Leadership training - case studies

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‘There aren’t many jobs like mine’

Deborah Murphy is directorate manager of specialist palliative care at the Royal Liverpool and Broadgreen University Hospitals Trust and associate director of the Marie Curie Palliative Care Institute in Liverpool.

With a nursing background specialising in oncology, Deborah has a unique role both as a clinical director heading up a busy specialist palliative care service of over 50 staff including doctors, nurses, allied health professionals and researchers, and as an influential voice nationally and internationally, in the field of palliative and end of care life policy.

As a senior NHS leader at managerial, clinical and policy level and with many years of NHS experience under her belt, Deborah understands only too well the current challenges facing the service as it adapts to the new, sweeping structural reforms.  

When she learned about the Accredited Manager Programme she was very keen to take part. She explains: “There aren’t many jobs like mine in the NHS that straddle management, leadership, clinical and policy matters.

Time to reflect

“I wanted to ensure that I can continue to use my skills and expertise to enable and work with others, regardless of how the structure of the service changes over the coming years, to ensure the very highest standards of palliative and end of life care for all patients and carers.

“My day-to-day work is extremely busy, due to my dual roles and I often find myself juggling many balls in the air. The AMP has almost forced me to stop, take a breath and reflect on my leadership skills, my performance as a manager and a leader and my ability to influence and effect change.

“I’ve welcomed the opportunity to cast an analytical, critical eye on how I interact, lead, enable and influence those who I come into contact with and how we work and interact together as a department, particularly at a time when the NHS is going through such extensive change and there is a lot of uncertainty about how the future will shape up.”

While the significant NHS reforms have many critics both inside and outside the service, Deborah is positive about the changes.

Hugely worthwhile process

She says:  “I see the restructure as a tremendous opportunity for managers to take a proactive role in influencing the development of the NHS. These are exciting times but in order for these opportunities to be maximised and for managers to really make a difference, they need to have at their disposal the leadership skills and abilities to influence, innovate, inspire and adapt.

“I have found the AMP to be a hugely worthwhile process. It has not only reinforced what I do as a clinical manager and as a leader on a day-to-day level, but has also taught me to get into the discipline of taking some time for regular ‘blue sky thinking’.

“My PA now blocks time off in my diary when I can’t take telephone calls or go to meetings, to reflect on my work, my roles, my team and the issues we are facing.

“Regardless of grade or management level, this process is invaluable, equipping managers with the ability to review, reflect, reformulate and plan for the future.”

‘Medical school does not really prepare you for the demands of being a manager’

Dr Ahmed Samy Yassin is clinical director of gynaecology services at Stockport Foundation Trust based at Stepping Hill Hospital in Stockport.

He leads a large, multidisciplinary team of over 60 staff including consultants, surgeons, trainee doctors, radiologists, nurses, midwives and nursing support and administrative staff in the busy women’s unit.

Having worked in his clinical director role for two years balancing the complex challenges associated with providing patient care while managing staff and resources with increasingly tighter financial constraints, Ahmed decided he needed to further develop his managerial and leadership skills.

He explains: “There are no two ways about it – medical school does not really prepare you for the demands of being a manager and heading up a hospital department.

“Managerial tasks such as leading teams, motivating staff, conducting appraisals, business planning, policy and procedural development, financial and resources decision-making are all elements that need to be addressed on a daily basis, while ensuring the highest possible levels of patient care.

Difficult decisions

“I was very mindful of the fact that I had not had any management training, so when I found out about the Institute of Healthcare Management’s Accredited Manager Programme I jumped at the chance to take a formal management qualification and build on my ‘on-the-job’ management experience to date.

“As clinical director, I have to make important, often difficult decisions and I wanted to ensure that as a manager and a leader that I am performing my duties properly, essentially ‘doing the right thing’ from a non-clinical, managerial perspective.

“Doing the AMP has, first and foremost, taught me the importance of reflecting on my day-to-day work, reviewing what’s gone well, what hasn’t and how we could do things better.

“In my opinion, reflection is not something that we doctors do very often. It does not come naturally to us and it’s not a particularly common or well-known practice among clinicians, but it can reap so many benefits.

“I have also learned how to facilitate more effectively to make things happen. With the structural reforms to the NHS and the imminent creation of commissioning groups, I see this as a key leadership skill that many clinical directors will need to develop in order to negotiate and commission resources and services successfully across different departments, organisations and sectors.

“Another huge benefit of the programme has been the opportunity to take stock of my career development and identify my own strengths and weaknesses.

“I have learnt that I need to work on my delegation skills more and always follow up with team members if tasks are not achieved, rather than completing them myself.”

The AMP is an 18-week university accredited training programme specifically to develop management and leadership skills through facilitated learning. Participants are encouraged to reflect on their work and map their managerial experiences against 11 behaviours. It is an intensive programme requiring a significant commitment of time, as Ahmed explains:

“I found the amount of time it takes to complete the AMP extremely challenging and I must admit it was a real hard slog towards the end to get all my assignments completed on time.

In fact, I had to cancel all my weekends for several weeks (and put my social life on hold!) to get everything finished. Having said that, it has been an extremely worthwhile process and I would encourage any doctors considering doing the AMP to go for it.”

‘It is important that my knowledge and skills keep pace with the reforms’

Jacqui Pennington is head of hotel services at the Royal Liverpool & Broadgreen University Hospitals NHS Trust and is responsible for managing in-house teams and out-sourced cleaning, catering, portering and linen services contracts, worth some £12m.

Having worked for over 27 years in the NHS, she had not embarked on any formal management qualifications since completing an HND aged 21.

Now 50 and with the NHS restructure looming on the horizon, she decided it was time to both test and develop her managerial and leadership skills by doing the Institute of Healthcare Management’s Accredited Manager Programme.

“There is no doubt that the restructure currently taking place will have an impact on my role and it is important to me that my knowledge and skills keep pace with the reforms as the ripple effect of the changes are felt throughout all aspects of the NHS,” she explains.

“It was somewhat daunting to embark on a formal management qualification after such a long time working in a number of different roles in the private sector as well as the NHS, but I’ve always wanted to move with the times and embrace innovation.

“Now seemed as good a time as any, particularly now my children have grown up and I can devote more time to developing my career.

“At first, I found the programme quite challenging. Rather than sitting in a classroom and being taught management and leadership principles, the onus is on individual learning and reflection based on your own work experiences.

“I struggled with this at first but then after a few weeks of grappling with it, I had one of those ‘light bulb moments’ when everything just fell into place and made perfect sense!

“I now understand the importance of reflection on my leadership development and I have particularly appreciated the opportunity to take time out to reflect on what I am doing as a manager and also what we are doing as a department, collectively, to identify what we can all do better.

“During the course of the programme, I’ve learned so many things about myself. I’ve learned that rather than buckle under pressure, I actually thrive when the heat is on and I’m adept at taking measured risks when required – something that I would never have believed about myself!”