‘I've never had a conversation like this in 30 years as an NHS CEO’

“I’ve been a NHS trust chief executive for 30 years and I’ve never had a conversation like the one we’ve just been through in the last hour and a half.”

This was how David Loughton, CEO of Royal Wolverhampton Trust, summarised the discussion between a dozen NHS trust chief executives brought together by HSJ to discuss the personal and organisational impact of the pandemic. The CEOs were all drawn from HSJ’s list of the service’s top 50 trust chief executives published in March and the full, unedited conversation can be read here. 

The long-serving Mr Loughton remarked how different the conversation was from the one that the group would have had before the pandemic in which the chiefs would have been “competing with one another [to show that] my organisation’s doing better than yours.”

Instead he had witnessed his peers “share their weaknesses, their fears, their own feelings.

“We’ve changed as a group of chief executives”, he claimed. “And I don’t think we will ever go back because of the experience we’ve been through.”

Fittingly it was the man placed number one in HSJ’s list of top 50 chief executives that got the ball rolling.

South West Yorkshire Partnership FT chief executive Rob Webster said he had only realised how much the pandemic had affected him when he tried to take a break from the pressures of the job.

“I try and keep well by going out for a run. Running is a great way to do nothing in a world in which you’re not allowed to do nothing. But there were times when I’d be crying while I was running, though I didn’t realise it at first”.

One of the themes of the wider conversation was that the pandemic had seen NHS staff become “kinder” to each other, and Mr Webster resolved to be “a bit kinder to myself” and to “recognise that actually I’m not super human”.

Sherwood Forest’s Richard Mitchell agreed: “We’ve been through a huge amount of trauma over the last 12 months, and to look after others we also need to be looking after ourselves.”

This theme was developed by Frimley’s Neil Dardis, who reflected on the “personal challenges” of having to admit that he did not “know the answers” to many of the questions that the pandemic asked of the NHS in its early days.

“I’d never quite taken such an open-ended approach to my leadership”, he recalled.

This approach extended to being more forthcoming to colleagues about the difficulties he was facing in his personal life.

During the pandemic the Frimley chief lost a friend he had know since 11 to cancer. Mr Dardis said he “would never have probably shared that with the organisation”, but that the challenges of the pandemic had made him “realise we’ve all got things going on, that we can’t just leave at the main entrance.”

Mr Mitchell had a similar tale to tell.

“A willingness to share personal vulnerability is really powerful. Both my parents have been incredibly unwell over the last 12 months. Sadly, my dad passed away in March. I wouldn’t have probably told the organisation about that [before the pandemic] but by telling people it’s opened up a whole series of conversations [with colleagues]”.

Patricia Miller, chief executive of Dorset County Hospital FT, revealed that she had spent the first four months of the pandemic off work while she battled breast cancer.

Being ill during this time meant Ms Miller was better able to understand the experience of patients during the pandemic. This “lived experience” fed through to her weekly staff blog in which she tells “everybody everything that happens in my life, unless it’s something that my husband particularly doesn’t want anyone to know.”

The reception to the blog and her willingness to open up about her struggles was revelatory.

“I hadn’t appreciated just how powerful that can be in a time when everybody is frightened and knows that we don’t all know the answers to all the problems. Talking about the range of emotions that I went through during covid resulted in a lot of email communication from staff saying that they were seeking help because if I was saying that it was okay to not be okay, then, then it was okay for them to admit that [too].”

Moorfield’s David Probert admitted that he had never thought about how the pandemic had affected him. But hearing his colleagues being so honest with their feelings led him to wonder why that was and to acknowledge that at times during the pandemic he felt “incredibly vulnerable”.

He said he would never use that “awful macho word ‘resilience’” and rejected “all that hero nonsense”, but said his experience of having to do his job, while caring for his sick wife and home schooling his children “made me realise I can dig deep and find another level of energy.”

At the same time, Mr Probert said that at times he felt guilty “sending my children to school every day, [and] not knowing what I was infecting them with when I came home”. He also blamed himself for the illness and death of staff who were redeployed into units dealing with covid positive patients.

For one of our chiefs the memory of lost colleagues, and the fear that they were in some way responsible for their deaths, is still too raw to talk about at length.

Salford’s Raj Jain said simply: “I lost nine staff to covid, and I remember all the names and families. I think that will stay with me forever.”

Mr Probert, as with many of the other chiefs taking part in the discussion, talked about his struggle when “people were looking to me for answers, looking to me to be made to feel positive and good.” This was an “awful responsibility”, but it also made “my job feel more real” than at any other time in his 22 year career.

The full discussion can be viewed here.