Direct contact with patients was always at the heart of my decision to pursue a career in clinical medicine, and is the source of much job satisfaction. The transition to clinical management has involved coming to terms with the move away from direct patient care towards more strategic work which will impact patients on a much greater scale.
Attitudes towards NHS managers are now changing, although there are still some who refer to the ‘dark side’ and seem to relish any opportunity to cause division – no coincidence that it’s usually those same individuals who complain management processes are forced upon them. But with the introduction of NHS management into medical school curricula and service innovation programmes for junior doctors, more clinicians are now realising that doctors are in a strong position to effect real change in the NHS.
Undertaking the Top manager programme at The King’s Fund helped me to make that transition to management, learning much about myself during the process. Three aspects that stood out to me were:
1. The discipline of being present in the ‘here and now’
Too often we are ineffective at work as our minds are one step ahead, fretting about the next meeting, the next clinic or the next on-call. Meetings used to stir up feelings of resentment in me for taking up valuable clinical time, and my aim would be to get through the agenda as quickly as possible – and then feel justified in my assumption that the meeting was pointless! But after the programme I now approach (most of) my numerous meetings with the expectation of learning something, or adding value by bringing my clinical knowledge and experience to the table. Thinking ahead will always have its place, but managing my anxiety sufficiently to stay present in the here and now leads to greater effectiveness, productivity and satisfaction.
2. Reconnecting with core values
People who work in health care are often admired for their desire to help others, but when the constant sacrifice is never enough it’s not surprising that our compassion is often eroded. On the programme, listening to the life experiences of guest speakers, visiting various community systems and even hearing from fellow course delegates of devastating encounters in the NHS allowed me to realise and get back in touch with my core values. One guest speaker who suffered mental health and addiction problems told of their harrowing journey through the system, and the lack of compassion they encountered was stark. Similarly, accounts of prejudice in the public sector against disadvantaged individuals from ethnic minority backgrounds hit home hard. I emerged on the other side feeling more certain of my principles and even more determined to embed them into my leadership style.
3. Noticing unconscious behaviour
Noticing how different people and different circumstances make us feel and – in some instances – recognising the possible origins of those feelings, gives us a better understanding of others’ behaviour. It also makes us more aware of the impact of our own behaviour, which is important in leadership and relationships in general. The programme helped me to notice. Now in my interactions at work I’m aware of people’s body language and the words they choose to express themselves. I am confident in my own intuition and, instead of making snap judgements, try to be inquisitive about the reasons for certain behaviour and what makes up the person beyond the exterior. The programme also gave me confidence to harness useful elements of my personality and behaviour, and put into perspective my less developed attributes – particularly during times of high stress.
The Top manager programme is a unique course – in its length, structure and depth of exploration. Initially the time commitment required sounded as attractive as being bleeped at 4am after having only three hours’ sleep over a 72-hour on-call weekend – only to be told by the instigator that they were just checking your pager works! Feelings of anxiety, frustration and even anger were common amongst attendees on the programme as we contemplated the hundreds of emails clogging up our inboxes. But on reflection I will always appreciate the time, space and carefully chosen surroundings that gave me permission to engage and learn away from the pressure-cooker environment of the NHS – which continues to overheat whether I am there or not.
Ultimately the programme has helped me in the challenge of becoming a senior manager within the NHS by enabling me to understand myself – and in doing so has clarified my core values and fortified my decision making. It has helped me to understand others more and realise that relationships lie at the centre of my work. By focusing more on the here and now, I am more effective and productive and feel that I am actually making a difference. All these aspects combined have made me a much more resilient leader.
- Find out more about our Top manager programme
Summer dates have now sold out, but we have just released the new dates for October 2016.