Breaking through the fog: A Black leader’s journey through the NHS

Having recently moved on from the NHS, I’m taking time to reflect on a career that has spanned over three decades. What sparked these reflections was a heartfelt public tribute I received from both the CEO and the Chair of the Quality Assurance Committee at an NHS Trust, recognising my work and approach to culture, compassionate care, quality and safety. It made me realise just how often we, as leaders from ethnic minorities, undervalue ourselves, despite the resilience, strength, and care we bring to our work.

Much of my NHS journey has not been easy; in truth, some of it has been deeply traumatic. However, I hope this reflection will resonate with others, especially those who feel invisible or discouraged, and show them that even in adversity, there is a way forward.

The early years: belief, barriers and becoming

Before I became a Chief Nurse, I arrived in the UK in the early 1990s from Zimbabwe where I had worked as Executive Officer for the government and a Programme Director for a Norwegian Save the Children organisation (Redd-Barna). I studied Mental Health Nursing at the University of Nottingham (1991–1994). After qualifying, I joined Derbyshire Healthcare on a bank contract while I waited for the shift from a student visa to a working visa. This wasn’t a quick or straightforward process; it was long-winded, complex, and frustrating. Due to the delays, I decided to continue studying, determined to use the time to further develop myself rather than lose momentum.

In 1994, I began a BA (Hons) in Applied Youth and Community Work at the University of Derby. I went on to complete a Diploma in Management, a Postgraduate Certificate in Health Promotion, and finally, an MBA by 2012. These qualifications didn’t come easily; they were earned over many years while working and raising two children. But I was driven. I had ambition, and I hoped that my dedication, knowledge and experience would be recognised by the NHS.

I was kidding myself.

I soon realised it wasn’t about capability or hard work; it was about connections. The culture of ‘who you know’ seemed more influential than skills or commitment. Still, I loved nursing, and while I loved working on the wards, I knew I wanted more. I wanted to lead.

A turning point: speaking up

After ten years of dedication and study, I mustered the courage to ask a senior trust leader why people from ethnic minority backgrounds didn’t seem to progress. At the time, I was in a band 7 role, which I had held for over three years, and I wanted to do more, to lead more.

To my surprise, I wasn’t reprimanded; I was invited to Trust HQ. I thought I was in trouble. Instead, I was acknowledged for my bravery and honesty. They asked me if I had a mentor or coach (I didn’t). They asked if I understood the structures at executive level (I didn’t). That meeting opened my eyes to a new world of operational, clinical, strategic, financial, and HR leadership.

I was encouraged to think about where I wanted to go. A coaching opportunity followed, and I set goals for myself. Soon after, I was offered a band 8 Clinical Lead post for the Lorenzo Project, deploying a new electronic health record system within the NHS. A huge leap, but an opportunity that led to further operational senior leadership roles.

The hidden costs of visibility

As exciting as that was, it also marked the beginning of something else. I had entered a space dominated by male professionals.

As a Black woman, I was treated as an anomaly and not in a good way. Meetings became battlegrounds. My line manager regularly humiliated me with remarks like: ‘What exactly are you good at?’ This wasn’t occasional, it was constant. I began dreading meetings. I dreaded showing up. I dreaded being seen. Eventually, the emotional toll became too much. I broke. I took my first sick leave in ten years due to a mental health breakdown.

Growing up, I knew racism existed, but I'd grown up in an environment where Black and white people lived together, and I had not yet experienced racism so overtly and in the workplace like this before. But this experience shattered that belief. I began to doubt myself. I started to believe I was worthless. My confidence disappeared and I disengaged from people and everyone.

Surviving, then thriving

The higher I climbed, the more hostile it felt. That hostility reinforced the internalised doubts which stayed with me for years. I now know it was Impostor Syndrome, a common experience particularly among women. Yomi Adegoke wrote that 66% of women feel like they’re not good enough despite their achievements. Sheryl Sandberg’s Lean In also helped me recognise my feelings and showed me I wasn’t alone.

I stayed true to myself and worked hard, but I grew tired. In 2013, I took a mutual agreed resignation and stepped away from the NHS for a year. I joined a recruitment agency, reset, and re-centred myself. In time, I returned to the NHS, this time as an Associate Director for Nursing and Safeguarding.

From 2014 onward, I moved trusts more frequently. Some might see that as a red flag or a lack of dedication to one role, but for me, it was a matter of survival. I had to protect myself. My CV showed movement, yes, but it also showed perseverance, resilience and growth.

A new way of leading

In 2021, I joined the Nye Bevan Executive Leadership Programme, and I received mentorship from the NHS Confederation’s Black Leadership Network. These experiences changed everything. They helped me understand how my silence in meetings, borne from the belief that no one was listening, was being misread as disinterest or arrogance.

Through coaching, learning sets, 360 feedback, Hogan assessments, and reflection, I learned to:

• share my vision

• speak with purpose

• listen actively

• engage with confidence.

I also came to understand institutional racism and how systems themselves can reinforce inequality, often subtly, but powerfully. My leadership style shifted to collaboration, compassion and clarity. And I stopped waiting for permission to speak. I felt proud of my accent, and sometimes I find it hard to express myself. It didn’t bother me, after all English is not my first language.

Giving back

I began mentoring and coaching other colleagues from ethnic minorities, helping them navigate the same barriers I faced. I trained in coaching through a programme called Getting to Equity, and I continue to grow my awareness of cultural competence and inclusive leadership.

I’ve also learned to recognise my own blind spots. For example, I hadn’t considered how being able-bodied gave me a different kind of privilege. By listening deeply and with curiosity, I began to understand the lived experiences of others better, and in doing so, became a more effective and empathetic leader.

There are still days when I retreat into my shell. My former CEO once told me this could be a sign of racial trauma. I’m learning how to manage it. I now understand that healing isn’t linear, but awareness is indeed powerful.

At the top: still fighting

In 2022, I was offered the interim Executive Director of Nursing role. When our CEO stepped aside, my Chief Nursing Officer moved into that role, and I stepped into hers. It was a proud moment, but also a vulnerable one. The higher up you go, the more exposed you become, especially as a Black woman in leadership.

But I was ready.

When I applied for a substantive Chief Nursing Officer role, I was successful. And that’s the role I’ve recently moved on from. That achievement didn’t erase the challenges, though. I still faced comments, sometimes laced with subtle bias. But this time, I had the confidence to respond with calmness, facts and strength.

Final thoughts

Racism won’t go away. However, I now know how to protect my health, well-being, and worth. I surround myself with allies – people who see me, support me, and stand with me. And I encourage others to do the same.

You don’t have to share every part of your life to be ‘authentic.’ Culture shapes us differently, and that’s okay. At the end of the day: ‘We are all human – we just don’t always realise it. And that’s the saddest part.’

So, here’s my message:

• Don’t fear feedback, seek it.

• Don’t hide your truth, own it.

• Don’t shrink yourself to fit in, rise and keep rising.

In September 2025 I started a new chapter as Executive Director of Nursing for Healthcare Jersey. The adventure continues – it’s not over yet. Watch this space.