. Supporting patients to make realistic choices about their care is essential, especially later in life.”
   • “One in four patients on the POPS model decide not to go ahead with surgery because it won’t deliver what matters to them. That’s not failure—that’s better, personalised care.”
   • “We need honest conversations about realistic choice versus patient choice. Not everything can be solved with intervention, and that’s okay.”

5. Optimism & Future of Healthcare
   • “I’m generally an optimistic person. Despite challenges, we have opportunities with the 10-year plan and a resetting of the healthcare landscape.”
   • “We’re seeing people with imagination looking at new ways of doing things, not stuck in old patterns. That’s encouraging.”
   • “Diversity and inclusion in leadership is essential. People from different backgrounds and regions should have the chance to lead and shape care.”

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Adrian reflects candidly on what it meant to hold the presidency during a period of sustained crisis for emergency departments. He describes the role as far more than representational, requiring careful judgement about when and how to speak publicly, knowing that statements could act as “Exocet missiles” in the policy and political arena. A recurring theme is the ethical tension between “being right” and “doing the right thing” — particularly the responsibility to avoid unintended harm to patients, such as increasing anxiety or deterring people from seeking care. Adrian emphasises that leadership decisions are rarely clear-cut and always involve trade-offs, requiring deliberate anticipation of second- and third-order consequences.

The discussion situates emergency department crowding not as an isolated failure, but as a visible symptom of wider system dysfunction — including delayed discharges, lack of community capacity, workforce pressures, and insufficient preventative services. Adrian describes how urgent and emergency care often competes with other parts of the system for political and policy attention, characterising this as a form of “Victim Olympics,” where services such as GP access, dentistry, elective care, and emergency care vie for visibility based on public and parliamentary pressure rather than system coherence.

Adrian traces how his leadership capability was shaped by a diverse career path, including clinical work in southern Africa, academic training in statistics and epidemiology, and senior departmental leadership during the COVID-19 pandemic. He highlights the importance of data literacy, credibility, and evidence-based advocacy, noting that the College deliberately framed its arguments through robust analysis to strengthen its influence. His experience leading an emergency department through the pandemic exposed him to intense change management demands and deepened his focus on staff wellbeing, resilience, and moral leadership under pressure.

A significant part of the episode focuses on policy-making and implementation. Adrian critiques the NHS’s tendency towards “initiative-itis,” where repeated plans and directives risk conflating activity with progress. He explains how the College took a deliberately challenging stance on urgent and emergency care plans, pushing for genuine collaboration, proper evaluation, and realism about priorities. This advocacy contributed to NHS England commissioning independent evaluation of proposed interventions through the National Institute for Health Research — a concrete example of how clinical leadership can shift system behaviour.

Looking ahead, Adrian outlines ongoing national work to define clear service specifications for emergency departments, arguing that without clinicians setting boundaries and standards, others will define them instead. He also discusses the College’s engagement with Parliament, including work through the All-Party Parliamentary Group on Emergency Care, producing regular reports on issues such as exit block, crowding, mental health, and children’s emergency care. He highlights the strategic nature of policy influence, including building alliances and identifying advocates within Parliament.

The episode closes with a strong message to trainees and early-career clinicians: leadership is not a distant or abstract concept, but something developed through engagement, research, and professional involvement. Adrian encourages listeners not to be bystanders, but to actively shape the systems they work within. Reflecting on his presidency, he describes it unequivocally as the best job he has ever done — challenging, demanding, and deeply meaningful.

The episode offers a rich, honest exploration of clinical leadership at scale, illustrating how credibility, courage, data, and values intersect when clinicians step into national leadership roles at the heart of healthcare policy and public debate.

Quotes from Adrian:
National Leadership & Policy Influence
• “We knew that what we were saying would land like an Exocet missile. Being right isn’t always the same as doing the right thing.”
• “Every leadership decision has trade-offs. They’re never completely obvious, and you have to spend time anticipating the consequences.”
• “In health policy there’s a kind of ‘Victim Olympics’ — the services that generate the most noise and anxiety get the most attention.”
• “If everything is a priority, then nothing really is.”
• “There’s a real risk of confusing activity with progress. Publishing a plan doesn’t mean you’ve fixed the problem.”
• “If clinicians don’t define what emergency care is and isn’t, someone else will do it for us.”

Clinical Leadership in High-Pressure Systems
• “Emergency department crowding isn’t the problem — it’s the symptom of everything else in the system not working.”
• “Leadership in healthcare is about weighing harm: not just what’s happening today, but what your actions might trigger tomorrow.”
• “You can do an awful lot of harm if you speak without being absolutely solid in your evidence.”
• “We spent a lot of time agonising over what our words would mean for patients, not just for policy makers.”
• “Change management during the pandemic was extraordinary — and the wellbeing of staff had to be at the centre of every decision.”

Emergency Medicine & Its System Role
• “Very few people go to A&E compared to GP or dentistry — but when emergency care fails, the consequences are immediate and visible.”
• “Emergency medicine sits at the sharp end of the system, receiving the impact of failures everywhere else.”
• “Exit block is not an emergency department issue; it’s a whole-system issue.”
• “We need clear service specifications for emergency departments so that expectations are realistic and safe.”

Developing Future Clinical Leaders
• “Don’t be a bystander. Get involved — in research, in your College, in shaping how the system works.”
• “Leadership skills don’t come from training programmes alone; they come from experience, credibility, and engagement over time.”

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Dr O’Riordan begins by describing her career journey. After many years as a hospital geriatrician, she made a deliberate decision in 2016 to move into community geriatrics, recognising that continuing in the same hospital model would only intensify pressures without improving outcomes. She joined a community trust and helped develop proactive frailty services, integrated community teams, and community hospital support. When COVID-19 struck, her team rapidly pivoted from proactive care to a full hospital at home model, establishing one of the largest and most mature frailty hospital-at-home services in the UK. That service now delivers hospital-level care in people’s own homes, both as a “step-up” alternative to admission and a “step-down” pathway to enable earlier discharge.

A central theme of the discussion is the distinction between “virtual wards” and true hospital at home. Dr O’Riordan explains that hospital at home is not simply remote monitoring or phone calls, but the delivery of genuine hospital-level care at home. This includes senior clinical decision-making, access to investigations, point-of-care testing, and treatments such as intravenous therapies. She stresses that the defining question should always be: would this person otherwise be in hospital? If the answer is yes, then hospital at home should provide the same intensity and accountability as an inpatient ward.

The conversation then turns to risk. Dr O’Riordan challenges traditional clinical notions of risk, arguing that what clinicians or organisations perceive as risky often differs profoundly from what patients value. Many frail older people see hospital admission itself as a major risk, associated with loss of mobility, independence, cognition, and dignity. She shares powerful reflections on how deconditioning is often caused not by illness but by hospitalisation, noting that frailty patients cared for at home have far shorter lengths of stay and often better outcomes. Hospital at home, she argues, enables more honest, compassionate conversations about goals of care, including end-of-life preferences, because patients remain in their own environment with control over decisions.

Dr O’Riordan reflects on how working in people’s homes changes power dynamics. In hospital settings, patients can quickly lose agency, while conversations about risk and dying are often rushed, impersonal, or conducted in unsuitable environments. At home, those conversations become more humane and aligned with what people actually want. She emphasises that supporting people to remain at home — even when that includes the possibility of dying there — is not about taking reckless risks, but about respecting autonomy and delivering care that aligns with patients’ values.

From a leadership perspective, Dr O’Riordan describes her role as that of a pioneer rather than a “farmer.” She sees her responsibility as persuading others that hospital at home is possible, safe, and effective, and then enabling multidisciplinary teams to deliver it. She highlights the importance of shared leadership, strong operational management, and close partnership between doctors, nurses, allied health professionals, and managers. No single leader can deliver this alone; success depends on trusted teams, robust governance, and collective ownership.

At a national level, Dr O’Riordan discusses the behind-the-scenes work required to embed new models of care. This includes influencing NHS England, regulators, royal colleges, and NICE to ensure guidance, standards, and governance frameworks support — rather than block — innovation. She notes that the UK is internationally advanced in hospital at home precisely because of the NHS’s ability to align policy, regulation, research, and funding at scale.

The episode also explores workforce and culture. Dr O’Riordan explains how she recruits for values, courage, and advocacy rather than rigid job roles, building diverse teams across different professional backgrounds. She places strong emphasis on psychological safety, supporting staff to be brave, and developing to take clinical responsibility in new ways. Developing the next generation of leaders is a priority for her, achieved not through courses alone but through mentorship, sponsorship, and shared national work.

Looking ahead, Dr O’Riordan describes her ambition to take urgent frailty care even further out of hospital — including the possibility of removing frail patients from emergency departments altogether and creating alternative urgent care pathways that work directly with ambulance services. She acknowledges that one of the hardest unresolved challenges is financial: shifting activity out of hospitals does not automatically release money, and meaningful change may require courageous decisions about bed closures once alternatives are fully established.

The episode closes with personal reflections and advice. Dr O’Riordan speaks directly to women in healthcare leadership, sharing her own experience of working part-time, raising children, and being told leadership was not compatible with that path. Her message is clear: persist, ignore discouraging voices, and support other women to lead. She ends on a note of optimism, believing that hospital at home and community-based frailty care will continue to grow — and that the NHS can be proud of how far it has already come.

Key quotes from the episode:
• “Hospital at home is unbelievably good — not because of me, but because hospital at home works.”
• “Deconditioning isn’t caused by illness; it’s caused by hospitalisation. It just doesn’t happen at home.”
• “The first question should always be: would this person be in hospital otherwise?”
• “What clinicians think is risky and what patients think is risky are often completely different things.”
• “Many patients think going to hospital is incredibly risky — because they know what they might lose.”
• “Just because we can do something doesn’t mean we should.”
• “At home, the power dynamics are completely different — people have control over their decisions.”
• “I’m a pioneer, not a farmer. I need others around me to make the system work day to day.”
• “You don’t recruit for job titles — you recruit for values, courage, and people who will fight for their patients.”
• “If there are hospital beds, they will get filled — even corridors become beds.”
• “To women in leadership: don’t let anyone put you down. Keep going. We really need you in this space.”

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Context

In this episode of Leadership and Culture in Healthcare, Matthew Winn speaks with Partha Kar, a senior clinician who combines frontline practice with national leadership roles. Partha reflects on leadership developed through clinical credibility, long-term system experience, and a strong commitment to accountability, team culture, and patient voice.

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Core Leadership Insight

Leadership is not a title. It is a set of behaviours grounded in vision, accountability, and trust.
Effective leaders create momentum by being authentic, surrounding themselves with expertise, and standing visibly with their teams—especially when things go wrong.

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Three Pillars of Effective Leadership

1. Lead with a Clear, Personal Vision
   • Leaders must believe in the direction they are taking others.
   • Enacting someone else’s vision without conviction erodes credibility.
   • Authentic leadership builds trust because people can see when belief is genuine.

Leadership takeaway:
If you don’t believe in the vision, neither will your team.

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1. Build Teams That Are Better Than You
   • Strong leaders actively seek people with greater expertise in data, operations, and specialist knowledge.
   • This requires humility and confidence, not control.
   • High-performing cultures value competence over hierarchy.

Leadership takeaway:
Your job is not to be the smartest person in the room, but to create the smartest room.

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1. Take Visible Accountability
   • Leaders must “put a flag down” on accountability.
   • Take credit last and responsibility first.
   • Teams perform better when they know their leader will protect them from unfair blame.

Leadership takeaway:
Trust is built when leaders absorb pressure so teams can focus on delivery.

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Culture in Practice

Be a Guide, Not a Gatekeeper
• Leadership should enable progress, not restrict it.
• Patient voice and staff voice are powerful drivers of sustainable change.
• Control-based cultures slow innovation and damage morale.

Respect Over Popularity
• Effective leadership does not require universal approval.
• Respect comes from integrity, consistency, and doing the right thing under pressure.

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Leadership Under Pressure
• The defining moments of leadership occur during challenge, not success.
• High-credibility leaders stand up publicly when things go wrong and say, “This was my call.”
• This behaviour strengthens loyalty, resilience, and performance.

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Practical Reflection Questions for Leaders
• Do I have a clear vision that I genuinely believe in?
• Have I surrounded myself with people who are better than me in key areas?
• When things go wrong, do I step forward—or step back?
• Am I acting as a guide for my team, or a gatekeeper?

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Final Thought

Sustainable leadership is built on authenticity, accountability, and respect—not hierarchy.
When leaders stand with their teams, culture follows.

Insightful Quotes on Leadership and Culture from Partha.

1. Leadership Identity & Purpose

“In your journey, be a guide, not a gatekeeper.”
This captures a core cultural stance: leadership as enablement rather than control.

“Being a consultant is a leadership role in its own right.”
A reminder that leadership is about influence and responsibility, not titles.

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1. Vision and Authenticity

“A lot of people don’t come with a vision. They come with trying to enact somebody else’s vision—and that’s always a struggle.”

“You may not believe in it when you’re doing the job, and that always shows.”
Authenticity is positioned as essential to credibility and momentum.

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1. Building Strong Teams and Culture

“You need to surround yourself with people who are better than you.”

“That’s not humble bragging—it’s being fortunate enough to have people who know more than you in their field.”
This reflects a psychologically safe culture where expertise is valued over ego.

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1. Accountability and Trust

“You put a flag down on accountability. I will stand for the team.”

“You don’t just turn up to take the prize—you also take the media when things are not right.”

“The team respects that you will take the flack on their behalf.”
A strong statement on protective leadership and moral courage.

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1. Leadership Under Pressure

“The best leaders stand out not just in success, but in times of difficulty.”

“They don’t just put it on the players—they say, ‘It’s my call. I made the call.’”
This draws a powerful parallel between healthcare and elite sports leadership.

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1. Respect Over Popularity

“People may not like your style, but they will respect that you’re doing it for the right reasons.”

“That respect is what allows you to drive things forward.”
Culture is framed as being built on trust and integrity, not consensus.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

In this episode of Leadership and Culture in Healthcare host Matthew Winn interviews Karen Poole, CSP “Influencer of the Year” and Allied Health Professions (AHP) Rehabilitation Consultant.

Karen explains her dual role: clinically as a consultant physiotherapist, and strategically as an AHP rehabilitation consultant influencing service design, patient pathways, and system change. Her work focuses on advocating for rehabilitation as a core part of healthcare delivery and ensuring services are designed to deliver the best outcomes for patients and populations.

Karen describes her non-linear career path — from neurophysiotherapy, to specialist clinical roles, to organisational AHP leadership — before becoming a consultant. A pivotal step in her leadership journey was moving away from pure clinical practice into an organisational leadership position where she could “have a seat at the table” and influence strategic decisions affecting rehabilitation services.

A key theme of the discussion is the lack of a clear, structured pathway for AHP professionals to progress from advanced practice into consultant roles, in contrast to medicine and nursing where career routes are well defined. While consultant frameworks exist and NHS England pathways are emerging, Karen highlights inconsistency in access and support nationwide.

She emphasises that senior clinical leadership is essential for rehabilitation services, particularly in organisations without rehabilitation medicine specialists. Her role fills a leadership vacuum and strengthens advocacy for rehabilitation at system level.

Karen concludes by stressing the need for stronger succession planning, clearer routes to consultant roles, and better workforce development in AHP — framing this as a strategic leadership issue rather than solely an individual career problem.

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Key Leadership Quotes

On leadership influence and advocacy

“I consult across pathways about patient care and I work across those systems to be able to influence for change.”

“Really working to advocate around patient care, but also around the services and how we design them… so we can get the best outcomes for our patient and our population.”

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On stepping into leadership beyond clinical identity

“It felt very different for me… moving away from my clinical ‘why’.”

“She said: ‘You’ll have a seat at the table… to start to be able to influence.’”

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On leadership as filling organisational gaps

“There wasn’t that senior voice to advocate for rehabilitation in its broadest sense… so the rehabilitation consultant role became an opportunity.”

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On leadership development and readiness

“You don’t suddenly wake up one day and you’re a consultant. You need to grow into that.”

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On system-wide leadership responsibility

“How are we succession planning and how are we supporting our workforce and our future workforce to move into these pivotal roles?”

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On structural leadership challenges in AHP

“We have the framework… but the gap is how we pragmatically support people to get there.”

“From advanced practice to consultant isn’t necessarily an automatic step.”

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Core Leadership Themes

1. Leadership is Influence, Not Title

Karen’s leadership is defined by system-level impact, not role labels — influencing pathways, services, and strategy.

1. Leadership Requires Stepping Out of Comfort

Moving from hands-on clinical work into strategic leadership is emotionally and professionally challenging, but essential for impact.

1. Leadership Is About Advocacy

Senior clinical leaders are necessary to champion underrepresented services like rehabilitation.

1. Leadership Needs Structure

AHP leadership development lacks clarity and consistency compared to medical and nursing routes.

1. Leadership Is a Workforce Responsibility

Succession planning is framed as a leadership obligation, not an individual career concern.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Host Matthew Winn interviews Andrew Hodge, Director of Paramedicine at a UK ambulance service, about clinical leadership, professional identity, and system-wide working in the NHS.

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Executive Summary

Andrew Hodge describes the emergence of clinical leadership within paramedicine as a turning point for the profession. He explains how the creation of board-level paramedic roles has given the profession a strategic voice within organisations traditionally dominated by medicine and nursing.

His leadership journey reflects a career deliberately broadened across multiple parts of the NHS — from frontline paramedicine to commissioning, clinical governance, patient safety, and consultancy roles. This system-wide experience has shaped his leadership style and belief in openness, learning culture, and multi-professional teamwork.

Hodge highlights that real leadership influence increases at executive level, where it becomes easier to shape strategy, represent the profession, and integrate paramedicine into wider pathways of care. He stresses that leadership now extends beyond ambulance services into primary care, hospitals, mental health, and prisons, positioning paramedics as system-wide clinicians rather than just emergency responders.

Culturally, he champions transparency, learning from incidents, professional respect, and integrated working. He sees the future of paramedicine embedded in neighbourhood teams, urgent care hubs, and cross-organisational models — where flexibility, collaboration, and system leadership are key.

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Leadership Themes

1. Clinical Leadership = Professional Voice

Paramedics finally have representation at executive level, shaping decisions affecting the profession and patient care.

1. Leadership Through Breadth, Not Just Promotion

Hodge’s influence comes from wide system experience — ambulance services, primary care, commissioning, governance, and consultancy.

1. Culture Is Built Through Learning & Transparency

Patient safety, openness, and reflection are foundational leadership responsibilities.

1. From Profession to System Leader

Leadership today is not just about leading paramedics — it’s about leading across systems and organisations.

1. Multi-professional Working Is the Future

Effective care comes from integrated teams, not professional silos.

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Key Quotes on Leadership & Culture (verbatim)

On professional leadership and representation

“At one time there was no chief paramedic on a board representing the profession.”

“It’s been a really important development… to have a chief paramedic on a board.”

“The role is to be the voice of the profession.”

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On leadership at executive level

“It’s been a lot easier… at exec level with directors to kind of just be alongside them, shaping it as you go.”

“I’ve got the opportunity to represent us and put things forward and try to steer the direction of travel for our profession.”

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On culture, learning and transparency

“Working on that serious incident agenda and how we learned from incidents and develop openness and transparency.”

“That was nothing to do with being a paramedic — it was just really good experience to be in a different part of the system.”

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On leadership as influence, not position

“The crossroads between clinical practice, leadership, research, education, supervision… that influenced the organisation in my small way felt really important.”

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On multi-professional teamwork

“Multi-professional working — that is much better.”

“If we can do that going forward as part of an integrated neighbourhood health team… that would really help the system and patients.”

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On future vision and culture change

“What excites me… is having more flexibility to go into different settings.”

“That would be really good for our profession — but it actually would really help us help the system and patients and partners much easier as well.”

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On leadership growth

“Learning to be on a board has been one of the steepest learning curves I’ve ever had.”

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Final Leadership Takeaways
• Leadership grows through experience across systems, not just promotion.
• Culture is led through visibility, honesty, and learning from failure.
• Professional influence changes when clinicians sit at board level.
• Integration, not siloed working, is the future of healthcare leadership.
• Clinical leaders must balance profession-first thinking with system responsibility.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Host Matthew Winn speaks with Dr Steve Turner, consultant paediatrician and President of the Royal College of Paediatrics and Child Health (RCPCH), about leadership, responsibility, and building a culture that supports children, clinicians, and the wider health system.

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Who is Dr Steve Turner?
• Consultant paediatrician in Aberdeen since 2003, originally from Blackburn.
• Works across general paediatrics, respiratory medicine, research and national leadership.
• President of RCPCH and Vice Chair of the Academy of Medical Royal Colleges.
• Continues to practise clinically, running clinics each week.

“I’m first and foremost a clinician… it would be difficult to do the role if you weren’t experiencing life as a clinician.”

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What the College Does

The RCPCH has four main functions:
1. Setting training standards for paediatricians.
2. Setting care standards for children and young people.
3. Advocating for the paediatric workforce.
4. Advocating for children and young people.

The College has over 25,000 members and is explicitly multi-professional, reflecting that child health depends on whole teams, not just doctors.

“We didn’t become the Royal College of Paediatrics — we became the Royal College of Paediatrics and Child Health.”

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The Role of President

Turner describes leadership in the College as enabling connection rather than control.

“I don’t see myself at the top of a triangle — I see myself at the heart of a circle.”

His role includes:
• Representing the College publicly.
• Advocating for clinicians and patients.
• Bridging understanding between clinicians, professional staff, and politicians.

“People who aren’t doctors don’t understand what doctors do … and why would they? Part of the role is explaining the reality of clinical life.”

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Leadership Style and Philosophy

Key leadership principles highlighted in the discussion include:

1. Connection Over Control

“My job is connecting people.”
Leadership is about enabling relationships and communication, not hierarchy.

1. Authentic Clinical Leadership

“You’ve got to be experiencing life as a clinician.”
Credibility comes from staying grounded in real patient care.

1. Creating a Risk-Taking Culture

As reflected in Matthew’s closing comments, Turner’s leadership message is about psychological safety:

“The challenge is about risk-taking culture.”
Healthcare leaders must move away from fear-based cultures toward learning and improvement.

1. Collective Leadership

“Leaders, managers and clinicians must work together.”
Strong organisations depend on trust across professional boundaries.

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Children at the Centre of Leadership

Turner emphasises that leadership in healthcare must prioritise prevention, early support and long-term outcomes for young people.

“We need to invest early in the life course.”

Matthew reinforces this:

“Twenty-five percent of the population are our future — and they need fabulous futures.”

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Closing Message

The conversation concludes on a hopeful and human note — that leadership should feel positive, not punishing.

“We need regular fist-bump moments for all.”

This reflects Turner’s belief that leadership should energise teams, celebrate progress, and keep children firmly at the centre of decision-making.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Matthew Winn interviews Tony Young, a clinician and national leader in healthcare innovation, about his career, leadership mindset, and how he manages multiple senior roles across healthcare, academia, and business.

Tony explains that he is a consultant urological surgeon at Southend Hospital, Associate Medical Director for Innovation and Transformation, National Clinical Director for Innovation at NHS England, and Chair of Innovation and Entrepreneurship at Anglia Ruskin University. He is also a non-executive director of an investment trust to better understand how finance, governance, and investment work outside the NHS.

Early in his career, Tony founded four companies as a junior doctor, raising £5 million and exiting each business. This entrepreneurial journey was not smooth—he nearly lost his home—but it gave him invaluable insights into risk, failure, and innovation. These experiences shaped his belief that healthcare must learn from business, and that systems change happens when clinicians engage with entrepreneurship and leadership beyond medicine.

Matthew challenges Tony on how he balances so many senior roles. Tony explains that the answer lies not in time management but in self-knowledge. His leadership transformation came through executive coaching, arranged by his former NHS England director, Ian Dodge, and particularly through coaching with Dame Una O’Brien, former Permanent Secretary at the Department of Health. Coaching helped Tony understand his internal “operating system” – how his mind works, how assumptions form, and how emotions and beliefs influence leadership behaviour.

Tony also draws on neuroscience and psychology, especially the thinking of Robert Kegan (author of Immunity to Change), to explain that leaders often struggle not because of workload but because of misalignment between their actions and their values. Once he became clear about his core values, he learned how to structure his working life around them.

He explains that when your work aligns with your values, you gain a sense of clarity, speed, energy, and resilience. For Tony, these values include equity, justice, creativity, education, family, community, and autonomy. Because all his roles express the same values, they reinforce each other rather than compete for energy.

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Key Leadership Quotes

“Not being normal, being a bit crazy, being on the edge – that’s where change happens.”

“I nearly lost my house. I learned a lot about business the hard way.”

“Coaching felt like a luxury for my mind.”

“I learned how my ‘operating system’ works – and why I think the way I think.”

“If you live according to your values, you can work at speed and scale.”

“When your work aligns with your values, your mind becomes super-efficient.”

“I don’t manage multiple jobs. I live one life in different expressions.”

“Healthcare is actually a very safe system compared to how the City works.”

⸻

Leadership Takeaways

1. Self-awareness is more important than time management

High performance is not about squeezing more hours into the day; it comes from understanding yourself, your motivations, and your mental patterns.

1. Coaching is not a luxury—it is leadership infrastructure

Access to high-quality coaching enables leaders to reflect, grow, and avoid burnout. It’s not weakness; it’s strategy.

1. Innovation happens at the edge

Tony’s career shows that progress in healthcare often comes from people willing to cross boundaries between medicine, business, and academia.

1. Values create energy

When your work reflects your personal values, you gain momentum rather than exhaustion.

1. Failure is a leadership teacher

Near-collapse in business taught Tony as much as success. Leadership maturity grows through challenge.

1. Think cross-sector

Understanding how money, governance, and investment work outside healthcare helps leaders build better systems inside healthcare.

1. Align roles around purpose, not status

Multiple jobs only work if they serve one unifying mission.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Saffron reflected that many of the ‘group models’ had been born out of the desire to meet local needs differently. However there was a need to have a national set of principles guiding the development and instigation of groups - potentially around: value, staff benefit, improvements in population outcomes and being well governed.

All models need great leadership at CEO and chair levels. The group chair needs great experience and therefore is probably not suitable for those without great executive or non executive experience already. The pipeline for future CEOs is bright, but the reality is that some of the sub accountable officer group/site role are as good training and development as a smaller accountable officer role could be.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The hospitals in Liverpool have a long history of Trusts and their locally supported brands. The balance in the group is the benefits deriving from scale and size balanced with local delivery. Each site has its own autonomous leadership team and the Group board then links across the organisations. The oversight of the Group is underpinned by an enhanced risk approach and the management teams and Group Board use assurance and risk registers to discuss the important aspects of care. A rigid governance approach ensures continuity and a standardised approach- this is blended with a delegated framework for leadership. There are five simple rules that cannot be altered across the trusts in the Group and these are not altered unless all relevant people in the group are involved and included to change. The risk approach is based on a 5x5x5 framework that involves a clear approach on the effectiveness of the controls over a risk.

The approach took time to develop and individuals and teams needed support to adopt this way or working.Internal audit was used extensively to test out the risk approach. Most leadership i site specific but there has begun to be cross organisational leadership, especially where organisations share sites.

This shared approach had in genesis in external reviews that were taken on specific organisations and clinical services and NHS England the local Integrated Care Boards both encouraged a different leadership approach to make service change happen.

The Group CEO has to stay out of the operational leadership teams and trust them to make their own decisions. The role needs to be focused on strategy, management of the local and national politics and negotiate a future for what the Group does. The role has to support leaders to flourish and know when to get out of their way!

The future for the Group will include a shaper for us on research; digitalising how care is organisation and delivered and support o make improvements in the health of the local population.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The organisational operates with local identity and delivery, supported by the benefits of being part of a larger organisation. It has worked hard on reducing variation; develop hospital site leadership; used clinical networks to drive out variation and all supported by shared support services.

Clinical networks work hard to establish how teams can be best in class and support across sites with capacity issues.

The Group arrangements to include Barking and Havering hospital saw Shane appointed as the CEO; a shared Chair with Barts Health and the ambition to seek improvement and use some of Barts experience and capacity. Following the departure of the joint chair - separate Chairs were appointed and it was agreed to unravel the Group arrangements. Shane now leads/Chairs a formal partnership of acute providers/collaborative between Barts, Barking &Havering and the Homerton hospital. There had been little intertwining of infrastructure between the two organisations, therefore the unravelling was not difficult.

The acute collaboration focuses on three key areas that were important to the three hospitals.

Being the group CEO is a privilege; very varied, but important to keep the people/staff experience at the forefront of his role to ensure values, behaviour, inclusion and equity are a core focus. Shane plans to be in a different hospital each day and his key role is to create the environment for leaders to flourish. The balance is to ensure the culture is good, but always with a razor sharp approach on delivery and performance.

Shane describes how his style has changed in the Barts health role - felt it would have been difficult to move into the role without multi-site experience (which he got at Bart’s before he was appointed CEO0. He learnt how to work through people and adapt to support change - not direct everything.

Discussed succession issues and the opportunity for future CEOS - Shane felt that site CEOs =, under an accountable officer, were a great opportunity for people to learn their trade and become more confident.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The two trusts remain as separate organisations with their own Boards. Roles were shared where there were gaps in leadership and opportunistically moved to a joint chair relatively recently.

The group approach is operated through a joint committee - there they agree on joint work which has included, governance, tackling racism, social value, talent management, quality improvement and collaboration. they have created joint thinking through involving the non executive directors; developing Boards together and creating relationships.

Angela described how merger and reducing independence is not something they are looking at. Currently their analysis is that there is no value in merging and they are focused on what each organisation wants to change and the value from working in a Group.

The CEO role can only be successful if there is a great team of support around them. Angela has a managing director in each organisation. The CEO has to lead the cultural changes - be intuitive about how change has to happen; change for the right reasons, not just because it is expected and manage risks tightly.

Advice for others in a similar position would be -1) bring executive teams together early and send regular time together 2) create a talent pool across organisations and support talent to thrive.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The local context is that local communities are wrapped around three large towns and small conurbations and the two hospitals serve these.

David describes how they have developed cross site leadership roles for general managers and clinical directors - this has enabled benefits for each hospital site. The approach was influenced by the approach used at Barnet and Chase Farm hospital sites. Goal is for single teams across sites, no divisions - a flat leadership structure - reporting directly into executives.

The merger was transacting as an acquisition, but they have culturally developed the approach as a merger. Trust has taken time to develop -but with joint roles; merged colours/new lanyards/executive teams on site in person across both hospitals throughout the week.

The merger transaction concluded just as the pandemic took hold, which in some ways made things easier as many of the established rules and ways of working changed.

Looking forward the larger Trust will ensure there is a larger pool of talent to draw from; developing clinical leadership is easier to support and staff can be at the very heart of all the developments across the organisation.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The collaboration started initially with a joint clincial strategy, which developed into a single accountability framework that the Trust Boards signed off in December 2023. A joint Chair and then a joint CEO followed. This approach was supported by site managing directors.

What made a difference initially ? 1) enthusiasm of clinicians 2) permissions to do things differently 3) focusing on the commonalities, not differences 4) proud organisations wanting to do things differently and developing joint digital approaches.

The Boards developed a joint approach by describing their challenges and working on joint challenges together. This always involved putting a patient first methodology and developing a common improvement language and approach. The Trusts formally evaluated the group approach judged against the outcomes they wanted to achieve.

Now the group has around 28K staff - develops work together; shares leadership approaches and have developed mature leadership teams, underpinned by a health research ethos.

The Group CEO role is different to single hospital CEO roles because Maria has to be out of the detail, delegate to her teams and focus on approaches that drive the benefit of working together. This means working through what is right for the population and is already then leading to different investment decisions. Control has to be delegated to teams and data analysis has to be enhanced to ensure the focus is on the right issues.

Maria describes how she had been used to a set of personal relationships and that underpinned how she worked effectively. Now she has to focus on maximum impacts; better use of data; work with teams across sites to make improvements; be non partisan; be an arbiter; narrate and manage relationships with external partners.

Looking to the future, Maria see the duty to collaborate and cooperate in the public realm as being crucial. Supporting a new set of senior leaders is going to be key. As a leader you must be courageous, curious and look to improve care all of the time.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The joint working of the Trusts is voluntary, with Trusts choosing to join the Group and operate in the way that has developed. With Committees in common, joint roles for the CEO and Chair and other executive roles, opportunistic approaches have flowed from the collaboration.

The Group has enabled new ways of working to be tested and sharing and adoption of this practice to be adopted at pace.

The “back office” infrastructure is shared where it makes sense, but there are differences and local approaches.

Glen has been a CEO for over 18 years so the joint approach builds on his experience and outlook. His approach has been to always encourage people to make change and challenges thinking. Success happens when decision making iOS devolved and people are supported in accountable structures/cultures. Importantly staff and services must be supported to take risks and learn what works.

As Group CEO, Glenn has had to move to a more coaching style as he cannot be so hands on. He still needs to be able to discharge his accountable officer role properly but does this increasingly by working through others. He needs to be able to provide the ‘air cover’ for the site based managing directors, so they can do their job effectively.

Looking forward - the Group is not dependent on Glen alone to succeed. All of the organisations can walk away from T he Group at any point and make their own choices.

The leadership role is to convene; scale up population health approaches; work as an integrator; earn the trust of others to support better care delivery. NHS organisations don't have to provide and lead everything -but must break new ground and evolve.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Macro themes from the episodes and Mark:

1. Where there is political consensus and stability, partnerships appear to be have developed and matured more easily
2. With upper tier councils spending 70% of their revenue on adult and children social care - any devolution or change, must come in this area to provide councils with the headspace and resources to fulfil their functions
3. Delivering 1300 separate statutory functions and 800 different services, in the light of 70% of money spent on social care - surely this is unsustainable?
4. Large appetite to deliver services differently, but given 1300 statutory elements – this must be supported and sometimes initiated by central Government
5. Where Councils are leading improvements for their populations holistically (equality, equity, healthy lifestyles, fairness, poverty eradication etc) there seems to be a case for giving them a broad public sector leadership role – straddling multiple sectors in the public sector world
6. Devolution could be a great opportunity to change and improve – but also a huge distraction if it is not focused on improving the outcomes for local residents
7. Huge desire to be family/person centric and it continues to be frustrating that data sharing is slow and difficult to achieve across sectors and organisations.

Leadership themes:

A. The relationship and trust between a local authority CEO, the leader of the council and broader set of politicians is key. This is tough balancing act for LA CEOs
B. CEO leaders have very adaptable leadership styles – real balance of needing accountability; support for staff and teams; delivery and driving of improved outcomes
C. LA CEOs are accountable to all elected members - not Parliament (as NHS CEO are). Therefore, across health and social care need to be more aware of the need to negotiate and find commonality – not operate with “diktats”.

Some salient quotes from the episodes:

“make the complex simple”
“Look for the opportunities and exploit for the benefit of local residents”
“CEO has to be a heat shied over staff”

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

https://nhsproviders.org/media/1154/nhs-providers-on-the-day-briefing-dalton-review-5-12-14.pdf

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Local Government is fundamentally about place, locally led by politicians and people Democratically elected to led with a mandate.

The differences between a local authority CEO and NHS CEO is the latter is accountable to Parliament as a n Accountable Officer, the former is “Head of paid service” and accountable to the councillors in the Council through collective leadership. Therefore a local authority is not directed by a single government department or Secretary of State - probably 4 or 5 central o-government departments that interlock with local authorities.

Stephen describes the skills of agility, listening and responding to residents, ensuing he triangulates views and opinions and remains very curious. Importantly a local authority CEO can not be active politically.

Setting thje culture right in the council is importantly -close vision and purpose; underpinned by 7 political ambitions. Role is to ensure there is not conflict between the politicians and council staff and sometimes operate as a heat shield and needs to be resilient.

Stephan described his optimism for the transformation that needs to take place and not getting sidetracked by local government re-organisations . There are huge opportunities with the Oxford to Cambridge development belt and he wants to ensure he eventually leaves well and leaves a good legacy for someone else to build upon.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Leading in the public sector is a privilege, vital and supporting how services are designed and improved it’s important. It is vital to be honest about money, resources and availability of support and wrap help around localities.

With the Government embarking on a devolution agenda, there are huge opportunities for change.

“Organisations are the way resources are brigaded to deliver something” - clear and simple message from Trevor.

“Everyone is responsibility to lead” and design how services are delivered to improve outcomes. Good example in the Norfolk area is social prescribers from local councils working directly in GP practices to support people to make good choices about their health.

Trevor is huge supporter of developing joined up public sectors in neighbourhood teams - allowing a joint/single view of the citizen and family; working without hierarchy - leadership is helping people unblock the problems they come against and allow success to flourish and provide cover when things fail (which they will).

Trevor describes his 26 years in the military and the trainning that provided. Everything is subordinate to the overall mission. His observation is that often inter public sector working fails because leaders don't find commonality and share the same mission. Ego needs to be left at the door; focus on creating success and understanding the human dimensions of change.

Final thoughts - look for opportunities; exploit them to reap benefits and overall - look to make a difference in the people we serve.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

A key challenge for the Council is how to switch resources to provide preventative support. 70% of expenditure is on children and adult social care - the aspiration is ensure that residents can live well, support neighbourhood health developments, uses holistic support to residents and is co-designed by them. The Council has two missions -to ensures neighbourhood thrive and support improved fairness and reduce inequality.

Manchester “places” are coterminous with Boroughs/unitary government and led by local Government chief executives. Integrated care board staff are aligned to the ‘places’ and leaders of health and care have spent time developing relationships and trust.

In the Council, compassionate leadership is vital and expected of all staff. Important that staff are psychological safe, able to challenge and have different views.

Alison has 20 years of experience in the civil service and organisational development and passionate about asset based working - see the person; ensure everything is person centred in design; understand individual preferences and listen deeply.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The authority has seen a rise of 70% in demand for eduction, health care plans; spends 60-70% of its income on adult and children social care responsibilities and has to deliver an annual break even position to fulfill the requirements on the Council.

Partnership with the NHS works best when people are invested in each other; have mutual respect and trust between each other and understand each others’ perspective and issues. NHS organisations are key anchor institutions and contribute to the local economy.

The challenges looking ahead include 1) creating a shared common delivery approach with the NHS 2) how to fund a preventative approach, rather than waiting for people to decline our become unwell 3) making changes together without the Government respirating to structural solutions.

Final reflections on her personal impact, Rachel described - never stop and give up; be creative and work out how to do things differently.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

David Hare discussed what the sector does, the similarities in culture with NHS providers, the future developments that are likely to happen and how the sector can work hand in glove with the NHS to deliver local healthcare.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Nick Costa has worked in healthcare for 17 years and previous had roles in the logistics, retail and manufacturing sectors. His approach and interest is in providing a great customer focus and making a difference. The company works as a partner with the local NHS organisations - UK wide it is responsibility for 3% of NHS elective activity.

Ramsay bases itself on clinical excellence; focus on logistics and ensuring it support to staff well. In the recruitment phase clarity on roles and expectations is important; recruit for behaviours and values base and include into the team environment within the recruitment process to ensure a great “fit”. Operating across so many units and a large geography, maintaining a good culture in the organisation needs: 1) team events to bring people together. 2) ensure customer feedback is provided to each operating unit. 3) support local leadership teams to lead with clear expectations. 4) ensure the executive team are visible and out and about. 5) cluster units together to provide leadership and operational support 6) ensure everyone is aligned through the strategic intent, down to units and personal objectives 7) great communication 8) keep hierarchy flat

Nick describes his leadership approach, what has supported him and what helps him keep a healthy balance to sustain himself.

Looking ahead, Nick describes how we need to break down the barriers between the NHS and the independent sector. The independent sector must and wants to, train more and provide the space and activity to ensure that happens. The IS world can do more to share great practice and extend what is does on behalf of the NHS.

Finally Nick describes how accountability and responsibility in our organisations and the NHS needs to be strengthened.

Website:
https://www.ramsayhealth.co.uk/](https://www.ramsayhealth.co.uk

Linkedin:
https://www.linkedin.com/in/nick-costa-22b85a20?utm\_source=share&utm\_campaign=share\_via&utm\_content=profile&utm\_medium=ios\_app](https://www.linkedin.com/in/nick-costa-22b85a20?utm_source=share&utm_campaign=share_via&utm_content=profile&utm_medium=ios_app)

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Intrigued by partnership models in insurance models he worked in roles that were based around behavioural change and rewarding people for making changes in their lifestyles. Premiums are lowered for those who make changes - evidenced by data and analysis.

Vitality have experienced that it takes 7-10 weeks to break a habit and make change in lifestyles.

The applicability of this approach to the NHS would be:

1. Offer health checks
2. Track their physical activity
3. Use prompts to make lifestyle change

The approach to supporting staff to be healthy revolves around incentivising them to make change and achieve “gold level’. The same approach could be used in the NHS.

Why don’t Boards report on how they are supporting staff to be healthy - not just their core workforce statistics on absences etc.

Reflecting on the differences between the independent sector and the NHS, Keith defines - innovation, flexibility and standards. Consultants sign up with the clear knowledge that they will be judged against patient feedback, and data on clinical outcomes - therefore consultants are chosen to work for them on best outcomes, which minimises cost to the insurer.

As Keith looks to the future and steps down from the Managing Director role in not too distant future, he reflects on what he is likely to be spending his time doing.

@vitality_UK

https://www.vitality.co.uk/

(https://www.linkedin.com/in/keith-klintworth-b7739b?utm_source=share&utm_campaign=share_via&utm_content=profile&utm_medium=ios_app)

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

After being awarded a NHS contract outside of their “home’ patch in 2010, attracting investment, forming a new Board and leadership team, the form has gone from strength to strength. Now employing nearly 900 people, the organisation stays small, focussed and niche.

The value base and ethos is very similar to NHS organisations with a clear focus on people, quality, being dynamic and pioneering. They have partnered with academia and have diversified their service offer.

Andrew describes his hands on leadership approach. Recently he signed 75 birthday card for staff, is visible at ‘welcome to connect’ events, and has a sharp focus on employee support.

As a business owner and he has learnt from other business leaders; sought the challenge from investors and surrounded himself with talented individuals to drive innovation in the organisation

Andres reflects on advice to future leaders- be resilient, have fun, be yourself, have courage, do things the right way.

https://www.connecthealth.co.uk/

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Feedback from people who have spoken up or who would have wanted to is that there is fear; concern about individual detriment and a sense of futility - what will actually change and therefor what is the point?

A role of the National Guardian is to speak truth to power and shine a light in areas where staff and data say there are problems - such as the recent report into the culture in ambulance providers.

Looking forward Jayne is eager that culture within organisations is viewed as important as finance or performance dynamics. As more sectors embrace the Guardian approach (police/fire) there is an opportunity to embed this speaking up culture throughout the public sector and ensure we avoid the silences that incur in far too many places.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Data and insight is a key plank of the organisational approach. using the national trainee survey it has detailed information of organisations supporting trainees at departmental level. Strategically it is becoming more important to be sharing that information with other national regulators, to enable better insight and drive targeted action.

There are now higher numbers of doctors coming onto the register who were trained outside of the UK, than trained in the country and this has meant the GMC has had to adapt to this reality. They have also developed support for employers on caring and supporting for those who were trained outside the UK to ensure their assimilation and transition into UK healthcare is successful and that cultural and non UK training issues do not drive referrals into the fitness to practice process.

Charlie describes what keeps him resilient as a leader. Learning and depending on a team is crucial; balance in work and home life; regular exercise with dogs and competitive table tennis to keep him sharp!

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The NMC protects the public through the standards of registering professional to have a licence to practice; regulates the standards of professional education to terrain our clinicians and quality assures the programmes that are provided in educational institutions.

The organisation has changed alto of the past 5 years - 20% of the register are people that trained outside of the UK; users and professionals are involved as a critical eye and friend in how the organisation works and the use of data/insights is far more prevalent.

By far the largest number of referrals received about clinicians are from the general public, not employers. The NMC has worked hard to ensure they are able to advise and support employees, not be the first reaction to something that could have gone wrong for a registrant.

Andrea described the hard road in making cultural change in any organisation, including the NMC and reflects on her personal impact as a leader.

She leaves the organisation with unfinished business due to her needing urgent and pressing treatment from the NHS that will take some time to recover from. We all wish Andrea well in her recovery.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The organisation has a wealth of data and developed greater data processing and insight capability over the past five years.

The high level themes about care and health and bright into the ‘state of care’ reports that shines a light on particular aspects of the health and care sectors.

Increasingly over the past five years, Ian has led the organisation to be proactive, using the emerging concerns protocol , that brings national organisations together to tackle and support providers that have quality and leadership issues.

Ian describes his leadership roles across many sectors, his leadership style and hopes for the future.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

During the episode Henrietta discussed people who have inspired her; the roles she has undertaken that have prepared her for this role and the impact she is/will be making in safety of patients.

https://www.patientsafetycommissioner.org.uk/

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

In the podcast Michael discusses how the NHS staff survey is the longest running staff survey worldwide across all sectors. Designed in 2003, it has 20 years of data and feedback from 600K people per year. 

The evidence shows the best predictor of NHS organisational performance is staff engagement - specifically the involvement of staff in decision making (also predicts performance, quality and financial outcomes). Inclusive and supportive staff leadership is one of the most important factors, where leaders listen and are empathetic.

Michael discusses the themes of an appreciative culture; the fundamental importance of team working and the data showing staff workload and burnout being the biggest negative factors and predictor of good  patient outcomes. 
 
The importance of using staff survey data intelligently is shown that if you want to understand what will be happening in an individual organisation in the near further - look at engagement; burnout and team working scores. They will predict what outcomes are going to be achieved.

Summarising the themes from the series one episodes with NHS chief executives, Matthew and Michael, discussed how good organisations have a clear DNA - based around vision; values; totally linked into objectives and priorities for all. Leaders must be present - not just visible -don't have an agenda and make sure you Listen with fascination. This has a ripple effect as others will mirror this approach.

Michale ends the episode with a reflection that leadership is not a cloak you put on —its authenticity; humility to learn; nurturing our capacity to empathise; compassion is thought; lean into the difficult; being compassionate helps others and helps ourselves; be self compassionate and support others.

The summary of conversations with CEOs can be found here: https://www.linkedin.com/posts/matthew-winn-b750b67a_leadershipandcultureinhealthcare-activity-7201477667332726784-4BzQ?utm_source=share&utm_medium=member_ios

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The Trust has a long pedigree in leadership development, manager and clinicians working as a single team, values based recruitment, and involving/engaging staff with real time data.

Describing her development and support she has received over the years, Birju describes her passion and mission to lead the organisation into the next 10 years - firmly focused on the needs of local residents, their staff and partnerships with local authorities and other health care providers.

Twitter: @BirjuBartoli

LinkedIn: http://linkedin.com/in/birju-bartoli-02291a107

www.Northumbria.nhs.uk

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

With challenge from non-executive directors in 2012 the executive team embarked on involving staff, getting the basics right and responding to what staff were saying needed changing/developing.

Since this point many initiatives and approaches have  improved quality, staff involvement, leadership and driven increasing amount of innovation.

Julian described his career starting in the probation sector and his impact as a leader And the increasing need to look at solutions in other industries that we can adapt into healthcare.

https://www.berkshirehealthcare.nhs.uk

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

with a focus on data and staff engagement/involvement, Kent community are making chnages to their culture and the way care is delivered. Listening events, staff forums and a drive for compassion leadership and teams has seen turnover rates improve. 

Mairead Discusses her leadership style, who has inspired her, an approach to continually learn and be challenged to improve.

Kent Community Health NHS Foundation Trust

twitter: NHSKentCHFT

LinkedIn: http://linkedin.com/in/mairead-mccormick-209a4680

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

 Surrey and Borders Partnership NHS Foundation Trust was formed from three mental health organisations - the culture puts kindness, curiosity and inquisitiveness at its core.

Balance is always to test things out and push the boundaries and avoid the orgnaisation stifling invocation. We need to encourage testing a new approaches, that ensure when things go wrong will have low consequences. 

Role modelling by executive teams is crucial and leadership development, backed up by QI methodology is key. 

Being a CEO is highly personal - getting it right for our local residents and patients is the main reason to do the job.

https://www.sabp.nhs.uk

Twitter: graham_wareham

Linkedin: https://www.linkedin.com/in/graham-wareham-b15ba113?utm_source=share&utm_campaign=share_via&utm_content=profile&utm_medium=ios_app

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The team used the leadership into action methodology; created an internal improvement academy; engaged; listed; acted; be honest when things go wrong and developed a vibrant leadership culture.

Poor behaviour was tackled and a set of shared and owned values implemented.

Hal shares how he developed as a leader and sustains his approach. 

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Cambridgeshire Community Services NHS Trust Is also the Trust that is led by the podcast host, Matthew Winn - hence Anita, as deputy chief executive is talking about the culture and leadership in the organisation. 

https://www.cambscommunityservices.nhs.uk

Twitter: @pisanianita

LinkedIn: Anita Pisani

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Key components of the Trust wide culture are accountability; engagement with all staff; clear reporting on things that go wrong and ensuing all leaders are accessible and listen.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The leadership team were fed up with standards below what was acceptable and poor staff survey results, Combined started on a ‘listening project’; listened to their people and made changes.  This has led to an ongoing engagement culture and approach hard wired with specific levers and understanding how great teams work.

Buki explains how they did this, what has changed and gives insight into her leadership approach. 

Twitter: @combinedNHS

www.Combined.nhs.uk

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The Trust has invested in quality improvement methodologies and competence focusing in small changes - learnt from the Virginia Mason model. 

Neil has invested much of his time developing a committed, cohesive and established leadership team that devolves responsibility and support to service areas.  The organisation has appointed managing directors for specifics services areas, that lead interesting portfolio of specialist and local services. 

The ethos has been built on using data well, getting the basics right and learning from best practice. 

https://www.mpft.nhs.uk

Twitter: @NeilCarrNPFT

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

Tracy describes how to create psychological safe teams, but teams that challenge themselves, especially with service user and patient views on hope well they are doing.

The podcast hears from Tracy’s leadership style and personal impact and advice to people embarking on their leadership career.

https://dchs.nhs.uk

Twitter: @TracyAllenDCHS

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

• building relationships
• knowing the Trust inside out
• single purpose
• civility

Some key elements the team has learnt:

• develop values with staff 
• communicate, communicate, communicate
• ensure the values are visibly present and relevant
• focus on the importance of appraisals
• no one is more important than anyone else
• never revert to using your job title to make change and command people
• culture is not developed quickly
• do not over promise

At the Countess of Chester there is a huge re-building job to develop trust internally and with the public; ensure teams and services are resilience.  This will take time and must be built on developing trusting teams.

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.

The NHS staff survey has operated since 2003 and provides a rich source of comparative data and is recognised as one of the largest workforce surveys in the world. Last year over 630,000 colleagues took time to complete, fulfilling an aspiration of the survey that “we each have a voice that counts”.  The survey is abased around 111 questions, aggregating into 21 sub scores and 9 overall themes and responses are provided by all 215 NHS statutory provider organisations and around 50 other health care organisations.

The questions include alignment to the Copenhagen Burnout Inventory and the Health and Safety Executive stress assessment and tools and have also aligned workforce disability and race equality standards into the survey and standardised analysis on the confidence of staff to raise concerns and be confident these are acted upon are derived from the answers.

NHS England state there are four main purposes of the survey; 1) consistent survey, 2) ability to compare changes over time, 3) understand variation in staff experience and 4) drive improvement.  The first two are always fulfilled and latter two left entirely to the individual organisations to pursue.   Whilst employers must take primary responsibility to drive improvement in staff experience and support, local, regional and national regulatory/oversight architecture is not using this data forensically to aid them in their responsibilities.  Two areas standout as ripe for using the data effectively.

Firstly our regulatory environment must be able to benefit from an evidence based analysis of the culture and views of staff in an organisation they are focusing on. Which inspector would not do their job well if they had analysis, broken down by staff groups cut into themes of safety, team working, compassionate leadership, diversity and inclusion etc.  A healthy working culture takes time to build up and is a good indication that our teams are able to provide great care to local residents.

Secondly there is (rightly) a huge focus on health service productivity currently, but issues with productivity will not be solved unless you look under the bonnet. Alongside surveys such as the GMC training survey, we have an abundance of data to identify at team level, the dynamics that stop us being productive and report after report have concluded this will often be issues of leadership, culture, inclusion and safety.  So alongside data from the getting it right first time and the model hospital, why are we not getting into root causes of issues and publishing staff survey data to shine a light on what needs to change at organisational and team level?

Matthew Winn, podcast host and an experienced leader in healthcare in the UK.