I started life in the NHS as a radiographer in the 1970s, training in a system based on learning on the job and day release for study that ended with a diploma. This apprenticeship approach suited me and I was quickly sucked into the team ethos with a real sense of belonging to the hospital family.
I was a clinical radiographer for 10 years and then became a clinical manager in the x-ray department without any management training at all. Learning on the job, and from the mistakes I made in terms of managing people and conflict, set me in good stead for the next stage in my career. I only hope I didn’t inflict any long-term damage on any of my teams!
I moved into general management in the mid-1990s and was lucky enough to work alongside a geriatrician in Leeds who taught me how important it was for clinicians and managers to work together to achieve the best results. I spent the next seven years working as a manager across a range of specialties, learning my trade as a general manager and, most importantly, developing my listening and communication skills.
Never once in that early period did I think about ever being a chief executive but I began to realise that I really wanted to support and develop people so they could make a difference for patients and their own colleagues.
I loved being a chief executive and consider myself very privileged to have led two super trusts with great people. I can’t think of another job that provides the variety, the intellectual challenge and the opportunity to work with so many interesting people and teams. Walking around the hospital and talking to staff was a pleasure and this helped the development of stronger communication channels, trust and common purpose as well as keeping me sane.
The dark times were difficult. You don’t want to start a spiral down throughout the organisation but you do need to be clear about the challenges that face the hospital and to support teams in doing what needs to be done. At first when dealing with difficult situations, I underestimated the impact my facial expressions and body language had on staff – you have to watch this all the time so you don’t send the wrong messages out.
Overall, I don’t think you should aspire to be a chief executive unless you are happy working with people. There will be others in your team that can do the other stuff but an organisation needs a leader who can communicate and develop relationships.
One of the most important relationships to be developed and fostered is that with the chair of the board of directors. I’ve worked with three really good chairs, all different but all with experience and strengths that complemented mine. This relationship is vital: you need someone to share things and chew the cud with, and you can’t always do this with members of the executive team. Being a chief executive can be a lonely job, but a strong relationship with the chair really helps you keep things in perspective.
I think it’s a real shame that people aren’t coming forward for chief executive roles. It does feel as though we have failed the next generation somehow. The old practice of sponsorship and talent spotting was useful and perhaps we need to adopt more informal mechanisms for nurturing individuals. However, the most positive thing that could happen would be to reduce the feeding frenzy that sometimes occurs when things don’t go as they should.
I have heard the phrase ‘won’t put my head above the parapet’ in relation to taking a chief executive role more times than I would like – that is a real shame as people are missing the potential of having an amazing career. I really hope that more clinicians ‘put their head above the parapet’. If they have the right support and development they could really make a difference and show clinical colleagues that the chief executive leadership role is one to aspire to in the future.
- Read Catherine's interview, as well as interviews with 11 other NHS leaders, in The chief executive's tale