Inspiring leader interview: NHS chief executive Colin Scales

Inspiring Leaders – Colin Scales - CEO – Bridgewater Community Healthcare NHS Foundation Trust

Linda Walmsley is a professional interviewer and business owner of UK executive and management recruitment firm, Walmsley Wilkinson Associates. During 2020 she continues a series of interviews with Business Leaders who have innovated within their field of expertise and have warranted the description of being an inspiring leader.

Profile

Colin Scales is Chief Executive of the NHS Bridgewater Trust. He was promoted to this role in April 2015 having spent nearly four years as the Trust’s Chief Operating Officer. Colin joined the health service in 1994 after leaving university. He has undertaken a range of roles in a number of different NHS organisations during his career.

These roles have included both the commissioning of services and the operational management and development of hospital services. He has also supplemented his operational experience with roles held within the Department of Health.

His passions include developing relationships between organisations to deliver the best for patients and identifying leadership skills with a focus on developing and supporting leaders to deliver excellent care.

Interview

What was your first paid job?

I left sixth form and went straight to university – initially I went to Leicester to do a business course, this didn’t quite work out as I expected it to. I did a term and left about Christmas time, so I got a job in a chain factory, to tide me over until I went back to university the following year. It was pretty heavy-duty stuff back then. The job was a linisher.

This company manufactured industrial chains for heavy machinery and enormous vehicles. My job was to spend 8 hours a day shaving the sharp metal edges off the cut metal. They would deliver me tons of containers filled with chunks of metal and I would stand there and shave the sharp pieces off. I did it for 9 months and it was my first paid employment. I got £100 a week, lived at home, no expenses - and I’ve never had so much money in my life.

It was fantastic to have that level of freedom for the first time. A linisher or linish grinder - look it up; great fun.

What were your career aspirations when you were younger?

Growing up, I was always on the arts side with subjects at school rather than the science side of academia. My interest in geography and place and society drew me to public service at a pretty early age. I guess my interest in inequalities and inequity probably at the time when I was choosing and undertaking A level study really encouraged me to focus on a career in public service. Which is why when I originally went to university to study business it didn’t tune in with me, as it was not what I was about.

I went on to a Geography and Humanities course, I always had this ambition to be working in a public service and I had no particular view as to whether or not this would be in the NHS or in Local Government or wherever in public service that would be.

From an early age my character was one that was geared towards doing something right. As trite as that sounds now, as I approach my 50’s, to look back at the younger me and suggest that I had some sort of social conscience, but I think I did and that came from a whole range of sources but it was always going to be public service for me.

Who or what, inspired you to embark on your career?

Well you look back don’t you at people or circumstances that might have shaped you as a person or your thinking or your outlook; particularly as you are thinking about courses which lead to careers. I was born in Belfast. We didn’t live there for long, but Mum and her family are all from Belfast. In the 70s and 80’s communities over in Northern Ireland were defined by whether they were Protestant and Unionist or Catholic and Nationalist.

My family were, as most working-class communities in Northern Ireland were, quite proud of their heritage, and mine were Protestant and Unionist. We spent quite bit of time over there and what always surprised me was the very overt nature of Unionism. You couldn’t go anywhere without seeing Union Jacks and red, white and blue bunting. I’d then come back to Lancashire, I’d think, well hang on we’re still in the UK but that doesn’t seem to appear of particular interest to folks over here and it took me a while to come to appreciate why.

As you age and as you start to think about what the future might bring and study the detail behind the what creates that type of environment, I became hugely interested in it. The politics and the violence in Northern Ireland caught headlines in the UK for decades, didn’t they? It was actually John Hulme who really started to symbolise what all that was about for me. That was very tricky for me given that John Hulme was an Irish Catholic, and Leader of the SDLP, but he was a very principled man and a very peaceful man. For me coming from a family that had such a very strong connection to Unionism, to be in such awe of somebody on the other side of the fence if you like, was quite challenging back then. I was in my late teen’s / early twenties at this point. He grew up on the Bogside in Londonderry and was affected personally by the Bloody Sunday massacre in ‘72. You can read about him and he’s written extensively but if you get a chance, I would recommend that you read his address on receiving of the Nobel Prize for Peace, jointly with David Trimble in ’98 on the back of the work they did to bring about the Good Friday Agreement within their communities nationally and internationally.

He’s an incredibly inspiring individual. He’s a socialist, and everything that I read and heard about him was characterised by his determination to do the right thing. is His narrative and his writing in the 70’s and 80’s is probably as relevant now as it was back then. My back story of coming from a family whose roots were so different to that of the guy that gave me such inspiration, is probably at the heart of what pushed me towards public service and the notion of making sure that you always do the right thing.

What 5 words best describe you?

There’s always a balance here of not coming across as being arrogant or too self-deprecating. I’ve jotted down some words. Having recently completed appraisals, I did ask my team for some descriptive words for me and said don’t worry what you say, just tell me what you think. I’ve also asked some of my friends and they describe me as are loyal, principled, blue (which is a reference to football), miserable and dry.

Then, my team came up with fair, exacting, supportive, encouraging and compassionate. There were more descriptions from my social circle which were unreliable, amusing, intelligent, eccentric, unpredictable and idiosyncratic. I was going to try to distil that down to the best five, but I couldn’t do it.

I guess, if you were to draw a Venn diagram of words that describe me there’s a good amount of overlap. It’s the first time I’ve asked for this sort of crystallized feedback for a while, but it’s important to do it as often as you can and there’s nothing there that really surprised me. I’m the same person, I don’t have many facets, you see me at work in the way that you might see me at the football, as you may see me in lots of different environments – there’s a good degree of overlap there.

There’s a seed in there, a little down, perhaps not miserable, certainly very measured and sometimes that’s perceived as being miserable.

Do you have a favourite saying or quote?

I have already talked about how John Hulme inspired me, and my favourite quote was from when he received the Nobel Peace Prize back in ’98.

“Difference is the essence of humanity. Difference is an accident of birth and should therefore never be the source of hatred or conflict. The answer to difference is to respect it. Therein lies a most fundamental principle of peace - respect for diversity.”

That is something that stayed with me – after having heard his address twenty odd years ago now, I think it’s re-surfaced given what we are all experiencing. At the heart of John’s address to the Nobel luminaries was a reflection on what they had achieved to bring peace to Northern Ireland. His ambition was to see a united Ireland and in that context was his focus on a united Europe. In the address he talked quite a lot about what a united Europe has brought to the continent in terms of bringing and maintaining peace post war. His ambition for the future I think, from a British perspective is perhaps sadly not going to be realised.

So, in the context of where we’ve been with Brexit, I think it’s quite a powerful reflection given when he wrote that and then of course, all that we are experiencing in respect of diversity and equality, Black Lives Matter and the essence of humanity being that respect for diversity which is often completely lost. It’s something that we really struggle with in the NHS as has been covered broadly over the course of the last 5 months both in terms of the exposure to, and the consequences of being exposed to COVID 19 and also the extent to which we are bringing forward talented, black, Asian minority ethnic colleagues into leadership roles in the NHS and the Public Sector generally. I think it’s a very contemporary message.

What technology are you passionate about?

I’m hugely interested in technology, but I don’t know if I’m passionate about it. Something I’m very interested in, is the application of technology in the delivery of health care as you might expect. In the job that I do and the services we provide, we probably don’t get the benefit of some of that innovation and technology that big hospitals, particularly teaching hospitals get.

I’m forever chasing down any examples of innovation or technology that can be applied to the services that my organisation provides. At the moment, we’re looking at a couple of areas. There’s the application of tele-health to support (usually) elderly people who live at home and the ability that comes from having really good tele-health at home that connects with long term conditions that have a risk of exacerbation. In some parts of the North West it’s possible for a single nurse, a senior nurse to be monitoring up to 400 patients at any one time through tele-health and remote technology.

That’s been around for a while, but it takes too long unfortunately to prove itself and to be invested in on a large scale but we’re on the cusp of doing that. It will bring huge benefits, not just to clinicians but also to patients who want to live their lives in a different way. I think the application and availability of technology on a very large scale is going to bring that. It’s cheap and it’s been proven to be effective.

The other thing for me is big data. There’s so much information out there which is starting to be harnessed and there’s a particular company in the States that’s really encouraging the UK health system to pick this up. Evidation is the name of the organisation and they’re using big data that comes from smart watches and smart phones and the sort of tech that’s keeping an eye on our health and wellbeing, exercise and behaviours and aggregating it up in order to do two things. Firstly, to support pharmaceutical development and then there’s something about widespread support to individual health, wellbeing and behaviour choices based on that big data. It will take a while for that to reach to the UK.

We don’t have the organisations like they do in the States that are applying it to different techniques. For me the big benefit will come from targeted interventions on the back of big data that really influence us to change our individual behaviours. We can see in advance of any difficulties emerging associated with lifestyle, what we need to do to affect that and the opportunity for a connection with GP’s and other health care professionals that might be able to provide perhaps a remote level of support engagement and advice to people who are taking decisions and offering interventions based on available data.

Then there’s the application of stem cell technology. One of the things my organisation does is that we provide a large network of community dental services across pretty much the whole of the North West. Stem cells technology is being used now, and I found this really difficult to come to terms with, because we’re all used to having our teeth excavated and filled but there’s now the ability using stem cells for dental tissue to regenerate itself and heal.

Now, of course we’re a good way away from having this level of treatment routinely, but the ability to have teeth to effectively heal themselves is something that I find quite fascinating. We do possess the ability for small fissures and defects in our teeth to self-repair but when it comes to dental disease and decay, the next evolution will be for the tissue to regenerate. It’s incredible. It’s fascinating. I can’t wait until the point where we’re all benefiting from that. We’re also seeing the use of stem cells to stimulate the production of insulin in people with diabetes so it’s really beginning to get to a point in effecting the day to day lives of individuals with very common conditions.

Tech is probably something that as a health system; compared to parts of Europe and the States or even in Australia, where the UK has a journey to take yet. We need a really clear strategy for technology in the NHS - a national strategy that empowers universities and the private sector to routinely engage directly with NHS organisations to bring these innovations forward to front line service delivery.

What’s your approach is to interviewing and hiring?

Traditionally what I’ve always done is focused on the skills and experience, the technical ability of someone to do the job and to demonstrate to me that you can do the job. I made a bad appointment into a very important senior role 4 or 5 years ago. This individual came forward and blew us away with his evidenced experience and skills, contemporary knowledge and knowledge of the subject, he was an expert, but he didn’t fit into the organisation. His behaviour became quite toxic and ended up doing harm.

As a result, we re-thought our recruitment processes. The output of a decent shortlisting exercise should automatically bring forward candidates who you know have the skills and experience, you know technically they’ve done it or could do it, so our approach now is very much about the how rather than the what and the scenario-based approach to demonstrating that they connect with our organisation’s values and behaviours.

We are quite a small organisation, we have about 2,500 staff, in the NHS that’s quite small. But we have a particular approach to doing what we do as a leadership team covering such a big geography. We have staff in a triangle from Crewe to, Preston to Oldham and pretty much everywhere in-between so it’s important that the leadership team is living our values and demonstrating behaviours that others ought to be acknowledging as doing the right things. We test that out now pretty extensively in our recruitment exercises.

The two Directors that we appointed in May/June this year were both internal appointments having competed for their roles from a really good external field. I think that’s partly because they’ve grown up over the course of the last 5 years in the organisation and were able to demonstrate the fact, they’d stayed around in an organisation with such a well-defined value set and been successful. This was important for us and clearly for them which others on the shortlist that day couldn’t do.

So, our focus is on being tuned into our values and testing some examples of behaviours. Make sure that you fit into what the organisation’s about. The stuff that’s done up stream in the scrutiny of experience and skills and all the tests that we all do, kind of gets people over the line, in that they are the SME (Subject Matter Expert) that we would need in those functional roles, so just prove to us now that you know how to behave rather than what to do.

Do you have a favourite interview question?

I like to dive into CV’s when I’m interviewing and pick out particular components of a CV that I find interesting. I guess though, the core question for me that I always come back to, is a test of an individual’s resilience and a willingness for a candidate to be honest about what is important. Whether you’re leading a big professional services company or you’re working in the public sector at a senior level, resilience is such an important characteristic.

I like to hear about how people have been through difficult experiences, learned from that and if they can demonstrate how they’ve applied that learning and shared that learning with others then even better. It’s important to understand whether the level of resilience somebody is describing to me is innate or whether it’s been acquired through experience and I think that the extent to which it’s in you, is an indicator of the fact that it’s not going away. You’ve got that resilience and strength of character and the ability to learn from bad experiences, to talk candidly about bad experiences, of things that haven’t gone quite well that were down to bad decisions on your part. I really want to hear all that stuff.

Crikey, I’ve made countless bad decisions in my career but sometimes you don’t want to talk about those so that candid description of how you’ve learned from bad experiences I think is always something that I’ll always test out.

How should the Human Resources function operate within an organisation?

HR is such a complex set of services. I’ve always been of a view that as much HR expertise as possible should be located at the front line, supporting and indeed being part of front-line service delivery teams. It’s really difficult to provide timely and meaningful HR support and advice if it’s seen as being an HQ function and it’s dislocated from reality.

There’s a wealth of experience and detailed knowledge of HR law that comes with being an HR professional so what I’m describing isn’t about devaluing the professional expertise that HR leaders have, far from it, it’s about making the best use of that expertise in a timely way and in an as accessible way as possible to ensure that personnel relations and staff engagement and everything that needs to work well to deliver great services is supported by great, local HR expertise.

Now, potentially it’s more expensive to do it that way, you always need a core, high level HR expert in your organisation. I’ve been working at board level in the NHS for nearly 20 years, and the organisations that I’ve worked in have always had a board-level HR Director which I think is essential when you’re employing thousands of people in an organisation. There’s always the need to have a more remote back office, transactional HR function which is there to support, that doesn’t need to be embedded in front line delivery. It might be more expensive but it’s less expensive than not having expert and accessible HR advice when it comes to disciplinary processes and grievances and all that stuff that emerges if we can’t advise clinical managers and deal with challenges at source.

The HR team in my organisation is really good at being on top of issues in the workplace and offering timely advice. It isn’t about enforcing or mandating anything, it’s about being proximate and having the relationships that means the advice you offer is respected and nearly always taken.

Has workplace diversity now become embedded or is there still much more to do?

I think undoubtedly there’s a huge amount of work to do with regards to embedding diversity in the workplace. My organisation, and the NHS generally, has been working on improving equality, diversity and inclusion and ensuring that respect for those principles become embedded. It must become central to how we lead our organisations and expect our senior people to ensure that inclusivity and respect for diversity is central to what we do.

Within my organisation, its core to our values, it’s one of our board’s five strategic objectives. But are we all living that value, and embracing inclusivity? No we’re not. It’s important it has that profile, but we’ve got so many examples of how diversity is not respected or embedded. Lots of experiences that people bring forward to the board, whether that is to do with caring responsibilities or race or religion or sexual orientation. We have work to do. We have a number of staff networks across the organisation that have been established over the course of the last twelve months.

Two or three months ago we established our black, Asian and /minority ethnic staff network and it’s been hugely successful in with engaging with colleagues from a BAME background and with different cultural heritages. What we’ve been able to bring forward is examples of how we haven’t been sensitive to the needs of our entire workforce. We have too many examples of how we’ve got that wrong. I have to take responsibility for that. I’ve been the CEO here for 5 years now and whilst we’ve come a huge way in engaging with staff, in making sure that our decisions in the services we offer are sensitive to the needs of our staff, patients and families, we’ve still got a mountain to climb and it’s deeply disappointing to hear some of the experiences of particularly black, Asian and minority ethnic colleagues who probably haven’t had the opportunity to speak up about their experiences, despite the fact that we’ve got mechanisms to enable people to do that.

So, no is the answer, it’s not embedded. But in my experience in the NHS, we have much more visibility of these issues now more than we did even six months ago. The tragic death of George Floyd and the Black Lives Matter movement are shining a very bright light on some of those issues across the world and into my own organisation as well as the inequitable consequences of COVID 19 on certain parts of the community. We know that people from black, Asian and, minority ethnic communities are more likely to be exposed to the coronavirus, to be infected and to suffer levels of mortality and morbidity that are disproportionately high compared to other parts of the community. This is something that we have got to address.

From my organisation, my personal perspective, we will focus relentlessly on improving the experience of both patients and staff where respect for equality and diversity isn’t embedded in the way it needs to be.

What legislation would you amend or implement to support the NHS given the current climate?

When I started in the NHS, 25 years ago, in the face of more organisational change, my boss said to me, ‘You stay around long enough you’ll see it all come back around’. Systems and structures and ways of doing things that are common now will be forgotten about in 2 years’ time, but they’ll be back in place in 10 years’ time and right enough that’s what I’ve seen. However when Foundation Trusts were established, I think the first ones came in around 2003/4 and they were just what the NHS needed; high performing, autonomous provider organisations that could get on and deliver great services, would drive up standards and benefit from the financial and governance freedoms that the legislation brought.

Increasingly though, Foundation Trusts as conceived 18 years ago are an anachronism now. I think legislative or policy changes that emerge should be about breaking down the autonomy of Foundation Trusts. The answers to the healthcare challenges that we face both in terms of levels of health and wellbeing in the community that need to be tackled, the financial predicament that the NHS has been in for the last 10 years, as well as the challenges of recruitment and retention and encouraging young people to choose the NHS as a career, none of that will be addressed through taking a single organisational approach. It has to be done on the basis of systems and groups of organisations working together.

Collections of health and care organisations, looking after the same population must come together to focus on the needs of that population and across a set of NHS Foundation Trusts or social care departments or voluntary sector organisations, the collective expertise exists to address what’s causing the health and wellbeing deficits within any population or community. The difficulty has been that we get our funding sources, our strategy from different directions, that our accountabilities and our objectives are not common. Individual organisations have a linear relationship with the Department of Health or to their respective regulator. So I expect to see legislation brought forward in the next year or so which encourages all of that isolation and organisational autonomy to melt away and to build something up which is very much focused on the collection of organisations in places and that we learn to forget about importance of an individual organisation. That is difficult from a constitutional perspective.

As CEO, constitutionally my job is to focus on what’s right for my organisation, about driving improvements through my board and the council of governor’s and making sure that I deliver the requirements of my Foundation Trust licence which is very clearly about the best interests of my Trust.. That has to be corrected. Whilst we all work together in places and serve populations together, organisational ambition or objectives do still get in the way and it does prevent a seamless approach from the perspective of patients and their families. We need to bring that forward over the next year or two.

Our experiences of COVID have been difficult and often harrowing, but it has brought professionals together who otherwise wouldn’t have worked together. Colleagues that touch the health of local people, whether that be the NHS or social care, the third sector, housing organisations, local businesses. We have seen the best of people in this adversity - focusing on the needs of vulnerable populations and I hope that’s going to stay with us.

We need to carry that forward into policy change, that will encourage us to think differently and to forget about the silos that come from organisational approaches to something that is much more lateral and engaging with our communities. I’m confident that something of that nature will come forward in the next eighteen months. It certainly needs to, and if it does then the NHS and care system will be sustainable long into the future.

We’ve had 72 years of the NHS. People have questioned whether there will be another 72 years, but I think if we can get the next stage of central policy right as it relates to organisations then our institution will be fine.

What do you think are the key elements of being a successful Chief Exec?

I think the very first thing that a chief executive needs to get right is a common purpose. Something within his or her organisation that their colleagues can latch onto. It comes back to the point I made earlier about recruitment, it’s the ‘how’ and not the ‘what’. When you work in the NHS, you read mission statements and it’s all about delivering great care, great service and being accessible. But that’s almost a given and if I’m sitting in a room full of clinician’s and I’m asking them what it is that drive’s them, what it is that connects them to the organisation, what is it that brings you to work and makes that an enjoyable experience, it’s the ability to deliver great service.

I’ve got the simplest job description in the world and it comes back to this common purpose - my daughter is 7 now and I sat in a school assembly with her a year or two ago, where the kids were asked to tell the teacher at the front of the class what their parents did for a living. Molly stood up and said (and we’d never had this conversation), “It’s my Daddy’s job to make sure the doctors and nurses have everything they need”. I thought fantastic, that’s just it. How I describe that back, is that it’s my job to create the conditions that enable our clinicians to deliver the best service to patients. That’s my job description in a sentence. For me that’s about creating a common purpose – our core values as an organisation... The how not the what.

People in the organisation need to be able to observe the contribution they make to what the organisation’s here for and I need to be able to articulate that in a really straightforward way. If I’m not doing that, if I’m not creating the conditions that enable doctors and nurses to deliver the best service, then I’m getting something wrong - it might be that the money’s not flowing that the HR practice isn’t working, or that we’ve not got enough clinicians in a particular environment but it’s the common purpose that I believe is central to being able to take people with you and to continue to deliver great services in really challenging circumstances.

We’ve all got friends or family that work in the NHS or that have certainly been exposed to the NHS in the last few months. It’s been such a difficult time for people that have witnessed some horrible things and keeping them afloat and keeping them engaged and motivated when they are absolutely dead on their feet is such a difficult thing to do. If we can come back to that common purpose and what it is we’re here for and to keep sharing that with folk in a way that doesn’t get tired and doesn’t become rhetorical then we’ll continue to deliver great services.

Spinning around that for me is the question of visibility and I and my team take that very seriously. That’s not just about now, at the moment we’re doing lots of live streams and MS Teams meetings, but at the same time we are trying to be out and about spending time with clinician’s in their environment, being visible, being accessible. That visibility and that absolute transparency with people is essential and that builds trust. It’s difficult to be visible. I spend a day a fortnight in clinical services and that’s not enough, I should be doing more than that and it varies from time to time but routinely a day out of my diary once every fortnight to be in a clinical environment, just to listen to what’s going on and to get myself closer to the detail.

Working in an NHS organisation, typically there’s always been, in all the organisations I’ve worked in, something of a divide between clinicians and the board; if you like ‘the management’. There’s that sort of invisible chasm that’s so difficult to breach but we need to continue to ensure that we’re not enabling that sort of dissonance between different parts of the organisation so that we can prosper.

Back to common purpose, visibility and being utterly transparent. Not being afraid to be absolutely candid about what’s going on, good and bad, so that our colleagues can really understand the contribution they make. By doing this, you are laying yourself out, your exposing yourself to challenge and criticism which is uncomfortable but you can’t generate good levels of engagement and morale across any organisation unless it’s leadership team is committed to absolute candour with the people that are sweating blood to do their best at a time of real challenge. If we can cultivate those relationships and be that person that’s trusted, and the clinical staff know that the leadership team is genuinely trying to create the conditions to enable them to deliver the best that they can then I think we’re halfway there.

The national NHS Staff Survey is issued to all NHS staff every autumn and about five years ago, when I’d just been doing my job a couple of months, we got some pretty crumby results. Since then we’ve poured a huge amount of effort into engagement, visibility and being present. Looking at the most recent staff survey we’ve come a huge way. Last year we were the second most improved Trust in the country in regard to staff engagement. Second most improved – we’ll take that.

How would you describe your leadership style?

People talk a lot about compassionate leadership, it’s probably an over- used term now as important as it is, but how people feel in working for my organisation couldn’t be more important to me. My wife’s a nurse and she’s had some pretty awful experiences as a senior nurse, she works in ITU, so the last four months have been pretty grim for her given the things that she’s and countless other nurses and doctors up and down the country have seen. We need to acknowledge that sometimes work is far from enjoyable.

If one person is coming to work and not enjoying it or having a bad time routinely or doesn’t enjoy working for my organisation, well we’re not getting it right. That matters to me and I want to make sure that it gets addressed. It’s important to be able to connect with the people that are having those difficult experiences and do something about it. Sometimes I can’t, their clinical challenges and patient circumstances are beyond my control, or their crap days are not to do with anything that’s going on at work.

It’s sometimes stuff that’s outside of work that I can’t influence but if I can I want to know about it but if I know about it I want to help and whilst that’s very altruistic as a leadership style, that’s what I strive to do, it’s what my team strives to do and it’s a philosophy that we try to ensure is diffused across the organisation. We’re seen as a pretty engaging and connected leadership team. I think I’m seen as somebody who’s available and understands what’s going on. I’ve enjoyed reading your other Inspiring Leaders interviews and I’m sure those individuals do things much better than I ever will, but I’m always learning.

How should you support your team as a leader in good and bad times?

These are difficult times. We’ve seen some horrible things, we’ve had members of staff pass away having been infected by COVID, people that were part of the organisation for many years and that is of course very difficult. Simply checking in with each other in the team and making sure that we’re doing ok. I’ve made sure that we all do that with one another. We have twice weekly connections as a team. We’re a small team, there’s seven of us as Executive’s in the Trust. In the difficult times of the last 4 months, making sure that we all know what’s going on in each other’s lives is important.

Now, quite often, people don’t want to offer that up. I know that I’ve got members of my team who’ve got some really challenging personal stuff going on and we’re able to share that. We all know that colleagues are coming to work and dealing with challenging issues and then they’re going home to deal with some other challenging issues. The interface between that is increasingly blurred. In the difficult times we all respect the fact that we don’t know really what’s going on in somebody’s life.

Whether they choose to tell us or whether they don’t, we don’t really know unless we’re experiencing it so we all have to make sure that we are respecting the fact people will bring baggage to work. Sometimes they’ll share it with the group, sometimes they’ll share it with a particular colleague they’re close to, but we all need to behave in a way that respects that people have got difficult things to deal with.

I think that’s just as important when we are going through good times. I would hope that the approach that I take to leading my team doesn’t materially change depending on what we are experiencing. We’ve had some difficult things to deal with pre-COVID and some really great things that we’ve experienced as a group. I hope that I’m able to offer a relatively consistent approach to dealing with the needs of the organisation and my team. I think whilst being sensitive to particular issues that individuals or the group throw up, COVID is an example of something that will hopefully never come again, that consistency I think is essential.

Exuding to team members and the wider organisation that sense of control and assurance and confidence is so important and it comes back I guess to the point around leadership style in that you can’t really sit in the staff room and just be one of the lads or lasses because people look to you to be providing leadership and direction and some strength in difficult times. I think that’s essential as part of a consistent track in relation to how the team behaves and how I offer that leadership to the group.

What’s your biggest career highlight or achievement to date?

There are a couple of things that I’ve really enjoyed over the course of the last few years. There were personal achievements that come with opening new services. I was the Chief Operating Officer at Lancashire Teaching Hospitals for several years. We opened a new surgical assessment facility which was a big deal for me at the time. You look back and think from start to finish that’s something that I can feel proud of and it’s still there. It’s not called the Colin Scales Surgical Assessment Unit sadly, perhaps when I retire it will be? (Laughing). I drivepast it though and think without me that wouldn’t be there, so that’s pleasing.

Being appointed as a Chief Executive was a really proud moment. I’d work in the organisation for a couple of years and had never, despite the fact that I’d worked in the NHS for so long, I’d never really had that hierarchical ambition to be a Chief Executive. I talked to people in their twenties now who are coming through training schemes and they say, ‘I’ll be a Chief Executive by the time I’m 37’. I think, well that’s fine but don’t be driven by that, just find your way. I never really had that desire to progress up the ladder in the way that I did, so that was pleasing.

What I’m most of proud of is that I’ve built a great team over the course of the last two years and with one exception, they’ve all been internal appointments. I think that’s a result of the fact that we’ve worked really hard at talent management and succession planning in the Trust. I appointed my HR Director in June. She’d been the Deputy HRD for a while and she had an opportunity about two years ago to apply for the Director of HR job but she decided she didn’t see herself as a Director. We wrapped some support around her and provided her with the confidence to get her to the point where she could legitimately think about doing that job. We did it with others as well and interviewed 4 or 5 candidates in June, including two existing HR Directors, and she blew them away. She’s absolutely fantastic.

So, building the team we’ve got that shares the value set that the organisation has conceived and the approach to delivery and focus on the wellbeing of our workforce is something that I’m really proud of. I had a couple of false starts at building a team in the early days of being Chief Executive and I described a bad appointment that it took a while to get beyond. Having learnt from that and created a team of leaders, some of whom are in executive roles for the first time and are prospering, is something I’m dead proud of.

What’s next for you and the Trust?

I talked about the need to develop a system approach to healthcare. As an organisation we’ve taken a couple of big strategic decisions over the last couple of years to exit services. We were too big. We provided too much across a very big geography. We’ve pared that back and I think we’ve got to a size and shape of organisation for the services which we provide that is just about right.

There’s a bit of consolidation to do now but there’s also something about making sure that we’re going to be a leading contributor to what will emerge on the other side of new policy from Government which will be about systems. Making sure that community-based health and care is central to the systems that emerge in the next two or three years is key.

Making sure that it isn’t the hospital sector that sucks in all of the money, that we’ve developed a strategy, a strategic narrative that acknowledges the need to be working with communities and populations to improve prevention and health and wellbeing which isn’t about the treatment and fixing that happens when we get it wrong but which is about getting upstream and ensuring our clinicians are instilling good lifestyle choices and behaviours in individuals - whether we get the benefit of big data in time to do that, one would hope we do, but I want to steer the organisation now into new territory which is very much about ensuring that communities of local people are engaged in a way that ensures they’re focused on improving their own health, their own wellbeing and lifestyles and then the clinical expertise that my organisation brings can serve to enhance that.

Everything that needs to be developed societally on the back of COVID, the health service must be central to. As an organisation that has roots in the community, we are stitched into the fabric of local communities .We will continue to refresh our approach and to make sure that health and wellbeing, rather than the treatment of poor health, is something that characterises the NHS, certainly in our geography, as we move to the next phase of this amazing institution.

I want to see this happen over the course of the next couple of years and it’s a big step change for us and the NHS generally. The future must be characterised by an NHS that is working up stream from the problems that bring poor health and increasingly supporting people to make the right choices.

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