We Must Involve Clinicians on All Levels to Transform the NHS

My goal is to involve clinicians at all levels in running and improving services. After all it is the staff on the frontline who will truly make a difference to the delivery of care in our hospitals. It is vital to let them know we are actively supporting them.

After a successful twenty-four year medical career I decided it was time to move into a management role. I didn't make this decision lightly as I loved my job as a histopathology consultant, but believed I could bring a different perspective to NHS management and contribute to patient care in a different way. I know first-hand how hospitals work, and I have a view of the world that comes from being part of the hospital clinical staff. Since 2007 I've been working as Chief Executive for the Heart of England Foundation Trust looking after over 11,000 staff, 1500 beds and managing a turnover of £620 million.

My goal is to involve clinicians at all levels in running and improving services. After all it is the staff on the frontline who will truly make a difference to the delivery of care in our hospitals. It is vital to let them know we are actively supporting them.

I publish my diary as a section of my homepage www.marknewbold.com in order to be as open as possible. I share everything from meetings I am attending, to teaching I do and discussions I have. I include my views and opinions too. Gaining trust from staff and patients is my number one priority and the only way to achieve this is by being authentic and transparent. I aim to be approachable to all employees on all levels.

As well as publishing my diary online, I also publicly document any issues the hospital is facing, from emergency pressures to preparing for the winter months ahead. Winter is a challenging period for acute hospitals and we run three separate Emergency Departments. It is particularly important to ensure timely discharge home, so that we can comfortably manage the new patients at the 'front door' who are most acutely unwell.

I also regularly hold meetings with my staff to discuss our challenges, listening to their suggestions and taking on board their ideas. It is important to me that I am critical, both of myself and of the hospital.

Another way of interacting with my staff and patients is through social media. I look after my personal twitter account @drmarknewbold and try to respond to most tweets. I engage with patients, public, staff and NHS management on a daily basis. I am often asked if this puts me in a vulnerable position. Of course it does but by tweeting I am in touch with current news and opinion, and closer to our patients and closer to the staff at the hospital. A critical tweet gives me the chance to reflect and improve on a daily basis. If a patient tells me that they received good care at the hospital I make sure I let the responsible staff know. A recent twitter conversation with younger colleagues resulted in a leadership and management learning set for junior doctors. Twitter creates positive change at the Heart of England Foundation Trust.

As NHS leaders we are facing a new era. We are moving to a new set of priorities with a firm focus on quality, and a very different culture in the way we operate as an organisation. I believe that involving more clinicians in management is a vital part of these changes. Medical professionals have a practical understanding of how hospitals work, and they make many of the decisions that affect patients directly, and commit resources. From junior staff to senior clinicians, most have hands on experience and truly understand both the patient's and the clinician's point of view.

When I train managers I always encourage them to look at the wider context in which they work, because we are all part of a large and complex system. It is important to listen to people's opinions, follow news story and look at underlying themes as well as staying on top of hot topics and trends. Wider knowledge is very helpful when managing teams. In recent years the NHS has not performed as well as it could have, and now is the time to listen and make changes. We must listen more to patients, their relatives, and staff, and we must operate in a more open way with clinical safety and quality of care truly at the top of our agenda. It is both challenging and exciting to be working in NHS management at this crucial time - there is much to do but the opportunities for making worthwhile change are greater than ever before.

Dr Mark Newbold will be discussing these issues with NHS Managers directly at Hospital Directions on 27th and 28th November at London ExCeL. www.hospitaldirections.co.uk

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