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Private sector experience is vital to develop nurse leaders

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Today’s NHS leaders need to use a huge range of skills. The only way to make sure they are equipped is through widespread collaboration, including with the private sector, says Mandie Sunderland. Leave a comment on on this story to contribute to a national debate on the future of NHS leadership

Never before in the history of the NHS have those in leadership positions required such a plethora of skills just to get through the working day.

Healthcare in the UK is now delivered under the scrutiny of politicians, the media, a new breed of regulators and the public. Leaders need to develop a set of skills they can use to adapt and react to this scrutiny as well as continuing to deliver patient care in complex organisations employing a huge number of professional groups. It is no longer sufficient just to be a good manager.

Leaders in the NHS need to have their own expert professional knowledge, but they also require highly developed political, business and negotiation skills if they are to be effective - indeed, if they are to survive.

It is therefore important that we move away from our historic habit of working in silos and make provision for our future leaders to cross boundaries more easily, for example from acute to primary care to social services and even to the private and independent sectors. Mental health services have been particularly good at this in recent years through integrated working with social services.

‘I would like to see collaboration with the private sector’

I spent six months working in Northern Ireland several years ago, where NHS trusts encompassed acute, community, mental health and social services. Being
an executive director in that environment was a huge personal challenge, but I learnt more in that period than I had done in the previous six years as a director.

Crossing boundaries can be particularly difficult for clinical leaders because of our backgrounds of specialisation. It is not, however, impossible. I know several clinical leaders holding board positions, many of them nurses.

The advent of commissioning is a good example of where a varied healthcare background can only add value to the process and enhance relationships between providers and commissioners and vice versa.

The use of secondments across health and social care economies would be a good starting point, as would collaboration with regulators. We all work in the same system and experience of the difficulties, processes and legislation experienced by each organisation would prove invaluable to NHS leaders, both clinical and managerial.

I would go one step further and include private sector companies, particularly those with a reputation for strong customer focus as this area continues to be a challenge for us in the NHS.

We are entering a difficult period.

We know that we are going to have run our services in a more productive and efficient way while maintaining quality of care. This is going to prove a challenge, particularly to clinical leaders who are going to need an increased ability to innovate, take risks and negotiate for the future development of their services.

We will need to learn to adapt our model of leadership development and career progression, which does not always allow for the nurturing of this skill set.

I do not underestimate the difficulties collaboration will pose, particularly in the areas of human resource management and an organisation’s ability (and willingness) to release their good people.

We do, however, have an obligation to the leaders of the future and the healthy survival of the NHS to explore ways to make this a reality. It is hard being a leader
in the NHS right now, you need to be resilient, creative and adaptable - oh and don’t forget the sense of humour.

Mandie Sunderland is chief nurse at Heart of England Foundation Trust

The Department of Health and the National Leadership council want your views on how the NHS should be managed. You can contribute to the debate by posting a comment below

  • 3 Comments

Readers' comments (3)

  • I did this and was penalised by reducing my pay from 8a to band 5 - (due to leaving NHS for 10 years to manage 250 people in a care environment). Please explain to people who think " if you leave for the private sector you can't cope with the job" that it is not so protected out there and VERY character building. I must add I challenged the rate and was uplifted to top band 6

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  • I left the NHS in 1999 and over the following years I successfully set up acute pain services in a private hospital. I then decided to apply for posts (2004-5) within the NHS to be told that I had been out of the NHS for too long! (even though the job was I was applying for was exactly what I was doing in the private sector & working towards very similar guidelines etc). Also, when you look at many NHS sites for jobs (only recently) there are many advertised as internal application only etc. The NHS does themselves no favours, there is a wealth of experience outside of the NHS and it is about time they learnt to take on board others experience - and if anyone is used to working within budget it is people within the private sector.

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  • I must agree with the posters and the article.
    As a nurse leader and manager,I have worked in the NHS,military,private sector(internationally), and for international NGOs.

    When I tested the water of NHS management,it was clear that any experience that was not NHS was scoffed at.
    Also there was a clear leading indicator of time served.
    Dead folks shoes were to be filled by aspiring acolytes who had done the time.

    I am now in Asia,and happily managing a large construction project medical service.
    splendid renumeration,managerial freedom and respect.
    I get to design and run a responsive,cost effective model of care, that is rated highly by all stakeholders.

    NHS-happy to go into an open competition/interview process,but not the toxic stalanist model currently on offer.

    I do fear for the future.
    The response to the basic fact of not enough income into the NHS and increasing demand, seems to be industrial action.

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