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Leadership in the NHS – Professor Frances A Bu’Lock

Leadership in the NHS

Professor Frances A Bu’Lock

Professor Frances A Bu’Lock

Having been asked to write on this topic after given a talk at the RSM on innovation (managing our little patient with ectopia cordis), I was a bit flummoxed. My leadership? other people’s leadership? What is leadership? I don’t really usually think of myself as a leader but I guess as an NHS consultant, it’s pretty much part of the job description. I do also like to follow though; I play the cello and get a real buzz out of trying really hard to be part of something much bigger where we all follow the conductor (and the music) as best was we can to create a beautiful sound.

I’ve not been on any formal leadership courses other than as a Girl Guide; which seemed to involve a lot of odd tasks in the dark, and was probably more about team working really. Maybe I should have done; might have saved me from quite a bit of trouble?!

I grew up in a house full of bright and opinionated people, the ‘cut and thrust’ was probably a good preparation for many aspects of NHS life but not for learning to tolerate the foolish.  Studying in Cambridge and Oxford was a privilege and undoubtedly contributed to my facility to question and ‘push the boundaries’. My first forays into the less academic world of hospital work taught me that a question can be perceived as a threat rather than a request for information. Oddly, that was a shock I’ve never really quite got over.

So where has the leadership come in?

There is leadership in patient care; not just in telling people what to do but in getting other clinicians and team members to think for themselves about what is needed, to teach the knowledge and skills to make and implement decisions, and enable patient care to progress. There is leadership in teaching; both didactic, by example, and sometimes by inspiration. ‘Encouraging’ colleagues to believe that little bit more in their own skills, capabilities and themselves. Sometimes it needs a bit of plain speaking and sometimes that can backfire. Humour often helps. But even that can be double edged; irony doesn’t always hit the spot when English isn’t everyone’s first cultural background.

There are battles to be fought in the NHS. I’ve spent the best part of 15 years striving to ensure my congenital cardiac unit retains its surgical programme, against those who thought they knew better or had differing agenda. I’ve had to lead in different areas for this; not just clinically but with ‘paperwork’, public opinion (the media, politicians & stakeholder groups) & endless ‘meetings’. It’s tiring and you realise very quickly that more than one leader is needed… having an inspirational, active and astute Chief Executive added an additional level of leadership learning I haven’t experienced before and from which I can certainly learn more.

My patients and their parents remain my strongest inspiration and motivation; sharing their lives and watching them (usually) grow and develop is a privilege that as yet hasn’t grown old.


Professor Frances A Bu’Lock (MD FRCP) is an Honorary Professor in Congenital and Paediatric Cardiology at the East Midlands Congenital Heart Centre and University of Leicester Glenfield Hospital 



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