Catherine

Chief Executive, Leicestershire County & Rutland PCT

What kind of business and personal qualities do Gateway graduates need?

I'm certainly looking, when I see people coming off the scheme, so see that they have got a degree of maturity and self-assurance. They would need to have good interpersonal skills particularly in terms of influencing and negotiating with people.

What kind of skills would you expect Gateway participants to show?

I would expect people that I see coming off the scheme to have a degree of maturity and experience, to have a lot of confidence in themselves. They need to have good interpersonal skills because they're certainly going to be getting into some difficult negotiations with a range of different professionals, and they need to be flexible because of the wide range and diversity of roles that the PCT has.

What would you say to any chief executive thinking of taking someone from the Gateway programme?

I would say to a colleague, a fellow chief executive, that it's really worth investing in having a Gateway entrant. They do bring skills that people who are trained and developed within the NHS don't have and because of that they bring some innovation and some challenge to the management team.

How do you see Gateway participants fitting in with existing managers?

The NHS is about to go on this journey to become, for PCTs at least, world class commissioners and that involves us operating far more as an insurer than as a traditional NHS organization. I think the skills that the Gateway people bring in are really, really relevant for that future vision of PCTs.

Why is the programme important for the future plans of the NHS?

Currently we are spending quite a lot of money on external management consultants to bolster up the gaps, both in capacity and capability. To be able to bring in our own people and have that really fabulous blend of someone who brings that external experience but can learn about the public sectors and it's values; I think it's a really good investment for the future.

Jane

Chief Executive, Leicestershire County & Rutland PCT

Where were you before you joined the NHS?

Before I joined the NHS I did a science degree originally and then I came over here from New Zealand and I really wanted to get into publishing. So I got into science publishing, worked for some commercial publishers, and then I ended up moving out of commercial publishing and went to head up the publishing operation at the Natural History Museum, which was fantastic fun. I really loved it there. I wanted to stay in that not-for-profit sector and so I ended up going to the Welcome Trust, which is a big biomedical charity. I headed up their publishing group for about 5 years and thoroughly enjoyed that. I did a whole range of different things besides publishing, and that was really what got me interested in taking a change of direction.

What were your major achievements?

One of the things I enjoyed enormously was reinvigorating the whole publishing programme at the Natural History Museum. When I arrived they'd sold off all of their back list, got rid of most of the staff, had virtually nothing happening, and then after four years we had a whole range of popular books for children and adults; we had fantastic references books that were really beautiful using all the images from the library; and we had re-launched the academic journals and reinvigorated that programme. So it took a lot of effort but it was a really exciting sort of team approach, and I think that's one of the things I particularly enjoy - helping a team to achieve things.

Why did you apply for the programme?

I started enjoying more and more the things that I was doing outside of publishing, so I thought 'time for a career change'. I decided to move outside my little pigeon hole of being the expert in publishing and to take much more advantage of my general management skills and try and explore all these areas I was getting more and more interested in.

What's your role here?

I'm at the hospital here and I manage the Governance Team. The team itself is about 16 people and we cover a range of different areas of regulations. So, research and development, risk and health and safety, patient safety, clinical audit, customer care, complaints management, all the way through to litigation and legal services.

How have you found your role so far?

Well to be absolutely honest when I was first told the role that might be available to me here, I wasn't that excited about it. It sounded very different from what I had done before. I was always the person in the office who didn't want to fill out their risk assessment forms and who didn't want to have to do all the formal beauracratic processes! Now I'm here I'm fantastically enjoying my role because it stretches across the whole of the organization. I get to dabble in all sorts of different areas and yet I'm sitting outside them. I've also got some really exciting initiatives around patient safety, improving outcomes for patients and looking at patient experience, which I think are fundamental to the whole organization. That I get to lead and influence those is a fantastic opportunity.

Is this the first time that you have considered moving into the public sector?

Well I moved from the commercial sector to the not-for-profit sector about ten years ago, and I loved the not-for-profit sector and definitely didn't want to move back into commercial work. The public sector itself wasn't necessarily the appeal for me, I think I'm definitely motivated by people who are working because they believe in what their organization is trying to do, rather than being motivated by the bottom line, and that's shared by both the public sector and the not-for-profit sector (more broadly). I've been fantastically lucky in working with people who really are highly motivated, committed, believing people, who want to make a difference, and I wanted that part to continue.

How did you get your role?

I applied to the Gateway scheme because I it looked interesting, but I really didn't know much about it. You kind of go through a couple of online assessments and they're quite fun, and then you get to the assessment day, which also seemed fun in a completely different kind of way. I think I enjoyed the fact that I was being successful without necessarily thinking about all of the consequences of where I was going. But the more I got involved and the more I met people, the more interesting it seemed and then you finally get to the point at which your told ‘yes, you've made it through', and then it starts feeling a lot more serious.

What advice would you give to people going through the process?

I think once you get the point where you've been accepted and you start looking for jobs, it's really important to ask as many questions as you can, particularly of previous Gateway candidates. You need to take time to understand exactly what a job description means because you probably know very little about it from outside the NHS. Find out about the organization that you might be attracted to, make sure that your chief executive is well respected. Find out what the culture of that organization is like. Ask lots of questions about the different parts of the NHS, should you be in primary care, should you be in secondary care, and really investigate that as much as you can. I've been really lucky and I'm delighted with the place I've ended up in but not everybody does feel that comfortable in their first ‘setting', and it's so fundamental to helping you survive your first few months.

Tell me about the orientation process.

I've been fantastically lucky in my orientation. I had a 2-month induction where I learnt a huge amount about the organization and how it works. I met lots of people who were really friendly and open, and it was a fantastically useful experience for someone who'd never ever worked in the NHS before. Everybody at times feels a sense of frustration at not being able to get on with things but my advice would be relax and enjoy that because it stands you in fantastic stead later on. It's just enormously valuable to have those contacts, to have that base level understanding of how things work.

Tell me about networking opportunities.

The programme offers you fantastic support primarily from the other Gateway candidates, so you get together on a regular basis with them. As you get to know each other better, you start keeping in more regular touch in terms of email contact and so on. It's a really challenging experience entering this whole new career at a reasonably senior level and so you need that support. You need to know that what your experiencing is not unique to you, that there are other people experiencing all those same challenges and just hearing that and exchanging stories is really beneficial. You also get a chance to network more widely and some of that depends on how good your local support systems are. Once again we're very lucky here that we get fantastic support to do lots of different things. The NHS seems to be all about networks and contacts and so I would encourage people to take as much advantage of that as they can. We get to meet some very impressive, hard-hitting, high-powered people in the NHS, and having that exposure to those senior visionaries is also an amazing opportunity and one you wouldn't get entering most careers.

Julie

Senior PrograImme Manager

Where were you before you joined the programme?

I've spent the last 16 years working in local government. I was at a small district authority and my last job before I came into the NHS was as Head of Leisure and Youth Services for the council. I was responsible for all the cultural and leisure activities and all the services we provided for young people.

Why did you decide to switch careers?

Basically, I wanted to progress professionally within my local authority role, however the opportunities in local authority are very scarce once you get higher up the grades in terms of seniority - but I didn't really want to move my family and relocate to another part of the country. I wanted to make a change to continue in the public sector, which is where my background is, but to work in an organisation that has more opportunities and the NHS is obviously the biggest employer in Europe. They have plenty of opportunities and there are many different management streams within the NHS, so I knew that my skills (which I had developed over the time working with the government) would be applicable and would stand me in good stead. So the opportunity to be able to take a complete career change at that point, with no previous knowledge or experience of the NHS, was made possible through the Gateway programme. Such an opportunity doesn't really come along in many other fields. It has allowed me to continue working at a senior level, and with the opportunity to progress into a more senior position in management within public sector was the key reason for me wanting to make the change.

What has the Gateway to Leadership programme enabled you to do?

Well it's enabled me to come in and hit the road running, in terms of working within another sector, within a new organisation and it's enabled me to come in with a level of authority to deliver projects well within my capabilities. It gives you the gravitas to come and do that within a different setting and a different organisation.

Where do you see yourself in the next 5 years?

It's difficult to say so early on in the Gateway Programme where I'll end up in the next 5 years because Gateway does provide plenty of opportunity to move around and experience lots of different areas. We're being given the opportunity to shadow and work in different organisations whilst working here within in the Trust. There's an opportunity to go and work within the SHA and to go and see what happens in the PCTs. So I think the future will depend on the experiences I'll have over the coming months, and where I find the area that interests me the most.

What challenges have you faced?

I think the NHS is a very unique and complex organisation. Coming from the public sector I thought it would be very similar but it has its own very distinct character and challenges from the management perspective that you can't underestimate, especially as you have the clinical side of the service along with the managerial and the constraints. But it's a very public facing organisation. Its people that we're really dealing with, and the drivers (in terms of the hospital and the NHS in general) are very different to those I expect you'd find in the commercial sector. The challenge is bringing around change and improvement when the drivers for change are very difficult to articulate. This is because it's a very large and complex organisation and to bring about change you are really working through people rather than financial performance. It's a very challenging environment and I am sure my management skills will develop as a result of working within the NHS.

What advice could you give people starting the process?

The advice I'd give anybody wanting to come on to the programme is to find out as much as possible about the different roles that are available to them within the NHS, and to really understand what those roles involve, so that you can steer your placement accordingly. Try and speak to people who have been on the programme. There are some very common themes coming out in terms of the experiences that we've all had and it's useful for people to get that background.

Tell me about living the NHS values.

In terms of the NHS, I think what makes a difference to me coming to work is that, at the end of the day you're really helping people improve the quality of their lives. What fascinates me is the diversity of the patients and visitors that come into the hospital. Since I've been here in particular, personally I have a friend who has been diagnosed with cancer and being part of something that's helping them improve their chances is what it's all about. Working in the NHS is very important to people.

Alex

Divisional Manager, Emergency Division

What were you doing before you joined the Programme?

I graduated in engineering from university, I spent a year teaching in Le Soto in Southern Africa, and then I joined Esso (or Exxon-Mobil), and I worked on an oil refinery at Fawley near Southampton for 13 years. During that time I did Economics and Logistics, a lot of day-to-day operational management of the refinery and then I joined the NHS about two and a half years ago.

Why did you apply for the programme?

I think there were a number of reasons. Partly, I'd never aspired to work for a multi-national oil company for my entire life and make lots of money for the world's biggest company. It was something I'd done, I had an engineering background. I wanted to go and get experience and training and personal development, and I had been keen for a number of years to move into the public sector or the not-for-profit sector. There'd been this underlying desire to do that. I'd been promoted as high as I could go in the UK and the company had been pushing me for a number of years to go to Brussels or the US and for family reasons that was going to be very difficult. I wasn't happy to just stop there. I wanted to be in a position where I could progress, so I was looking for an organisation where there would be progression opportunities but within the UK. The NHS is the biggest employer in the UK so I felt pretty sure there would be plenty of opportunities.

How did you come to apply?

I saw a national advert for the Gateway Programme in a National newspaper and I was really excited because I had been looking for ways to get into the Public sector at an equivalent level to the one I was operating at in Exxon. It was very difficult because lots of things require you to have knowledge and experience of the public sector as opposed to just a set of transferable skills. Also, I'd worked for Esso for 13 years so there was a certain amount of confidence issues as to whether or not I could make the transition into a completely different organisation.

What did you gain from being on the Gateway to Leadership Programme?

It's been fantastic, I mean in the short time I've been here I started off in a project role delivering a range of organisational and development projects, and physical projects. We closed three buildings external to the hospital and moved over 100 people into the main hospital building. It was fascinating. I got to know my way around the hospital; I got to know a huge number of people around the hospital- not always in the best circumstances because quite often I was knocking on their door saying: ‘You know you've got this big office, well, two more people are joining you in it!' But it was a great way of getting to meet people. It was a great project in terms of having a clear deadline - we needed the building empty by the end of March; it was clear whether or not we'd succeeded or failed. We succeeded and I got a reputation as someone who could deliver projects and meet objectives so that was great.

I then went on to become Head of Governance, which was fascinating because ‘governance' wasn't really a word I'd used before It is often a clinical professional who becomes Head of Governance because it's about clinical standards. One of the things I thought I bought to the service was that in the oil industry we'd been very concerned about quality and safety and we had lots of systems to ensure that safe and high quality products were produced, and I didn't think some of the systems in the NHS were as robust as the one's we'd had in the oil industry. So it was great to bring that new perspective of how you can improve safety and quality. I did that job for a year and a half and now I am the Divisional Manager of the Emergency Division. It's one of three clinical divisions in the hospital and I'm in charge of Emergency Department, A & E, Orthopaedics, Elderly Care, Radiology, Therapies, a whole range of medical specialties, and it's just brilliant… it's great!

How much has the Gateway Programme helped you achieve your goals?

For me there are a number of benefits. There was a real benefit of the peer support. I was the only Gateway person here when I started and being able to go off and meet with other Gateway people on the modules and talk to them about their experiences was really helpful. The actual training modules we did were also excellent and in many ways it wasn't long until I felt like I knew more about the broader health economy issues than many of my colleagues who had worked here for many years. I was getting the perspective of the Chief Executive of the NHS; we had a module on International Health Care Systems where people came from around the world to talk to us about their health care systems; we did a module on Westminster and Whitehall where we learnt about Health Policy is developed and then implemented. All that was fascinating, it was really helpful and accelerated my learning about what the Health Service is for and how it operates. Also, as part of the Gateway Learning Scheme, we formed “Action Learning Sets” more locally. There's a group of eight of us who get together and meet every couple of months, and we just bounce things off one another about what's going on and it has two benefits: it's really useful to be able to hear other peoples perspectives on issues I'm working through; and I learn heaps about the Primary Care Trusts, the Mental Health Trusts and the SHAs, from those people.

Where will you be in 5 years?

I'd like to be on the board of an NHS Organisation. One of the great opportunities that the board here has given me is attending board meetings, spending time with the non-exec directors and the executive directors, and understanding what their roles entail. Certainly that is something I would like to do. I've been in an acute trust for the last two and a half years. I had six-month secondments to the Strategic Health Authority just doing a day a week for them on a patient safety initiative, and that gave me a fascinating insight into the SHA. I had an option to apply for a job there rather than come back here but I really felt my background was in operational management and wanted to prove to myself that I could do operational management in the NHS. The acute sector is where I think real operational management is most relevant, but I would like to see some other organisations like PCTs, SHAs, or Mental Health Trusts or perhaps an Ambulance Trust, just to get a more rounded picture. But certainly a board level post in 5 years.

How has the Programme added value to your NHS experience?

There are lots of benefits to joining the NHS through the Gateway to Leadership programme as opposed to just applying for a job. It's given me a network of people around the country, in many different types of healthcare organisations, which has been really helpful in terms of a depth of knowledge and understanding about how the health economy works. Having come in fresh with no NHS experience and being given a job with real responsibility, access to the board, the chief executive and the non-exec's – it has all been really helpful. The way the Gateway Programme encourages people to go and find a mentor and to form Action Learning Sets - all of that is been very positive and would be harder to do without that structure around you.

Compare the NHS to your previous employer.

One of the biggest differences is the professional hierarchy. It's just more complicated. You have doctors, and nurses, and physiotherapists, a whole range of professionals who all have a very strong allegiance to their profession which often trumps their allegiance to the organisation and that makes management really interesting because it's not as if everyone sees themselves clearly as a member of your organisation above all. Often they don't. Even a member of the NHS isn't as important as the fact they are a nurse, a physiotherapist or a doctor. So that's quite interesting, to ensure people do work in a multi-disciplinary way. For a long time the NHS has worked in multi-disciplinary teams but you just feel the difference from the private sector. In terms of values, I feel that staff are more wholly valued, there's certainly more opportunities for flexible working. One of the things that amazed me when I first arrived here was that a member of the board worked four days a week - I could just never imagine someone in Exxon who was board level working any form of part time or flexible working. That was a real inspiration that they actually understood work-life balance issues - that's quite a difference for me.

Mark

Chief Executive, West Midlands Commissioning Business Support Agency

What are the biggest challenges in the NHS at the moment?

The biggest challenges are all the changes that are going on and the uncertainty that this creates - it's an enormous but very exciting agenda. We're trying to keep the organisations delivering great quality services and also really focusing on the patient and what difference we can make to the patient experience. With everything going on, that can be quite difficult and sometimes we can lose sight of the patient.

How would you rate the quality of Gateway participants?

The quality of the participants has been absolutely brilliant. I think the NHS has gained a great deal from the Gateway Programme and the skills that we've brought in from other sectors - I think that's a real testament to the programme.

Why are people attracted to the programme?

The NHS is a great place to work. I think that people who have joined the programme think they've got some value to add to the organisation and I think that's one of the greatest attributes of the programme.

What kind of qualities would you expect from a Gateway participant?

I think people need to be very resilient. They need to be very tolerant and patient. They need to be highly intelligent, and need to be able to deal with really complex issues, which the NHS certainly has in spades. We're looking for people who get on well with others, who are good team players, understand where the NHS is going and have a real value set that they feel they can contribute to a public sector organisation like the NHS.

What would you say to another Chief Executive thinking about employing a Gateway participant?

I'd absolutely encourage them to do so! It's a great programme and the skills you get from the people you employ are great. They go through a really difficult and rigorous process to get a place and because of that we get really, really high quality people who are very good at hitting the ground running, bringing new ideas into the organisation and progressing very quickly through a career path. This means that the NHS gains a great deal from the programme.

Why is the Gateway Programme important?

I think it's important because it brings new skills into the NHS. We're a constantly changing organisation and as a culture we need to adapt and adopt new ways of working. Bringing new people in through the Gateway Programme brings new skills into the NHS that we really need and really value.

Mary

Chief Executive, West Midlands Commissioning Business Support Agency

Give me an outline of your career to date.

I'm a nurse by background; I trained not only in Nursing but in Research and have worked in all levels at the NHS from hospital through to the Department of Health. I've been in this organisation for 13 years, firstly as Director of Nursing and then I've been Chief Executive for 5 years.

Is it an exciting job to do?

It certainly is. Every day is different and I think particularly since we've become a Foundation Trust, the opportunity to develop and do things that are more innovative has been fantastic.

What do you think your major achievements are?

I've been very proud of influencing the national strategies on Clinical Audit and Research & Development when I worked at various levels through to the Department of Health. More latterly since arriving in the hospital, and becoming Chief Executive, I think it's been about changing the culture of the organisation so we're much more focused on the clinical needs of the service and what our patients need.

What are the challenges in the NHS today?

There are many challenges in any role and in any big, complex organisation. Particularly for the NHS it's about becoming more innovative and much more focused on your patient as a customer. It's about enabling all your staff to realize what that means and how you influence that change.

What's your involvement in the Gateway Programme?

We've had for candidates from the Gateway Programme in the past four years and they've been extremely successful. So far only one of those has left the organisation but has gone on to a similar hospital in a more senior role. We've managed to have the other three candidates progressing through the organisation, one of who is now at sub-director level. I really hope she'll be at director level within two years.

Tell me about the quality of participants.

The participants from the Gateway Programme have been absolutely amazing and I really do see it as a very easy way to tap into the brightest, more able, senior people across the whole of the UK. So it's an amazing programme.

What do participants bring to the hospital?

Many industrial or commercial organisations have very strong management development programmes and my experience has been that these individuals come with a range of skills and expertise; they've worked in different industries, they question us, they challenge us in a very professional way and make us just think differently about how we do things.

How do you ensure the Gateway participants fit into the NHS organisation?

I think what's really important is that you induct them really well into the organisation so that they understand the culture and why people perhaps behave differently in the NHS compared to their commercial experience. But once you've done that then what you need to do is really free them up so that they can behave as they want to behave and we then benefit from their changes.

How do they work alongside the current managers?

They not only complement our current managers but they share their expertise so our traditional NHS managers learn from them, and they learn from the NHS managers because there are some extremely good NHS managers as well.

Philip

Strategic Planning Lead, Leicestershire County and Rutland PCT

What has joining the NHS meant to you?

Joining the Gateway to Leadership Programme was in all honesty quite a huge leap of faith, but I think what it has given me in the few months I've already been here is a real sense of delivering something of value, not share holder value, but real value to real peoples lives of the community that I live in.

What were you doing before you joined the NHS?

Before I joined the NHS and the Gateway to Leadership Programme I was a management consultant working for PA Consultant Group, largely delivering change type programmes within the oil and gas sector.

Why did you decide to change your career route?

I took the decision to make the change for several reasons really. There's the unashamedly clichéd view that actually you want to deliver something of value, particularly in the community that I live. I think that throughout the cohort and the organisation that I'm working in, there is a sense of shared value and that really does come through. The other reason would be the Gateway scheme itself. I think it's a privilege to be on a programme that offers such high quality, world-class leadership development. And of course it offers you the opportunity to join an organisation like the NHS at such a senior level that perhaps you wouldn't necessarily be able to do through a different route.

Why did you apply for the Gateway Programme?

Well it was interesting as it was advertised as ‘Come to Life'. I think that's quite a general theme throughout the cohort, that people really have a sense of shared value and a sense of really wanting to do some good. Which I know is clichéd but it does really come through. Also I was attracted by the opportunity, the challenge, of moving into an environment that speaks a completely different language to that which I'm used to. It was also good to be given the opportunity to progress quite quickly up into senior positions and be provided the support and development to do that.

How did you end up doing the job that you do now?

After the interview process you get support from the scheme in putting you in contact with a lot of organisations that have places or have previously employed Gateway candidates. I met with the Director of Market Development here at Leicestershire - who's also a Gateway Alumni. I began looking at the strategy and healthcare reform side of things and the local delivery programme, trying to actually understand the connection between that and the needs assessment that takes place within the local authority. So trying to get an end-to-end picture of how we take what our population needs and what we deliver, and what we commission as a PCT. When a new director role was created because of all the policy going into different directions, I moved into that role. I think partly because it's a new area for the NHS, that somebody coming from the outside with the kind of skills that I'd got, the kind of resourcing skills, the processing and project management skills, and perhaps some of the commercial skills that maybe don't exist in a great deal within the NHS, it all makes it quite attractive to go into that new environment.

How does life in the NHS differ from your old job?

My new role, compared to my previous life, is fundamentally different. It's not just things like the language, or sitting in meetings and not understanding the clinical terms that are being discussed. I think I've now been exposed to the big P- politics - which perhaps I wouldn't have been exposed to before. Culturally, it's different because you really do get that sense that you've got a group of people working towards a common goal, which perhaps is different to where I've been before. It's not about shareholder value, it's about stakeholder value, it's about the patients, the population, and it's about their lives. Particularly now that the agenda's moved towards prevention rather than the cure - smoking cessation, obesity plans, those kinds of things. So getting involved as a commissioner, commissioning services that you know are going to have a long term benefit to the community is really quite exciting.

What are the benefits of the Gateway Programme?

Being on the Gateway Scheme is a huge benefit compared to applying directly to the NHS. First of all it gives you formal access to a senior mentor and senior coaches - these are senior executives of organisations that perhaps you wouldn't necessarily get to meet. The other side of it is that you get to meet people from outside the NHS, Senior Policy Thinkers or people from the Kings Fund for instance that I wouldn't normally come into contact with either. So from that sense it's a good, structured way of getting access to some of the broader NHS thinking.

Tell me about other people on the programme.

One of the most important parts of the Gateway Programme actually is the cohort itself and collectively moving through this programme. And of course there are quite a number of Gateway Alumni throughout the organisation. It is excellent to have that sense of shared learning (we started Learning Sets together), of having an instant network within the organisation that if you applied directly you just wouldn't get - so I think that's quite important.

What do NHS values mean to you personally?

Living the NHS values, for me personally, is fundamental to the reason why I'm here. I really do feel that you get a sense of common values working in the NHS. Everybody knows that the NHS is a values-based organisation, but what does that really mean? For me there's a tangible sense that people aren't here for the money - if you want to be rich, don't come to the NHS! People are here to help people, to save lives, to prevent long-term illness. There's a real drive towards making peoples lives better.

Saba

Senior Account Manager, West Midlands Commissioning Business Support Agency

What were you doing before you joined the programme?

Before I joined the programme I was working for a Local Authority, and I had been working in Regeneration for over 5 years. I was a Neighbourhood Manager and I was leading on 1 of 11 Pathfinders for the Neighbourhood Management in the city. Prior to that, I was part of a New Deal for Communities Programme, which was a £50 million regeneration programme over 10 years and I was the lead for raising atonement and participation in life long learning.

Why did you apply for the Gateway Programme?

I was looking for a challenge. I was looking to work in the public sector and was quite keen on the work that I do having an impact on people's lives and communities. I wanted to develop my experience and leadership skills, and be in a position that was going to give me some challenges and complexity but also was contributing something to the wider community. When I saw the advert for the Leadership Programme I thought it was a great opportunity to join at a senior management level, build on the experience that I had, to bring my perspective to an environment, which is quite exciting in terms of the change that is going on. There's a big move in the NHS from being responsive to patients needs towards preventative care. I was keen to have that support system [from the NHS Gateway to Leadership Programme] and what I realised quite quickly was it's got a very high profile, and the calibre of the people, and the experience of the people involved in the programme, is very high. It gives you a really good platform to join the NHS.

What support do you get in your initial introduction period?

The Gateway Leadership Programme is very challenging. The programme offers an induction on which you have speakers (chief executives, directors from the Department of Health or from the Strategic Health Authority) so you get a really good flavour overall of what the NHS is going through, of it's history, and the way the organisations are structured. Through the modules of the Leadership Programme you get to learn about the different aspects from a clinical and managerial point of view. So the programme offers you a really good foundation of the knowledge you might lack from not having worked in the NHS. Because of the calibre of the people who are involved you really are getting a high level of expertise injected into the programme and a really good network that would take you much longer to establish if you just joined the NHS. I've already come into contact with chief executives and directors, have coaching set-up and people that are going to be mentoring me, so it's a good package of support. I'm also quite fortunate in terms of working for CBSA. It's an innovative and forward thinking department which, is hosted by Dudley PCT. The people that are there are both from the NHS and non-NHS because what we're doing requires a real diversity. There's a good support network within CBSA as well, particularly because they employ other Gateway people.

What has the Gateway Programme allowed you to achieve so far?

The Gateway to Leadership Programme has first and foremost enabled me to enter the NHS in a senior management role, which wasn't possible before because of my lack of health background and experience. It allows you to get in at the right level if you're somebody who's ambitious and keen to progress their career in the NHS. You can get in at the right level so that you can still learn about the NHS whilst you're still doing a job and still contributing at a senior level. Because of the way the modules are scheduled and because of the way the support is built around you, in terms of coaching and mentoring, it provides you with a good network of people you can contact and gain support from, and learn from - the programme's been very good for that. You also get an instant network in the Gateway participants as well. There are 20 people that I know that are working at a senior level within the NHS, having the same experiences as me, and we're able to support each other.

What networking opportunities are there?

The networking opportunities you get are unparalleled because you have access to chief executives and directors who are participating and contributing to the programme in the modules that are delivered. You won't get the opportunity to get that instant contact with those people if you don't do the programme. You liase with these people and create networks that allow you to learn and that also support you in the role that you're doing. For me, another key element is that the Gateway Programme allows you to have an instant network within the participants. There are 20 people on the programme experiencing exactly what I'm experiencing - coming into the NHS without any prior health experience, all operating at senior management level. You've got an instant network within which you can share problems, solutions, different approaches - it really allows you to get a great perspective quite quickly.

What is it like to work for the NHS?

The challenges within the NHS that are most different to my previous roles are concerned with the level of change that the NHS is going through. For me, it's a lot of change happening in a complex environment. It's for the better, but it requires a completely different way of working. There's a different set of skills, different experiences, different approaches all required. I think the most interesting challenge for me is the work around commissioning and risk stratification, around the preventative approach and life style issues - as opposed to being the responsive service that, traditionally, the NHS has been. That is a key challenge for the NHS, and has been a key interest for me personally.

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