Leaders on leadership – NHS Senior Leaders reflect on their roles

The NHS is a very unique organisation, that so many are proud to work for. In difficult and transient times like that of COVID-19, we as a society have relied on the NHS to get us through – testing, taking care of those who got the virus and continuing their exceptional care of other patients. To lead in the NHS is to shoulder the burden of responsibility. 

We’re currently speaking to a number of NHS senior leaders as part of PNE Podcast series “The Person Behind the Job Title”. In the series, Jack Jacob is talking to senior leaders about their career journeys, bugbears, challenges and what leadership means to them. It’s well worth a listen if you haven’t already.

So far, we’ve spoken to 5 senior leaders – CXOs in very different NHS trusts – and we’ve had some fantastic insight from them on what it means to be a leader in the NHS. 

Here’s what David Walliker, Phillipa Winter, James Devine, Lisa Emery, and Paul Bytheway have had to say about being leaders in the NHS.

On working for the NHS

Most people I think, work in health because they genuinely want to improve healthcare for a population. The nice thing about being the Chief Executive role is that you are completely accountable for shaping services for the 600,000 people that rely on this hospital. What an amazing responsibility to have that you’re able to shape something so important to people as healthcare.

James Devine, CEO, Medway NHS Foundation Trust

The NHS gives you a purpose. It gives you a sense of achievement.We deployed at pace the patient entertainment solution, so that the patients could video call, because we couldn’t have visitors to the hospital. That wasn’t particularly difficult, apart from securing the kit (because we’re in the middle of a pandemic and everyone was buying up the kit), but hearing the first video call of a grandmother with her grandchildren after not seeing them for 3 weeks, and the shrieks of delight from the grandchildren from the other side, or arranging a family to be able to say goodbye to a loved one over video – that gives you a sense of purpose that you’re doing something more wholesome than lining the pockets of shareholders. The ethos of the NHS and its place in our social conscience is special, and for all the tea in China I wouldn’t leave the NHS.

David Walliker, Chief Digital and Partnerships Officer, Oxford University Hospitals NHS Trust

I had a real profound event in my life in my first year at secondary school – my brother had a really bad motorbike accident. That was the turning point for me wanting to give something back in the NHS. I watched all the work they did on my brother at the time, and it absolutely amazed me.

Phillipa Winter, CIO, Bolton NHS Foundation Trust

There’s a sense of family, a sense of belonging, a sense of doing something for the greater good. Being involved in people’s lives, whether that’s staff or patients. The great stories, but also listening to the bad stories and knowing how you can change them. Working with patients and staff to change services. There’s no greater sense of accomplishment, than working in an organisation that is dedicated to helping people.

Paul Bytheway, Chief Operating Officer, North Midlands University Hospitals NHS Foundation Trust

On being a leader

It’s something that it takes time to learn. Having spent a number of years in fairly autonomous roles, managing programmes, you’re kind of in charge of delivering something. You have a defined set of things that have to be achieved and you get on and achieve them. Ultimately your ambition is to get a product or a system over the line and get it in and working. And that’s your imperative. The thing I found challenging about that is then shifting to being the person that says ‘this is what we need to do, and here’s how I’d like us to do it.’ I spent a lot of time thinking about people that I knew that had done that really well.

Lisa Emery, CIO, The Royal Marsden NHS Foundation Trust

I think being reflective is really important. I think when I was younger, I was probably less reflective. And I’m still a bit gungho. And if you give me the baton, I’m running with it, but not sure where I’m necessarily going, but I’m going. And that’s the thing that I’ve been more reflective on recently, because obviously, I need people to be with me! Communication is really key. It’s about managing expectations, and I think if you’ve all got a value, and you’ve all a combined goal, and everybody understands what their impact is on that goal, and they’re signed up to that, then you can’t really go wrong.

Phillipa Winter

I’m not somebody that stands at the end of people’s desks and points fingers and makes demands. My belief is that you empower people to be able to do the job to the best of their ability. Fundamentally, leadership is about identifying the potential in people that haven’t identified in themselves yet and give them a structure and an operating model that enables the individual, the department and the organisation to do the best.

David Walliker

I often say that the job of a good leader is seeing something in someone that that person doesn’t yet see in themselves.Your mentors and your leaders are there to bring out bits in you that you either didn’t know you had or you did know you have, but you didn’t have the confidence to bring out.

James Devine

It’s about engagement, involvement, being visible, being firm, but fair. Trying to ensure that you have a rapport, particularly a board level, because I think it’s really difficult at board level to build relationships. But also trying to build a relationship with the greater community of the hospital so that people recognise you for the supportive role that you play in your organisation.

Paul Bytheway


It’s been unprecedented. It has been a really tough, tragic time for a lot of people. I think for my team, when it was at its peak, it was really full on and really quite testing for staff. But we’ve also been able to deploy all sorts of great technology. We’ve put AI into radiology which is looking at chest X-rays of patients with COVID, which is a really innovative thing. But all these projects normally in the NHS will take some time. And we’ve not had any extra staff. So it’s really been firefighting, and the firefighting of what is that priority of that day or that scheme, and that’s been done over a matter of weeks which would normally be done over years.

Phillipa Winter

Going into COVID, I think if you asked any Chief Nurse or Medical Director, ‘what were those first few weeks like?’ – the fear was just unreal. This was a prolonged attack on the NHS, which I think was for all of us gave us sleepless nights. And now we’re obviously trying to get the services back up and running – making sure they join up and are delivered in a safe way for patients and staff who’ve worked so hard during the incident.

Paul Bytheway

COVID is an absolute tragedy and you know, the numbers that are flashed up on the bulletin every day – that’s somebody’s family. The pressure and stresses that it’s put the frontline staff under is unimaginable really. But what it has enabled us to do as a national health service is to effectively unite behind a common purpose. You didn’t have to cut through any competing objectives.

David Walliker

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