Clinical leadership case study: consultant clinical psychologist and director of therapies and executive lead for patient experience

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Michael Witney, Executive Lead for Patient Experience, Oxleas NHS Foundation Trust, on becoming a clinical leader.

My journey

I have been practising as a clinical psychologist for over 30 years. I studied and worked abroad before joining the NHS in 2001. I have worked in two NHS trusts, the second being Oxleas. I made a lateral move to Oxleas in 2009 — similar role and at the same pay band. About 18 months after joining Oxleas the opportunity arose to apply for the role of director of therapies. This was a fantastic opportunity.

My experience in the role has been very positive, and my portfolio of responsibilities has increased and diversified over time. I am a full member of the trust executive team and, quite rightly, I am expected to make a contribution across all areas and not just limit my focus to my particular portfolio. I report directly to the Chief Executive, which is very important as it gives a status to the role that is highly prized. It also gives direct voice to therapists in Oxleas, who are the second biggest professional group after nurses and account for about one-third of the clinical workforce. In Oxleas, in terms of my leadership responsibilities, I am seen as equal to my nurse and medical director colleagues who are also line managed by the Chief Executive. 

The turning point

Once I had been in the director role for a number of years, it was recognised that the role of director of therapies was a central feature of our structure in Oxleas, but I was not a member of the trust board. Given this, I started attending the board of directors in 2016 in an ‘in attendance’ capacity. This means that I am not an ‘executive’/’voting’ director on the board, but I am noted as ‘in attendance’. However, there is the expectation that in all respects (except for being a voting member), I am an equal member of the board and that I participate in the same way as my board colleagues. 

Having the director of therapies attending the board was highly valued by the therapist staff group they had always felt irked by not being seen as equivalent to nurses and doctors. There remains a slight concern among therapists that I am not a voting member. I also attend a range of board sub-committees.

Key barriers/challenges and how I worked through these

Firstly, I think it is really important to be personable. While it is important to raise concerns, ‘fight your corner’, etc, it is really critical that this is done in a polite, reasoned and collaborative manner. It is very important to be principled, but also willing to compromise and to consider the organisational goals as a whole. I think a key principle is that, as a director, you are required to not limit yourself to your narrow portfolio, but to consider broadly how you might contribute to helping the organisation resolve the challenges it faces and move it forward to the achieve the strategic goals it has set for itself.

Organisational support to make this happen

As a director who has a clinical background, I think it is important to support senior clinicians to remain in direct clinical practice, if at all possible — I continue to have a half day when I am working clinically in a service, providing frontline treatment to patients. This helps you remember your core skills and training, but also is essential when talking with your clinical colleagues about their work. It is very grounding and helps further the link between the board/executive and clinical practice.

I am one of the few directors who has a caseload of patients for whom I am clinically responsible in Oxleas. This adds huge value to conversations we have at the board/executive about a range of matters that impinge directly on practitioners as I have at least some current, active and direct experience of the clinical environment.  

My top tips

  • Be willing to be a 'can-do' type of person, while recognising your limitations.
  • Be willing to 'go the extra mile', take on tasks and responsibilities beyond a narrow range and be helpful to colleagues for the good of the organisation (and ultimately to help patients).
  • Show leadership - be willing to take on new challenges. Offer support to new ideas, be open and willing to explore doing things in a different way to help the organisation achieve its goals.

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