This episode of Leadership Insights shares the insights of three leaders who overcame imposter syndrome and the tools and techniques they use to lead during complexity.
- Dr Christian Hosker, Medical Director with Leeds and Yorkshire NHS Foundation Trust
- Laura Neal, Deputy Director of Nursing with the Isle of Wight NHS Trust
- Rachel Oster, Centre Manager and Registered Occupational Therapist working in Social Care
Speaker 1 Jeremy [00:00:07] Welcome to Leadership Insights. This podcast features interviews with people across the NHS and highlights insights and practical techniques for current and potential leaders. My name is Jeremy Kourdi, I write about leadership and I work with leaders. And in today’s episode, we look at the closely related challenges of learning and leading in the NHS, especially during times of challenge and change. Our guests will reflect on the insights they gained from the NHS Leadership Academy and we’ll be asking two questions. First, what are some of the tools and techniques that have helped you during periods of change and that you would recommend to help others? And secondly, what have you learnt from participating in the programmes with the NHS Leadership Academy? As you listen to our speakers. It is worth asking yourself what are the areas where my leadership could improve. Joining our discussion today are three fantastic leaders from across the National Health Service. Laura Neal is the Deputy Director of Nursing with the Isle of Wight NHS Trust. Rachel Oster is a Centre Manager and Registered Occupational Therapist working in social care. And we’ll hear first from Dr Christian Hosker. Christian is the Medical Director for Leeds and York Partnership NHS Foundation Trust.
Are there any insights or learning or tools and techniques that you’ve come across in the last couple of years that have helped you during times of challenge or change? Christian, what would what has helped you? What could you recommend to others?
Speaker 2 Christian [00:01:42] Yes. So, we’ve all had this experience that we’re going to have again. And so, I think we should reflect on that. If people aren’t reflecting, that’s certainly something to do. What I found was that when the pandemic arrived it turned everything on its head and obviously it’s had some horrendous impacts, and you know, whether that’s people actually dying or the impacts on society at large. But there was something about the clarity of purpose at the time, where a very complicated NHS system had to focus on a single problem. That was the number one priority at that time, and that felt very different actually. Things were possible that would normally take a long time to sort out and I can remember feeling quite enabled to make quick decisions and all the rest of it. The reason I mention this is because that’s at a particular point in time and you know, needs must at that time and there was a particular reason why that happened. But that’s not business as usual and life’s not always going to be like that.
And so, something important, I think about the mindset change that we need to start making, actively making away from that command and control action and less collective mindset that was in operation at that time and is still in operation because we’re not out of it yet. To think in the longer term how can we continue to reset back to getting a collective leadership mindset around some of the major challenges that we’re now left with or the major challenges that were already there anyway. So, being brave enough to take that step from that very structured approach to being able to make decisions to actually step back now and thinking well, we’ve got challenges we’re facing which none of us as individuals know the answers to. There’s no way that I know how to solve some of the issues that are ahead, so I shouldn’t pretend that I know how to do that so, we’ve got to make sure we’ve got enough voices at the table so that we can really think of some innovative ways of solving things.
So, I am mentioning that in terms of that I felt I learnt something about myself, about how in a way that could feel quite exhilarating, that absolute clarity of purpose and being able to make those quick decisions and I don’t want to completely let go of that because I think there’s something about, again a lesson to me about how if we can make things clear we should do. So, that those things that ought to be clear or as a leader you should be articulating and making clear to people we should definitely do that because you could see how effective that was at the start of the pandemic. But, the other learning thing is probably, and again, you know, this isn’t anything new, but it was very obvious, I think, during the pandemic about just thinking about the impact, what that impact we as leaders can have and how that can take its toll on other people. So, it’s just making sure that the various dials that wish to make the change, is tempered by the other dial, which is what about the people that are doing that change or are left with that change. And what about their wellbeing? And how can we continue to make their day a valuable day? And make sure they still want to come to work so, there’s definitely something about that.
Speaker 1 Jeremy [00:06:04] What are the top three tools or techniques that have helped you through difficult times or periods of change? And what would you recommend to help others?
Speaker 3 Laura [00:06:14] I think the first one would be the moral compass. I developed this in the Action Learning Sets and group, and that was to keep me central. Central in what I do always. And that is patience, team, organisation and self. So, if I am centred in all of those that keeps me positive and resilient. And to do that and to align to my purpose, I need to, when I’m looking after myself that’s the exercise, I’ve got to keep mentally resilient and keep patients for me close. So, I need to go and talk to patients. I need to be able to talk to staff as well on the frontline. I can’t be so removed, so these things will really help me. These are techniques that help me. And I know I love knowing what matters to patients and that that keeps me grounded from the floor to board. Again, I want to know what’s happening with the staff. So, what matters to the staff? And the only way you do that is by getting out of your office and going to talk to patients and stuff. I also meditate. I’ve really got to plan my time to free up time to innovate so I can be creative. I have a creative side that for me, you know, if I want to remain positive, I’ve got to keep to all of that sorts of spiritual aspects that make me whole. The other ones are behaviours. So, the first one for me was a moral compass, but the second one would be behaviours. And one of the tools and techniques that I learnt at the NHS Leadership Academy was something called BOFF, BOFF is the acronym for behaviour is the outcome of it, the feelings and then feedback and how that affects others. So, we’re going to be dealing with people who are compassion fatigued as we discussed earlier. They’re not quite who they would be ordinarily. And so, this helps me understand, what are the behaviours, keep me centred then take a step back and see what are the behaviours that are affecting others. What could be the outcome of that behaviour, feedback from you and others to learn from that, on what you would agree to do in the future? And then the third one for me would be to continue to do your 360 reviews. So, to have that facilitated support, the NHS leadership Academy support doesn’t just stop when you finish your course, continue it. It’s been great for my continuous development and confidence as a leader and to keep holding that metaphorical mirror up to myself, to adapt.
Speaker 1 Jeremy [00:09:08] The recent and ongoing challenges facing social care in the NHS are well known, but I’m keen to understand perhaps the top three tools and techniques that have helped you overcome some of these challenges, some of the most significant challenges. What are the tools and techniques that have helped you and that you would perhaps recommend to others?
Speaker Rachel [00:09:29] So use technology to your advantage. So, in the pandemic, we have gotten to grips with technology much faster than we would have done. And I think, you know, learn about all the different tools depending on what your organisation is using. I found some amazing tools, Google Jamboards and Mentimeter, and these are tools which are really fantastic for remote engagement with teams. It’s a way for people to give anonymous feedback, respond to presentations or questions in a live environment. And the learning that we’ve got from using tools like that to really get to the heart of what matters to people, what their concerns are, giving them a safe space to kind of contribute. And people sometimes own what they say, but sometimes they don’t. Sometimes they want to share something so that you know about it. And I’ve seen technology really harnessed for good during the pandemic. It’s connected us more. It’s given us more opportunity to engage, and it’s better for the planet as well. Quite often when we’re meeting in a more efficient and effective way online. So, technology would be one of my learnings. A little technique that I’d like to share that I feel is really useful is time boxing. So, I don’t know about you, but I have a really long to do list and it’s so long it’s quite overwhelming and it’s quite easy to get a bit paralysed when I stare at it in the morning. So what I’ve taken to doing in my calendar is boxing out time and that’s just quite simply where I box out an hour however long, and I pair that with an activity or goal and I just do a really focused piece of work and you know, it helps me to keep that boundary, just do it within that time, but also just prioritise my working week. So, for anyone who wants to tip around using their time in the day and using their email to kind of set up those boxes of time. I find that really effective and I think I mentioned coaching before. I think asking good questions that help people to discover their own solutions is brilliant. And I think when people do that, they own it for themselves. So, those are my top three things coaching, technology and a little simple strategy around focusing your time.
Speaker 1 Jeremy [00:11:51] To highlight some of those messages. I really like the emphasis on the need to be clear about you and your team’s purpose. I was also struck by the need to stay centred and look after yourself and to recognise where you could improve. And of course, consistently highlighted was the need to work collaboratively and support each other.
Our next conversations highlight insights from the NHS Leadership Academy. We’ll hear from Rachel Oster and first Christian Hosker again. You’ve participated in a couple of NHS Leadership programmes. How were they? What did you value about those?
Speaker 2 Christian [00:12:29] Well, what drew me in in the first place as a doctor as that’s my primary profession is being a clinical doctor and I find myself taking on more and more leadership positions. But without, you know, I’m very grounded in the world of medicine and what being a doctor required but didn’t have any formal training on leadership. Small bits here and there to perhaps wet the appetite but nothing that felt like a framework to fall back on. So, that leaves you in a position where you have to think what it feels like to lead in this way, or to be making decisions in this way or to be thinking about change in this way. Perhaps there is another way, perhaps there is other stuff I should be doing, so, want the comfort and perhaps the confidence that would come from having a framework on which I could lead with it.
So, that’s why I’ve really enjoyed doing the leadership courses. The NHS Leadership Academy stuff has worked really well because the initial one, the Mary Seacole, was quite involved, actually and gave a bit of a glimpse of the theory and the Elizabeth Garett Anderson really went into a lot of the theory and evidence. It made you sort of step back, whether it’s the kind of more practical stuff or the actual writing about it, you had to step back and look at the evidence and think about how it applies. Everyone is different but to me, that was kind of fascinating. And I’m sure it’s the same in any industry but healthcare is particularly complicated. And I think you really need a real repertoire of leadership skills as well and it opens you up and lets you see different approaches and different ways of leading.
And also, I think a really powerful thing is the ability to connect with other people in similar roles and hear about their problems and challenges. It’s makes you realise you’re not the only person struggling with pretty similar issues that come up time and time again. And so, I think, doing Action Learning Sets and doing tutor groups and just rubbing shoulders with people that in the day-to-day and organisational stuff in my Trust I would be like in contact with. We’re all in a bit of a bubble and very much focused on the same problems. So, it’s just nice to have conversations with people that are in a different branch of the NHS even in non-patient-facing roles for example. What I liked about of course and we talked about this on the course is getting you out of your comfort zone and forcing you to stretch a bit. So, for me those bits where it’s more of a stretch was probably about turning theoretical thinking about stuff into a real kind of impact and change and taking that additional step. Just wouldn’t it be nice to actually, let’s think about how we can actually change this?
I mean, having said all that, I think it’s iterative that probably why I’ll struggle to answer this question is because the course I think is iterative. Well, I think it’s designed like that I think to have a gradual change.
So, previously when I reflected on this similar question, I kind of struggled and think well, was I already thinking like that before the course? Or did the course open my eyes to it, I think it’s probably a combination of those things? The importance and the opportunities that a diverse workforce can provide, for example. So that’s a real thread that goes through the Elizabeth Garrett Anderson course that I wouldn’t have been aware of that before doing the course. But I think it’s the fact that it provides you with the opportunity to really talk about that, to look into the evidence and the theory about that and to write about it. It just takes it to the next level, and I think that sets the cycle for intent as well. Where you are more motivated to actually make some change connected to that? So, yes, that’s probably the best way I can sum it up, I think.
Speaker 1 Jeremy [00:17:22] Thank you. That’s a great answer.
What have you learnt from participating in the programmes of the NHS Leadership Academy?
Speaker 3 Laura [00:17:32] Well, a wonderful journey. One that, you know, I look back in fondness with on the NHS Leadership Academy and for me the really practical bits where I learnt how to weave new skills of leadership, not just improving myself, but ultimately, what does that mean for patient experience? I thought I knew a lot. I didn’t. It really took me back to a place that is at my heart and that’s the patients. I learnt how to weave the key golden threads, get back to purpose, patient experience and being central in a world of complex systems and constant change. And what that meant. It equipped me with more confidence in leadership. I definitely had imposter syndrome before I went to the academy, so I have more belief in myself and others and what a great gift to give to somebody. But also, a deeper understanding of equality and diversity and values-based leadership and to listen, learn and gain further understanding. I’m really around other people in the team understanding the diversity in the team and that somebody might think a little bit of difference to you. We don’t all think the same. The personal impact, it helped me drive and build a foundation of things. I’ve been brought up in a world of management consultancy but never really sort of utilised all of the tools but the Elizabeth Garrett Anderson programme with Michael West package and really brought out a great love for organisational development for me and building on inclusive teams going forward. The research within leadership and enabling decisions. So, pulling together the best scholar’s work so that’s Michael West’s work and others.
Also, learning from other sectors is something I love about the course. Learning about what the army does for teams, learning around how to put that into context and also sort of learning from like Marks and Spencer’s, Coca-Cola and taking it wider. And ultimately, I think the biggest thing was what is it like being on the receiving end of me.
Speaker 1 Jeremy [00:20:02] I really like the idea that learning is a journey and it never ends. Other themes that stood out for me were the importance of learning as a way of shifting mindsets. It’s not only about developing skills, but about shifting the way we think as well, and the fact that learning is essential for succeeding in a world of change. It’s personal, and it improves our openness and our ability to listen, to understand and to improve. Learning and questioning really go hand in hand. And I love the question, what is it like to be led by me?
The last word goes to Rachel Oster. What has been the most significant learning for you in the last year?
Speaker 3 Rachel [00:20:43] I think what’s the most significant learning has been overcoming my own self-doubt. I think getting on the course and being with a group of leaders, you can’t help but feel a little worm in your brain. Am I as good as these people? Like, should I be here? And for me, I found the course really helped me to realise my own potential, realise that I had a whole set of skills and experience and abilities that I could bring to that course that I could share with others. And a pivotal moment for me on the course where it really clicked was when we did the 360 exercise where we got a group of people that we worked with to comment on us as leaders and individuals. And I deliberately was brave and chose a mixture of people, some who I knew would be my number one fan and some who I thought when they might not be my number one fan but I want to hear what they’ve got to say. So, I’d encourage people when undertaking that exercise to actually feel a bit uncomfortable with that list of names, because that’s really good. That will give you a really good reflection. The feedback I got blew me away. Like I think I was quite tearful when I read my 360 because one of the comments was that I just needed to believe in myself. And, you know, I knew that everyone else was saying my potential and I just needed to really take that on for myself and have that belief that, you know, leadership is right for me and it’s good for me to be myself and be authentic because only I can do that. And you can read loads books. You can read loads HBR articles. But really, I think it boils down to just being yourself and letting it flow through you. And after the 360, I took on some coaching. So, we have an in-house coaching service which is brilliant in my organisation. I met with a coach and I said, look, I’ve struggled with self-belief. This is my 360, this is my experience. I really want to take this forward and understand how I can unlock that further in myself. And I had probably had about three or four coaching sessions, which were absolutely brilliant, and it really helped me to crystalise things and just take the leap, really. And I ended up applying for the job that I’m in now, which was a significant promotion. And, you know, I don’t think without the course, without doing that 360, without exposing some of that fear within me, I don’t think I would have done it if it hadn’t been for the course. It was kind of the push that I needed to do it. And I did want to mention that I think women can be really vulnerable to feelings of imposter syndrome, and I don’t think that we should be. I think in some ways that’s a bit of a societal construct, and I just think we need to trust that we are equally as good as everyone else and to go for it and not let anything hold us back. I think that’s really important. And I often go back to my 360 when I need a little boost on a down day, a hard day, and just take in those comments in terms of what other people have said about me. And the programme has given me a brilliant opportunity to do that.
Speaker 1 jeremy [00:24:18] Really thoughtful comments from all of our guests. What stood out for me, for example, was highlighting the value of feedback, the need to be authentic, to be yourself, and the importance of developing your confidence, starting with a clear view of your strengths and those areas for development. I did also like that idea that we could take more of a strengths-based approach to development. It’s not just about fixing a weakness, but development can also be about moving from good to great. Finding ways to make your strengths world class. And that’s a great way to finish today’s episode. My name is Jeremy Kourdi and I’ll see you next time for more Leadership Insights.