November 16, 2023

DataRobot: To Manage Care Demand Surges this Winter, We Need to Look Into Intelligent Data Approaches

The NHS is bracing itself for yet another difficult winter; one which will test capacity and resources to the limit. Currently, systems are straining under the weight of an ageing population, increased diagnosis rates of chronic conditions, rising cost of living, long waits, staff shortages and outdated infrastructure. Come the colder months, we will see more urgent demands for innovations to radically enhance care. Rather than reacting to these mounting healthcare challenges, we need a more proactive approach that leverages intelligence to drive informed decision-making – an approach the DataRobot team understands intimately.

DataRobot: Building Intelligence-Founded Infrastructures that Stand Up to Winter 

Dan Hughes and Paul St. Georges, Strategic Account Director and Senior Data Scientist at DataRobot respectively, believe that new technologies have an unprecedented role to play in alleviating strain across the NHS. By harnessing the transformative power of artificial intelligence and leveraging world-class data analytics, DataRobot works closely with NHS organisations to enhance resource allocation, streamline workflows, and strengthen clinical decision-making. Looking towards winter system pressures, Dan and Paul emphasise that ensuring resilience hinges on how well systems can interact, leverage and optimise data. This will prove critical for upcoming demand and flow planning. 

To achieve this, there is opportunity to implement data-driven solutions, such as the DataRobot AI platform, to granularly analyse care pathways and optimise components via AI. Paul commented: “I think this is where true innovation in patient flow will begin. It will start with us making advanced, data-driven decisions on how to optimise, or be proactive with the information we already know.  This is where AI and predictive modelling - something we deliver strongly on - will help health services across the board. From GP visits, 111 calls, hospital visits and readmission, artificial intelligence will allow us to do more than react to crisis, but to pre-empt the impact of events across flow”. 

The Successful Implementation of AI Requires True Partnership and System-Wide Coordination

Certainly, technology holds great potential; however, its successful implementation depends on the expertise of the professionals leveraging it. Ultimately, alleviating winter crises requires a coordinated effort among technology partners and the entire healthcare system. If applied judiciously, data and AI could make an important contribution. 

Both Dan and Paul stress the importance of collaboration in creating data platforms that can “make an advanced decision about how to optimise or act in advance, instead of waiting for the problem to arise”. Dan compares having access to “wider data feeds to having a wider field of view”, allowing execs to join dots and spot patterns across GP surgeries, ED departments and even whole NHS trusts. Patients can be seen faster and additional pressure can be relieved across the board, improving the level of service for everyone. 

The Art of the Possible for Winter Resilience: Digital Solutions and Closer Collaboration

Beyond technology, events like the NHS Executive Strategy Summit offer invaluable opportunities for COOs to engage with peers, share best practices, and collectively build more robust and responsive NHS infrastructures. As Dan states, the immense importance of an event like the NHS Executive Strategy Summit, is in the opportunity for operational executives to share in a “ton of thought leadership”.

New ideas and insight will come from having system partners, technical teams, and those in leadership positions all in one space. Stepping away from the day-to-day, alongside peers facing similar challenges in demand forecasting, will not only make healthcare professionals feel less alone, but, as Paul notes, facilitate the creation of concrete solutions to real issues. 

The NHS Executive Strategy Summit  is on the 7th of November in London, organised by Meet Health Events and Proud2bOps.

To learn more about the event, visit: learn more about Proud2bOps, visit:

November 14, 2023

Development opportunity: School for Change Agents

Would you like to develop skills to make a difference and create change in health and care?

The School for Change Agents by NHS Horizons is a free, online, self-paced course designed for health and care staff at any level to build the confidence and community to unleash their inner change agent!

This year, they have partnered with NHS England’s Healthcare Inequalities Improvement Team to bring you stories of real change agents across the country making a positive impact tackling health inequality.

The next run of School starts on 13 November on Future Learn and lasts five weeks.

Everyone taking part in the School has five weeks from when they start to complete the modules. If you’d like to extend your access, you can upgrade for a small fee. The great news is if you work for the NHS or in social care, you can get an upgrade at no cost to you thanks to a partnership we have with FutureLearn, you can find out more about this here.

If you want to make change a reality, then sign up today at

We hope to see lots of members there!

Join the #S4CA community on X (formerly twitter) and Facebook

Listen to the Podcast: Agents Assemble

November 13, 2023

Rachna Vyas: The Importance of NHS Leaders Learning from Each Other to Tackle Patient Flow

Rachna Vyas, Chief Operating Officer for NHS Leicester, Leicestershire and Rutland ICB, offers her perspective on NHS-wide knowledge sharing, integration and why her system is scrapping a ‘winter plan’.

Our teams are at the heart of what makes the NHS tick. The onset of this winter follows a series of mounting pressures through the year including the impact from industrial action across sectors, the constant challenge to manage patient flow, and an evolving way in which our patients expect services to be delivered across the year. Leaders at every level, operational and strategic, are making key decisions on how to best tackle these issues across systems on a day-to-day basis, which is why events like the NHS Executive Strategy Summit 2023 are so important. The event, organised by Meet Health Events and Proud2bOps, will bring together strategic and operational leaders from across the wider health and care system to discuss these challenges and engage in collective problem-solving.

Distilled Post had a conversation with Rachna Vyas in the buildup to the event. Rachna is the Chief Operating Officer at the NHS Leicester, Leicestershire and Rutland Integrated Care Board (ICB). Rachna began her NHS career in 2005, and her previous roles include the Executive Director for Integration and Transformation for the three Clinical Commissioning Groups in Leicester, Leicestershire and Rutland. In this role she led the design and implementation of transformed models of care for urgent care, elective care, children’s services, all age mental health and learning disability services.

Rachna sees plainly the value of the NHS: “We can do wonderful things with people, achieving the best outcomes for them and their loved ones on a daily basis.” But when the system is presented with challenges such as those we see as winter pressures, she sees protecting the wellbeing of staff as paramount - “Our teams are tired. We’ve had a really difficult couple of years… there’s more and more pressure on services, with inflation and the cost of living impacting on people personally also”. For the NHS to function as it should in these difficult times, Rachna says “we've got to look after the well-being of staff groups across the entirety of pathways that we've got, because without them at their best, the NHS does not work at its best.” Rachna revealed that the NHS Leicester, Leicestershire and Rutland ICB “no longer has a winter plan. We have developed a surge and resilience plan across health and care services covering all seasons.” She explained the shift away from viewing winter as a specific season to prepare for: “we know that ‘winter pressures’ just doesn't seem to stop for health and care services. So we are now looking at seasonal pressures… this is not just about winter anymore. This is now about sustainable services, dealing with surges just like any other sector would.”

The conversation turned to the potential role of greater care in the community in alleviating pressure on the NHS. When asked whether there were patients in her ICB area that might benefit more from care in the community, Rachna had this to say: “I don't think you'll find a trust up and down the country that would tell you that we haven't got patients like that…if you can provide services outside of an acute setting, safely and in a timely fashion, that's absolutely what we should do as its what the majority of our populations ask for regularly” One of the difficulties lies in managing the fact that patients are most often admitted with multiple conditions; Rachna identified dealing with this complexity as a key issue for care in the community, but pointed towards GPs and specialists working together as a potential solution - “Partnership teams like these are used to handling risk in a very different way to individual specialist colleagues and we can evidence improvements in both patient experience and patient outcomes when we work across these boundaries”. 

Initiatives such as care in the community will help to improve patient flow, but only when supplemented by other good practices such as enhanced digital strategies: “it’s about digital transformation as well as clinical transformation”. Echoing many other operational leaders in this interview series, digital integration was a key phrase for Rachna. “I think we need to do better as a set of people and a set of organisations on how we share data safely across these systems so that we've got one plan.”

Rachna feels positive about the potential of the NHS Executive Strategy Summit: “Because somebody's always doing something better than we are, and sharing how somebody's made something happen is incredibly important”. Giving the space for operational leaders to learn from a variety of approaches, as well as to contribute to a supportive and understanding environment, is vital as they face the challenges ahead. As Rachna concluded, “it's time and headspace to listen, to learn and to think differently, which is invaluable when you're in these roles”.

The NHS Executive Strategy Summit is on the 7th of November in London, organised by Meet Health Events and Proud2bOps.

To learn more about the event, visit:

To learn more about Proud2bOps, visit:

November 13, 2023

“The darkest hour is always before dawn”: Emma McGuigan and Chris Oliver on Winter Pressures and the Potential of Technology

The NHS Executive Strategy Summit (NESS) represents a collaboration between meetHealth and Proud2Bops, with the aim of bringing together Chief Operating Officers (COOs) from across the NHS to work together and find solutions to pressing issues including patient flow, winter pressures and digital strategies. 

In the buildup to the event on 7th November, Distilled Post sat down with Chris Oliver and Emma McGuigan.  Respectively they are the Chief Executive Officer (CEO) and Chief Operating Officer of the Lancashire and South Cumbria Foundation Trust (LSCft), and the conversation covered winter pressures, resilience and the potential of technological innovation in optimising patient flow and freeing up beds. 

The areas the LSCft has oversight of include the Fylde Coast and within it Blackpool, one of the most deprived deciles in the country according to English Indices of Deprivation data collected in 2019. COO Emma commented on the situation facing LSCft as winter approaches: “urgent care’s not had a break”. Data from the British Red Cross in 2021 revealed that there were around twice as many attendances to A&E departments in England for the 10% of the population living in the most deprived areas (2.2 million), compared with the least deprived 10% (1.1 million). Emma found similarities between the situation facing the NHS this winter and last; while the winter of 2022 was set in the context of the disruption caused by the Covid-19 pandemic, in 2023 hospitals and clinical practices are regathering following significant and sustained industrial action over the summer. The key strategy for the short term, Emma surmised, was “preparedness across individuals and services” - put simply, “you do as much early planning as you can do”.

She views the longer term solution to winter resilience as a rather more difficult question. “It’s probably unsustainable to keep on going like this, we have to go into winter in better positions”. Chris added that the vision for a longer term solution had to be wider and consider more variables in its scope, including social care and the impacts of austerity: “the fix for the NHS can’t just involve the NHS”. 

The discussion moved to the potentially crucial role of technology in developing a longer-term solution. Chris identified AI as an extremely promising tool, particularly in supporting people to live healthier lives at home. Technology, he asserted, could help surpass the barriers that currently exist to obstruct consistently successful care in the community, which in turn can free up vital bed space on wards. With regards to virtual wards, Chris suggested that what was needed was “to give clinical teams the space and freedom to develop them with tech companies”. He described within his own Trust an exciting new model of care forming; focusing on community care and a move away from a focus on inpatient beds. Chris cited examples across the world where there is smaller bed capacity and money, which has already been released, being re-invested into community care - with a resultant decrease in occupancy numbers. Improving care in the community eases significant burdens on capacity without causing poorer outcomes. As Chris asserted, “in financial terms - for every one person in an acute bed, we can look after 39 people in a community team, keeping them closer to family, friends and their support network”. 

Despite the challenges ahead, there was still room for positivity. Emma shared that “I’m really glad that so many of my team are going to NESS. They get some time with peers, time to prepare and take a breath, reflect ahead of winter”. Such spaces to share experiences and collaborate on solutions are vital for those in NHS management positions, particularly as the first official day of winter for the NHS - 1 November - approaches. As Emma says, “we’ve done it before, we can do it again. And the darkest hour is always before the dawn”. 

The NESS, organised by Meethealth and Proud2Bops, is on the 7th November in London.

The NESS is on the 7th of November in London, organised by Meet Health Events and Proud2bOps.

To learn more about the event, visit:

November 13, 2023

The Power of Connection: Emma Challans-Rasool on Building Community Through the NHS Executive Strategy Summit

“The purpose is to bring people together to feel energised and connected”: Emma Challans-Rasool on the benefits of the NHS Executive Strategy Summit  and creating a deliberately developmental space for operational professionals”

In preparation for the NHS Executive Strategy Summit on the 7th November, Distilled Post spoke with Emma Challans-Rasool about improving patient flow, perceptions of operations professionals and the benefits of the summit. The event is an opportunity for senior Operational and System Leaders, including Chief Executive Officers and Chief Operating Officers to come together from across the NHS to discuss solutions to issues including winter pressures, patient flow and digital strategies. Also present will be representatives from leading companies seeking to implement digital solutions to these issues. 

The event is co-organised by Meet Health Events and Proud2bOps, of which Emma is the Founder and Chair. Proud2bOps is the UK’s only supportive network for operational managers and leaders in the healthcare sector. With over 1,300 members, the network provides a safe space for operational professionals to connect, share best practices and develop leadership and management skills. Emma is a Director in Horizons and Proud2bOps and has worked across healthcare for over 20 years.   Her career spans operational leadership, OD and transformation, improvement, and management development. 

The conversation started with a discussion on how providers can improve patient flow throughout the system in a sustainable way. “It fundamentally comes down to the workforce, in terms of capacity and capability” Emma said. Although she acknowledged that one factor was capacity and sufficient numbers of staff, Emma pointed towards other pertinent questions: “have we equipped our workforce with the tools, knowledge and consistent support for development of their skills to be able to effectively lead and support patient flow?”. Emma suggested that we should be asking “have we got people who have been invested in and developed to be the best that they can be in a role, from a knowledge and skills perspective.  We should ask ourselves this first before judging effectiveness of patient flow”. 

“I think it’s fair to say that morale and motivation across the NHS at the moment is particularly fragile”, Emma added. Indeed, a survey conducted by NHS Providers in September 2022 revealed that a majority (61%) of NHS Trust leaders reported a rise in staff sickness absence due to mental health, while the ongoing cost of living crisis had resulted in two thirds (68%) of respondents reporting significant impacts from staff leaving Trusts to work in other more competitively paid sectors such as retail or hospitality. Improving “the culture and the climate” is vital, Emma surmised, in improving patient flow. 

Discussing patient flow led to a conversation on the potential of technology to help with this particular issue; as Emma observed, public use of the NHS has totally transformed since its foundation; “today, it’s not delivering what it was asked to deliver all those years ago - it’s delivering something totally different on what are still in many cases traditional models of design and delivery, that are not fit for purpose”. She acknowledged that digital solutions would take time to reach the mainstream and highlighted their significance in solving some of the most pressing issues facing the service   

Extraordinarily, no network existed to support and connect operational professionals in the healthcare sector prior to Proud2bOps. “Ops has never really been recognised as a profession in its own right” Emma said; she thinks that perhaps the lack of clarity surrounding the role can often lead to negative stereotyping of managers compared to other clinical roles. Proud2bOps provides a space for communities of operations professionals to come together in a safe, supportive climate to discuss shared problems and share examples of operational excellence. Emma described it as “a network, but it’s more of a social movement that has grown with purpose, engagement and founded on core values and principles… which is where you get the true culture change”. Proud2bOps is a success because of its members and their passion.  

The conversation ended with a question on what has inspired the collaboration on the NHS Executive Strategy Summit with Meet Health Events. “We try to ensure that we offer different platforms, spaces and opportunities for members to connect”. The NHS Executive Strategy Summit will “give attendees that reflective space and time where members can grow their relationships and have an in-depth conversation regarding operational excellence”, which Emma believes can be more “emotive and meaningful” than virtual discussions. The collaboration with Meet Health Events came about because “they appreciate and recognise Ops… and they have similar values, aims, ambitions and objectives for improving patient care”. “They’re mindful of the operating environment of the NHS and the challenges faced in terms of planning and delivering services. So instead of trying to do things alone, let’s do it in partnership”. This spirit of collaboration will be in abundance at the NHS Strategy Executive Summit, and as Emma concluded: “the purpose is to bring people together to feel energised and connected, and to give back to our communities through attendees taking away key learnings and insights they can adopt into their own environments”. 

The NHS Executive Strategy Summit  is on the 7th of November in London, organised by Meet Health Events and Proud2bOps.

To learn more about the event, visit:
To learn more about Proud2bOps, visit:

November 2, 2023

“Managers value you; do you know enough to value them?” by Emma Challans-Rasool and Charlotte Williams

We have all read headlines that the NHS is overly controlled and bloated at the top by managers, who if they were just stripped away would see much better value for the public and make doctors and nurses’ lives easier.  It is true that as a manager working in a non-clinical capacity, the public, the media, and politicians rarely want to see or hear from you – the opinion of a “grey suit” carries less credibility or influence than a practitioner from the coalface of the service. Managers are frequently and unapologetically portrayed and perceived as the over-paid, restricting bureaucrats who are determined – at best – to prevent innovation and clinical freedom by strangling them with gateways, approvals, and incessant meetings, and at worst are only truly out for their own personal power.

We know that these representations aren’t true, however. In January 2022 the NHS Confederation and independent academics from the University of York and London South Bank University reported that managers make up c.2% of the workforce compared to 9.5% of the UK workforce[1], similar figures from Nuffield Trust showed this was 4% and 10% respectively in 2015[2]; the number of managers having been cut back in recent years, despite the COVID-19 pandemic. As Stephen Black has argued, even medical charities employ more managers than the NHS.

With such an enduringly and unerringly negative reputation, what can be done to support managers better in the NHS? Why is it so hard to shift attitudes towards managers, particularly those who have not been clinically trained, or not holding clinical management roles? Is it because we all have little understanding of what managers do and therefore contribute? We believe it is time to raise the profile of managers[3].

The lived experience of most healthcare managers is nothing like these lazy misrepresentations (although occasionally volumes of meetings can be a bit much) – their work feels urgent, important, and necessary – indeed essential. Their work in the operational delivery of services so patients can access their appointments, or hospital beds reliably, of managing and supporting staff wellbeing and development, of securing finance, of quality improvement, of enabling improved productivity so more treatments can be undertaken and of securing sustainable investment for local people, is never done. There is always more to do, always greater demands from regulators, too few hours in the day and more often than not, little if any leeway in what must be done and when. Managers carry a huge sense of duty and feel heavy responsibility for their roles and outcomes, with usually few local peers for support, given the tiny proportion that managers make of the NHS workforce.  Our managers often feel that they are on their own.

Colleagues from all professional backgrounds demand and recognise good management, valuing it and appreciating the struggle when it is lacking. Managers enable talented clinicians to succeed, they create the conditions for effective teamwork, excellent service, and compassionate care to thrive. Often this is seamless, invisible to the unfamiliar, and therefore sadly taken for granted by those less connected or informed.

Too often does the media or local gossip resort to “manager-bashing” – the tolerance for any errors or misjudgements so limited, the assumption that senior leaders must be out for their own ends so lazily cited and consistently propagated. Why should it be so hard to believe that management staff might have the same values and drive as clinicians do? That they have chosen public service and the health care profession because they want to make a difference to our lives, our world, and our society.  Managers need to be allowed to take their role as central to the multi-disciplinary team – just as no two doctors are the same, no two managers are the same, and stereotypes belittle us all. This is why it is so important to all our success for clinical leaders to be visible and audible in their support for managers.

In this series of blogs with BMJ Leader we challenge all clinical leaders, from any profession, to inform themselves about NHS management – what do you really know about them – the managers you work with? And we challenge you to commit to championing NHS managers and upholding a parity of esteem; what stops you from advocating for your manager peers in access to development and opportunity, research, and innovation? What role do you have to play in influencing the image of the profession positively?

Join us in the next few months as we raise a Call to Action, inviting our clinical colleagues to celebrate managers, as members of the same team.

Upcoming session: Proud2bOps and the FMLM have joined together to support a collaborative conversation between Medical and Operational Managers. Sharing insights into each other’s role and why we should champion each other and work better together. Thursday 24th November, 12:30-13:45.  If you are an NHS Operational Manager or a Medical leader in a provider organisation and would like to join this session please register here:


  1. NHS Confederation (2022), Is the NHS overmanaged?
  3. Strengthening NHS management and leadership – The Health Foundation

October 16, 2023

An opportunity to be part of the Proud2bOps Advisory Group

I am very excited to announce the opportunity to be part of the Proud2bOps Advisory Group. As a member of the Advisory Group, you will play a crucial role in shaping the direction of our organisation, contributing to our strategic goals, and providing valuable support to myself as the Founder and Chair of Proud2bOps and my fellow company Directors. Your insights and expertise will be instrumental in driving forward the ambitions and impact of Proud2bOps and ensuring that we remain aligned with our Strategic Mission, Vision, and Values.

Introduction to Proud2bOps

Proud2bOps is a National Network for Operational Managers and Leaders of provider Health and Care organisations. Established in 2017, born from a gaping void in operational development and connection, Proud2bOps was formed. Proud2bOps is a deliberately developmental Network, bound by its values and principles and innovative approach to leadership and operational development. We are a multi-award-winning network, and we are very proud of our members.

Proud2bOps has a firm and respected place in the design and delivery of healthcare, optimising the skills and expertise of over 1,300 senior operational managers within Community, Independent, Mental Health, Acute and Ambulance Trusts. In addition to National representation, Proud2bOps Regional Networks exist across the 7 Regions of NHS England: London, Midlands, East of England, Northeast and Yorkshire, Southeast, Southwest, and Northwest, and from June 2023, spread into Trust level Proud2bOps@ Networks. Successful spread and adoption at scale is a key driver for our Network.

Proud2bOps works in partnership with National Health and Care bodies, including NHS England, Department of Health and Social Care, NHS Providers and NHS Confederation. Proud2bOps is recognised as ‘the’ go-to Network for operational expertise, voice, and impact. It is accurate to say that Proud2bOps has built a strong reputation across the operational workforce and National Government bodies and institutes.

Strategic vision

Proud2bOps is an innovative and growth-minded network, where working in partnership and building reputable relationships is a core objective and pre-requisite for the Network. As a network, we have set ourselves an ambitious and exciting journey over the next three years and we are enjoying taking this forward.

In March 2023, Proud2bOps was successful in securing certification as a Community Interest Company, a goal that we set ourselves some time ago. We now wish to successfully optimise this position, and we know that we cannot do it alone. We are also aware that we don’t necessarily have the level of experience needed to progress our growth and impact.

We will, therefore, introduce a Proud2bOps Advisory Group. Our advisory group will play a pivotal role in shaping, contributing, and supporting the Founder and Chair of Proud2bOps and fellow company Directors. With your contribution, we will drive forward the ambitions and impact of Proud2bOps and ensure delivery and impact against our Strategic Mission, Vision, and Values.

Advisory Group Member 

Our vision is to have a collection of dedicated volunteer members who advocate for Proud2bOps and contribute to the success of Proud2bOps CIC. The support provided by group members will help Proud2bOps protect and support health and care operational professionals across the UK, ensuring members continue to have a positive experience of the network and our professional recognition. 

Proud2bOps has successfully maintained a safe, supportive space for members and our partners. One where members feel valued, respected, supported, and involved in the development of the operational profession. We therefore expect our advisory board members to equally support these conditions and do their utmost to add value to our members and the delivery of health and care services. In return, members will respect your values, needs and contribution to the Network. 


Through providing contacts, ideas, and expertise, you will help Directors achieve the Network ambitions. You will be a member of the advisory group which will act as an organisational forum to review, consider, and support Directors in leading plans, interventions and activities which support the growth and impact of the Network. 

You will provide your experience and knowledge, and act as a critical friend and advisor to the Founder and Chair of the Network and senior members of the Poud2bOps Network team. The group will be asked to take responsibility for meeting an agreed income target for the network, which will contribute accordingly to the agreed objectives and in-year plans of Proud2bOps. 

You will be accessible and supportive to the Chair and Founder of the Network, whom will actively seek to optimise your skills and experience. 

Commitment of Board Members 

  • Be an active member of the Proud2bOps Advisory Group, attending a minimum of 75% of scheduled board meetings-scheduled to meet three times per year. 
  • Act as a coach and mentor to the Founder, Chair, and Directors of Proud2bOps on an ad-hoc basis. 
  • Support the Directors to meet planned targets by assisting in optimising your contacts to identify and open opportunities that start relationships that add value to the Network and its purpose. 
  • Act as an ambassador and advocate for operational managers and leaders. 
  • Where relevant, to help organise events and/or activities that generate new income, business, and partnerships for Proud2bOps. 
  • Identify opportunities to invite relevant, high-calibre professionals to join the group. 
  • Endeavour to recruit a replacement colleague to join the group upon your departure. 
  • Open your contacts and networks to Proud2bOps and advocate on our behalf. 
  • Support event delivery by providing ideas and feedback on specific areas when required by Proud2bOps. 
  • Operate in a way that is consistent with Proud2bOp's vision, values, and underlying principles. 
  • Keep confidential information that is shared by Proud2bOps CIC and any network-associated business or events that are not available in the public domain. 

Our vision is that our new Proud2bOps Advisory Group members are a recognised partner and friend to the Network and that their intent to be a member is to support the operational and management profession and contribute towards the success of the Proud2bOps strategy.

Apply Now

To express your interest in this Advisory Group Member position, please submit your CV and covering letter to by 6th November. If you have any questions or require further information, please feel free to contact Penny at

We look forward to receiving your interest and how you will make a positive difference to Proud2bOps and our professional communities. 

May 12, 2023

No more silos–our survival and success depend on collaborative leadership and development, and we can’t start too soon. By Emma Challans-Rasool and Charlotte Williams

This is our third blog, and it finds us further ahead in our ongoing journey to understand why managers and medics struggle to lead collectively and with trust and transparency in the NHS today. In our earlier blogs we explored how well understood healthcare managers are[1] and how partnership working in practice can be hampered by learnt mindsets reinforcing professional differences [2]The huge response to these blogs indicates the topic has relevance to many in UK health services today.

Earlier this Spring, to explore this further, we hosted a Tweet chat with BMJ Leader, Proud2bOps and the Faculty of Medical Leadership and Management (FMLM).  Our aim was to hear more voices on these topics, focusing on good collaboration and collective leadership between managers and medics. We considered what it looks and feels like when we take responsibility jointly and equally, and what stops it happening more often, or more widely encouraged to build greater strength, rather than feeling like a compromise. Reflections included frequent lack of time, a tolerance of ignorance, and gaps in understanding of each other’s roles.

One of the medically trained participants in the Tweet chat noted there can be a presumption amongst clinicians that they have a monopoly on patient-focused care and patient safety, when in their own experience, the most patient-focused people they had met were managers. Indeed, much good management training (such as that provided by the NHS Leadership Academy[3]), is focused on understanding the experience and delivery of services for users, and safety-critical principles and systems thinking. Clinicians may fail to realise this; assuming incorrectly that managers have all been schooled with a corporate MBA or have predominantly financial skills.

We heard that the curriculum at medical school and role models early in a medic’s career didn’t always see managers as on the same team. It isn’t just in our early training – colleagues noted, and we would agree, that it is still true that managers and clinicians often face different pressures and have varying views of what “good” means – aligned to divergent measures in how performance is assessed and valued. Managers need to lead here too – it’s too easy to hide behind the furniture of structures and processes than to engage on a human level and understand one another. These themes led to some suggestions for novel personal and professional learning, for blended education. As leaders we needed to be more intentional in recognising our own gaps in knowledge, and the risk of such cultural divides leading to a lack of respect, but formal tools can help.

Our work on this theme has revealed that current educational and organisational development systems are not well set up for managers and medics to understand one another. Conferences and training programmes tend to specialise or be accredited within professional boundaries, or structured to accommodate particular working patterns, which limit wider participation. The Messenger Review[4] has highlighted the poor structure and consistency in leadership development and a need for more focus on collaboration, as well as greater recognition of the skills and professionalism of NHS management.

Let us step back and consider the development of operational managers in UK Health services.  Proud2bOps is a national network established to energise, connect, and develop operational managers and leaders.  As a network, Proud2bOps recognises that the greatest learning and development takes place in the spaces where people feel safe, foster curiosity, and regularly connect with multiple professionals to access operational knowledge and practical excellence.  Despite these spaces being well evidenced to be hugely beneficial, reality remains that those that need it most, often fail to access these impactful opportunities because of professional boundaries we have ourselves put in place, and which structures within the NHS and professional regulators can reinforce.

If we need better collective leadership and collaboration, in this time-poor world how do we teach this, and find ways to learn this together, across professional boundaries – what if we approached this differently? As leaders we all also know that our competence is our responsibility. If you are reading this, you probably also believe in keeping your knowledge up to date with new ideas and research. We see opportunities to harness our leadership and curiosity to improve the status quo.

FMLM and Proud2bOps would rather start with collaboration, avoiding isolated leadership development, and so working together they propose a novel upstreaming and real-time collaborative approach to learning and development, and are keen to hear from colleagues and systems who feel the same.

Upstreaming means providing learning development opportunities that involve both medical and management professions and insist on collective responsibility and presence.  Rather than separate routes for clinical and non-clinical professions, and then perhaps at a more senior level learning paths may join – if you are fortunate to have the opportunity. Deliberately development offers would prepare and solidify understanding, shared experiences, and improve visibility of collective leadership and responsibility between managers and medics.  Building on this principle, we would take forward implementation of the Messenger Review recommendations and co-design leadership and management standards and related programmes to be multi-professional and reliant on collaborative learning, mutual respect, and responsibility.

Real-time development means moving away from “parachute” interventions – coming in when either there is a problem, or we want a special programme to help a specific cohort of individuals to emerge with skills and abilities that will save the day. Instead, we propose a supportive, collaborative programme, where problems and issues are recognised immediately and ongoing as they arise, as shared and professionals are connected. Such real-time development would focus on knowing each other and appreciating difference through appreciation of values and motivations on all sides.

Formal development will help of course, but as leaders what stops us from sitting down with colleagues across the professional spectrum and taking time to check in and make sure all points of view are understood; that we really do have shared goals, and shared expectations of what these really mean. Start with your own education – start today. Spend a day with a manager or medic you don’t know (or one you do or think you do). Ask what is available in your organisation as formal training and development for medics/managers and join. As a participant in our Tweet chat summarised perfectly: actively seek opportunities to learn. Really go after what you don’t know. Be vulnerable in that space. Listen a lot. Invite people into a conversation. If you can, help. Really help. In times like these we cannot afford not to.

Join the conversation: There is more to come from us on this topic in the future and we want to hear from you. Join us and BMJ Leader in further conversations – let us know what you try, and have tried, and what works.


[1] “Managers value you; do you know enough to value them?” by Emma Challans-Rasool and Charlotte Williams – The official blog of BMJ Leader



[4] Health and social care review: leadership for a collaborative and inclusive future – GOV.UK (

January 25, 2023

Why are managers so often seen to be on the “dark side”, and who puts them there? by Emma Challans-Rasool and Charlotte Williams

Thank you for joining us in this second of our blogs that consider the current climate for NHS managers, why it matters and what we could all do to make things better. In such challenging times we must pull together to build hope, build solutions, build the future.

Our first blog was a provocation  – pointing to lazy perceptions of NHS managers “Managers value you; do you know enough to value them?”.  As managers ourselves, we aim not to seek pity, but instead to highlight the reality of how constant “manager- bashing” and scapegoat framing as to why our NHS is failing or is “flabby” and inefficient is impacting on your colleagues, core members of your team.

So, why is it important to call this out?  What difference does it make that these perceptions persist if they aren’t true? Surely professional managers put up with this as a peril of the job and are big enough to deal with it – and indeed most are, but why should we?

For some time now, managers have been the poor relative in terms of deliberate opportunities for consistent development and training.  In June 2022, the eagerly awaited independent report from General Sir Gordon Messenger and Dame Linda Pollard of leadership in health and social care[1] commissioned by the Department of Health and Social Care stated that management is a vital element to delivering quality care, whilst also recognising that managers are doing this in incredibly challenging times.  The report further reinforced the need for greater consistency and deliberate development opportunities for early and mid-career managers.  One may argue, something that the majority, of medical professionals have had access to for many years.

Frequently medical managers are given contracted job plan time for leadership activities when managers are not – for example dedicated time to lead a transformation project, or for clinical governance duties, could we consider job plans for managers in a similar way that quantified their contribution similarly? If not, which questions of equity does this raise? Is it because managers’ worth in health and care isn’t so immediately obvious?

Let us consider one of the most common, structures for managing a clinical division or care group in an NHS provider organisation–the triumvirate leadership model.  This is the traditional clinical divisional structure found in most hospitals, community. and mental health Trusts and is where accountability and responsibility, is intended to be shared and jointly owned.  What springs to mind here is the expression ‘work as imagined v work as done’.

Typically, the triumvirate leadership model involves the Clinical or Medical Director, often a consultant, a lead for Nursing, Midwifery or AHP peer and a General Manager, the all-round jack of all trades for finance, workforce, improvement, HR, planning, reporting and more a generalist in many cases.  Most organisations will cite their “clinically-led” model, with a clinician first among equals (and rarely a nurse/AHP), but if a clinical division is not delivering to plan, patient waiting times are increasing, the divisional budget is in deficit, equipment needs replacing, and agency use is spiralling.  Which role gets the first call, takes a list of actions, is chased for a plan?

Indeed, clinical staff will be under pressure, no one is disputing the workload and risks borne by clinical teams in caring for patients. This is not in doubt. The point here is that often in leading services, managers more than pull their weight, trying their upmost to recover the position, influencing colleagues to give up more hours they should be with their families and loved ones and they themselves taking home endless work to meet deadlines or complete reports and respond to demands of overseers that often lead to little response, support, or action.  These managers often are asked to step up on performance, on delivery, because they are seen as generally more responsible for failure, with no clinical credibility to fall back on, with “generic” skills that could and should be better.  And we try to, we never want to let our team and our patients down, no health care professional does. We care about them no less than people with clinical qualifications and roles.

It is true that everyone in the NHS is facing challenges, it is true that times are very hard, resources and colleagues are sparse and no one escapes these concerns. But let’s not assume that managers don’t stand front and centre, facing it head on as we must all do, or that they hide in the shadows, serving a different master. Of course, there are examples of authentic, collaborative, and shared multi-professional responsibility and more equitable, multi-professional programmes of development.  Yet we observe that this is rare and often true, equitable joint opportunity and consequence is sparse.

We discussed this topic at a recent session which brought operational managers and medical staff together (Proud2bOps/FMLM/BMJ Leader). It was roundly recognised in common practice that siloes of duties existed.  Together it was reflected that NHS structures may unhelpfully create a barrier to shared responsibility and accountability.  Managers care as much about the outcomes, safety, experience, and effectiveness of services for individual patients as we care about the productivity and timeliness of them across all patients. Managers must be welcomed in holding to account clinical leaders just as much as managers by clinicians. This makes for a healthy and productive partnership – but how often is this the case? How often do managers feel comfortable and psychologically safe in questioning quality of care?  We need to stop creating silo education and training and instead unite to develop and learn together, rather than in professional isolation.

Will you join us in standing shoulder-to-shoulder to declare how we share a common purpose, how much we learn from working alongside each other and how proud we are of each other? Will you work to build ways to develop and value our professional managers?  We need all three pillars of our triumvirates to be strong, we need diversity of perspectives and creative solutions to what seem insurmountable challenges and we all deserve and need the respect, investment and, recognition to keep doing the job that we all do.  Managers do not, and have not, chosen to be on the dark side, following a different mission – they are alongside you on the same path.

We invite you, health, and care professionals all, to take time to reflect and be mindful of those within your diverse team. Consider how opportunities and development resources are distributed. Think about when you last walked in a manager’s shoes or engaged them in traditionally clinical matters for their input.  We all need a share of the bright spots and sparks of joy and hope to thrive, no one should be left in the dark.

*In the first quarter of 2023 we intend to run a live tweet session in partnership with the Faculty of Medical Leadership and Management, BMJ Leader and Proud2bOps.  If you would like to be involved and receive further details of this session, get in touch with us:


  1. Health and social care review: leadership for a collaborative and inclusive future – GOV.UK (


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