'If you don't get out and touch your business, you can't develop a vision that staff can buy into and deliver'

Patricia Lee, chief executive of hospitals for Nuffield Health, runs 31 hospitals with 6,000 staff and controls annual revenue of around £420m. She never thought this would happen when she trained as a nurse in the early 1980s.

“I would have laughed if you had suggested it to me,” she says. “I would have switched off if you’d started talking to me about profit, loss and cashflows. But I love it and I know other nurses could do this type of job.”

Her ambition is to encourage other nurses to consider senior management roles because “I know they can do it, they are just put off by the mystique”. Ms Lee maintains that running a multimillion-pound budget is as easy as running a household account - it just has a few more noughts on the end of every figure. And she says, if that scares you, there are plenty of people around to help - Nuffield Health has a top finance director and a team of accomplished accountants.

“I always wanted to nurse,” she says. “But I soon realised I could affect more people and influence care more if I were in charge.”

Ms Lee’s exposure to management began when she went on the NHS General Management Training Scheme from 1989 to 1993. “It exposed me to different management situations and was an intense period of self-development. I discovered my fears about management were unfounded, how I reacted under stress, and how to manage people through difficult and emotional situations and help them deliver their best.”

Ms Lee followed that with a residential leadership course at the Leadership Trust in Ross-on-Wye in 1998; she was the only NHS person among “high-level managers in commercial industries like oil and tobacco”. It “helped me explore my leadership capabilities, increase my self-awareness and realise my potential. Experiential exercises let me explore my emotional intelligence and its application to leadership. Once we were left in a field late at night and made to find our way back”. She says it was far better for her than any MBA and strategic or management theory course, as “only by truly understanding yourself can you ever begin to be an effective leader”.

Ms Lee’s penchant for fight rather than flight has always endured. She is ever ready to battle with accountants, staff and managers to advocate for patients but, after 18 years, left the NHS and in 1999 moved to Nuffield Health’s Exeter Hospital.

“I got frustrated by the politics and bureaucracy of the NHS,” she says. “I had been promoted to a point where I had lost touch with the front-line. People said joining Nuffield was the end of my career and I’d never work in the NHS again - that if I stayed I could be a chief executive in 18 months. But I knew Nuffield felt right.

“I loved that Exeter was a small hospital and I knew every member of staff and consultant. I love being able to speak with patients, walk to reception, find people I know and chat.”

She was concerned about the culture shift but says she recognised there were things the NHS could learn from independents and vice versa. As for the rest of the work - she learnt it on the job.

“What’s important in healthcare is the relationships - managers, nurses, doctors, patients. If you don’t get out and touch your business, you can’t develop a powerful strategy and vision that staff can buy into and deliver. Lots of change happens from the bottom up so you need to read about trends, look at innovations and talk to people in your business. Those skills are all things nurses have in abundance, so I’d encourage more of them to approach management.

“Don’t be put off by the numbers. I failed my O-level Maths, but now run a £420m business. I am not a natural financial whizz - but now I know what questions to ask.”

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