I would like to take this opportunity to acknowledge a number of organisations and individuals who have supported me throughout my career and through this scholarship ensuring that this was the fabulous opportunity and experience it promised to be.
Firstly I would like to offer my unreserved thanks to the Florence Nightingale Foundation and its trustees for initially accepting my application and also the professional leadership and support they have provided throughout the scholarship and beyond.
I would like to thank NHS Direct and in particular my Chief Executive Officer (CEO), Mr. Nick Chapman and my Chief Nurse/Clinical Director, Mrs. Tricia Hamilton for their unwavering support and belief in me. Along with Nick and Tricia I would like to acknowledge the support of friends and colleagues in the Senior Clinical Directorate of NHS Direct and also of the Divisional Management Team I was aligned to who supported me practically and emotionally through this process. My scholarship coincided with a huge organisational change within NHS Direct and therefore this support was even more appreciated given the upheaval colleagues were already experiencing.
I would like to thank Sue Machel for her time and input in looking into my psychology in terms of work, what my drivers were and ultimately what direction I wanted my career to take. Similarly I would like to thank both my mentors, Mr. Peter Siddall and latterly Mrs. Jacquie McKenna MBE for their support and guidance. Peter and Jacquie brought very different perspectives to the table due to their different backgrounds but both were equally influential in terms of their impact on me and the way I now view and ‘review’ things and they really helped facilitate my progression professionally during my scholarship.
I would like to thank my fellow scholars who have made this experience all the better. We all have different backgrounds, skill and abilities and together we form a formidable network.
Lastly I would like to offer a huge thank you to my family who have always been extremely supportive and accommodating. My work life as always been quite pressured and in some ways the scholarship added to that in so far as ‘doing more in the same time’ but they accepted that the scholarship brought its own unique benefits and trusted me in my expectation that one of these would be to help me to re-focus my work-life balance. Specifically I do want to acknowledge my mum and my dad who made me the person I am today. A person who would never be satisfied sitting on the side lines or settling for a comfortable role. I always need to push the boundaries and see what else I am capable and I know that in particular comes from my dad. Sadly my dad died before I received this scholarship but I know that he would be immensely proud.
This report describes the progress I as a Florence Nightingale Leadership Scholar made though my scholarship time. It wasn’t the journey I had anticipated and it was pretty challenging but the scholarship and the network of support that brought I believe was instrumental in ensuring that I navigated the enforced change in direction I experienced and ultimately helped me realise my goal of securing a new position within health care where I could make a real difference.
At the beginning of my journey with the Florence Nightingale Foundation I was working as a Director of Nursing with NHS Direct but was seconded to the role of Clinical Implementation Lead for West Midlands NHS 111 and also held the position of clinical subject matter expert for NHS 111 for NHS Direct. Once implemented I was then to take up the new role of Head of Clinical Services for NHS 111 with NHS Direct covering the two largest NHS 111 contracts NHS Direct held (West Midlands and North West).
NHS 111 implementation saw the closure of NHS Directs national 0845 4647 telephony service and like a number of people I had some concerns over the dismantling of a nationally networked service that was proven to be safe and importantly had proven to be very effective in the management of national issues (i.e. during the Polonium issue, response to SARS, response to pandemic flu etc) One of the key things that concerned me was the potential fragmentation of services and potential removal of general clinical cohesion of the access to health care and also the degradation of the role of clinicians in the NHS 111 service that could impact on decisions and therefore costs elsewhere in the patient pathway.
My intention therefore with my scholarship was to develop a clinical leadership network across NHS 111 providers to try to not lose the above. Commissioners had a clinical network in place but the providers didn’t and the competitive nature of procurement meant that there was very little ‘natural’ appetite for doing this amongst providers at that time. To me though it was very clear that in order to ensure shared learning, best practice and an ethos of working together in the interest of patients clinical leaders in NHS 111 needed this type of networking and I felt strongly that senior clinicians should be able to circumvent any commercials and ‘small p’ politics that might get in the way of that.
Unfortunately the decision taken for NHS Direct to pull out of the NHS 111 contracts put this vision on my part in some doubt. Initially it was unclear if I would take up a post with one of the interim providers identified to take over NHS Directs contracts. If that had been the case then I could have carried on with this particular path but it became clear that this was not going to be the case and that my involvement with NHS 111 would cease in March 2014. This was a great opportunity to take my career in a new direction and develop different skills and abilities and was extremely exciting but it did completely stop my work in pursuit of the NHS 111 Clinical Network. I did handover my thinking regards this to the new providers with a strong recommendation that this should still be done but it is fair to say the appetite to do so was low.
This change in direction therefore required me to change my view on what I was to do with my scholarship. The leadership scholarships is available to assist clinical leaders in their personal development but the ultimate aim is that by enhancing the clinical leaders skills and capabilities this will in turn result in better patient outcomes and experience by improving patient care etc. Even with that in mind thinking of what I could constructively do in terms of a project without an actual role (having been made redundant) was almost impossible. To try to work this out I had a number of meetings/calls with Professor Robb, with my mentor Jacquie McKenna (MBE) and with Sue Machel. I also had sessions with a life coach and a career coach to really formulate in my mind what I needed to do and how this would translate into better patient care.
My full report will serve to describe how I reconciled the above, what I did, what impact this had and what this has helped me to influence for the good of patients but it quite a journey! To close this abstract section off however I will explain that the culmination of all of this talking, soul searching, stock taking resulted in a recognition that the scholarship should be used to do two things:
· To develop my leadership qualities as was always intended (with the knowledge they would be out to good use in my next role)
· To explore my potential and opportunities for me in my career to ensure that the skills I had gained were not lost to patients.
I also made a conscious decision (with the support of the above named individuals) to stop worrying about having been made redundant and not being able to pursue my initial plan but to use the time to reflect and to consider my options fully and to not rush into any career decisions.