Over the past few months, today’s guest has been charting and sharing her learning from her first days, weeks and months in post as a new CEO. After her first 100 days she published a report about all she’s learnt and how it’s shaping her priorities - I highly recommend you reading it if you want a masterclass on how to demonstrate engagement, get buy-in and land well in your new role.

In this episode I’m talking with Laura Skaife-Knight, CEO of NHS Orkney. Laura has over 20 years’ of experience working in the NHS and is known for her work to improve patient and staff engagement. It may come as no surprise that Laura’s background is in communications - which is how we actually first met - and if you follow her online you’ll know she sees this as integral to her role as CEO.

We talk about:

• how a sport's discipline shaped her career and approach
• the path from journalist to communications director to CEO
• asking for feedback to understand and improve personal performance
• operating outside your comfort zone
• changing leadership styles and stepping authentically into your role
• landing well in a new role and approaching the first 100 days in post
• navigating working and living in the same community
• getting the basics right, sticking to the plan and avoiding priority overwhelm
• building relationships with the Chair and Board to gain alignment
• creating an inclusive culture
• working and engaging people in a remote and rural setting
• improving performance, engagement and morale
• succession planning
• the realities of being chief exec
• advice for aspiring CEOs

Resources and helpful links

• NHS Orkney Chief Executive 100-day report

Laura Skaife-Knight

Laura joined NHS Orkney in April 2023, bringing 20 years’ experience in the NHS and 13 years of Board-level experience to the Health Board. She has experience and a reputation for improving patient and staff experience in a range of England’s largest acute teaching hospitals to smaller, yet crucial, Trusts central to the delivery of regional integrated care. Laura joined NHS Orkney from The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust (QEH) where she was Deputy CEO between 2019 and 2023. Prior to this she worked for 12 years at Nottingham University Hospitals NHS Trust, where she was Director of Communications and External Relations, and Derby Hospitals Foundation Trust and University Hospitals of Leicester NHS Trust where she held senior communications and engagement roles.

@laura_skaife on X

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Lee Griffith: 00:00:02

Over the past few months, Today's guest has been

Lee Griffith: 00:00:04

charting and sharing her learning from her first days,

Lee Griffith: 00:00:07

weeks and months in post as a new CEO. After her first 100

Lee Griffith: 00:00:11

days she published a report about all she's learned and how

Lee Griffith: 00:00:14

it's shaping her priorities. Highly recommend you read it if

Lee Griffith: 00:00:17

you want a masterclass on how to demonstrate engagement, get buy

Lee Griffith: 00:00:20

in and land well in your new role. I'm Lee Griffith

Lee Griffith: 00:00:24

communication strategies executive coaching all round

Lee Griffith: 00:00:26

champion of leaders who shun the old school stereotypes. I'm here

Lee Griffith: 00:00:30

to help you get clear on your strategy, implement some self

Lee Griffith: 00:00:33

leadership and connect with those who serve through your

Lee Griffith: 00:00:35

communications so that you can deliver improved organizational

Lee Griffith: 00:00:38

performance, engagement and reputation sign up to my

Lee Griffith: 00:00:41

newsletters to receive even more useful insights into how to be

Lee Griffith: 00:00:44

an impactful leader. You can also find out how I can support

Lee Griffith: 00:00:47

your organization to better connect with the people it

Lee Griffith: 00:00:49

serves. Visit Sunday spies.com To find out more. In this

Lee Griffith: 00:00:54

episode, I'm talking to floor escape night CEO of NHS Oakley,

Lee Griffith: 00:00:58

Laura has over 20 years of experience working in the NHS

Lee Griffith: 00:01:01

and is known for her work to improve patient and staff

Lee Griffith: 00:01:04

engagement. It may come as no surprise that Laura's background

Lee Griffith: 00:01:07

is in communications, which actually side note is how we

Lee Griffith: 00:01:10

first met. And if you follow her online, you'll know she sees

Lee Griffith: 00:01:14

this as integral to her role as CEO. We talked about the path to

Lee Griffith: 00:01:18

become chief executive how to take people with you as a

Lee Griffith: 00:01:21

leader, building and rebuilding organizational cultures and the

Lee Griffith: 00:01:24

work she does to advocate for equality and inclusion. Enjoy.

Lee Griffith: 00:01:35

Hello, Laura. So firstly, thank you so much for joining us on

Lee Griffith: 00:01:40

the leaders with impact Podcast. I'm delighted that you've come

Lee Griffith: 00:01:43

on for those who won't know, we kind of know each other in a in

Lee Griffith: 00:01:47

a past life as it were in our old hats as communications

Lee Griffith: 00:01:51

directors many, many years ago. And neither of us are doing that

Lee Griffith: 00:01:54

now. But I think probably explore this a bit later on

Lee Griffith: 00:01:57

comms still plays a massive role in what you do. It certainly

Lee Griffith: 00:02:00

doesn't in what I do, even though we're perhaps not living

Lee Griffith: 00:02:03

the same kind of professional life as we did today. I want to

Lee Griffith: 00:02:07

start our conversation though, if you don't mind, we have a

Lee Griffith: 00:02:09

question that I asked everyone, which is what does impactful

Lee Griffith: 00:02:13

leadership look and feel like to you? Thank

Unknown: 00:02:16

you so much for having me on. I think a few key things

Unknown: 00:02:19

from my perspective, firstly, it's having that ability to

Unknown: 00:02:23

inspire people and take people with you. And I think you

Unknown: 00:02:26

achieve that in multiple ways, really, firstly, by gaining

Unknown: 00:02:28

credibility in any organization, and at the heart of that I think

Unknown: 00:02:32

it's about really being yourself being comfortable in your own

Unknown: 00:02:35

skin. And knowing how to inspire people and support people,

Unknown: 00:02:39

sometimes through some really difficult and challenging times

Unknown: 00:02:41

in organizations and fundamentally inspiring

Unknown: 00:02:44

confidence by getting results from an organization. An

Unknown: 00:02:47

underlying all of that, for me is the importance of visible

Unknown: 00:02:50

leadership. Yeah, that

Lee Griffith: 00:02:51

visibility and credibility by being yourself

Lee Griffith: 00:02:54

are really important elements. And I definitely want to touch

Lee Griffith: 00:02:57

on that a bit later. But I want to touch on your career path,

Lee Griffith: 00:03:02

because you've had a really interesting one, you started out

Lee Griffith: 00:03:05

as a journalist I understand. And then you've moved into

Lee Griffith: 00:03:08

management roles and senior management roles. You're now the

Lee Griffith: 00:03:11

Chief Exec of the NHS up in Orkney. I wonder what shaped you

Lee Griffith: 00:03:17

growing up as a person and how that's perhaps influenced your

Lee Griffith: 00:03:22

career and your approach to leadership?

Unknown: 00:03:24

Thank you. It's a really good question. I think a

Unknown: 00:03:26

few things really, I am from a very sporting background. So

Unknown: 00:03:30

from my early teens, really through to my 30s, I've been

Unknown: 00:03:34

very competitive and played a range of sport. And I think that

Unknown: 00:03:37

gives you a certain discipline, whether you like it or not gives

Unknown: 00:03:39

you that discipline around training, really constantly

Unknown: 00:03:42

wanting to raise the bar, do the best for yourself, and your

Unknown: 00:03:45

team, ultimately, and worked in the NHS is all about working as

Unknown: 00:03:48

a team and developing great teams. And we'll perhaps return

Unknown: 00:03:51

to that a little bit later. So I think that sporting discipline

Unknown: 00:03:53

put me in good stead. I think secondly, really that work ethic

Unknown: 00:03:57

and working hard. That's always been with me, I've always been

Unknown: 00:04:00

one to get up in the morning and trained, whether it's going to

Unknown: 00:04:03

tennis coaching, coaching other people going for a run and just

Unknown: 00:04:07

practicing different sports that's been ingrained in me from

Unknown: 00:04:10

when I was really young. And then finally, as I've got into

Unknown: 00:04:14

my career, I've been really fortunate to work with some

Unknown: 00:04:17

truly amazing leaders in the NHS. And I've learned from those

Unknown: 00:04:20

colleagues over the last 25 years taking the best bits from

Unknown: 00:04:23

those colleagues, but then really thought, How do I want to

Unknown: 00:04:26

lead and I think being given those opportunities, I perhaps

Unknown: 00:04:30

have been in the right place at the right time to take those

Unknown: 00:04:32

opportunities, but people have put faith in me. And what I'm

Unknown: 00:04:35

now trying to do is turn that around on its head to say people

Unknown: 00:04:39

have put faith in me. I know there are loads of brilliant and

Unknown: 00:04:41

bright stars working here. And those colleagues need an

Unknown: 00:04:44

opportunity like I've had over the last 20 plus years. So the

Lee Griffith: 00:04:48

path from journalist to Chief Exec perhaps

Lee Griffith: 00:04:51

isn't an obvious one. What changed for you in your career

Lee Griffith: 00:04:55

that made you make that shift?

Unknown: 00:04:58

Brilliant, brilliant question. I think firstly, I

Unknown: 00:05:01

knew I wanted to be a director of comms and people asked me

Unknown: 00:05:04

this regularly always wanted to be a director of comms and

Unknown: 00:05:06

achieve that before was 30. So you could argue our peak too

Unknown: 00:05:10

soon. That's perhaps for under the debate. And another day, I

Unknown: 00:05:13

did not know, I wanted to be a Deputy Chief Exec. And I

Unknown: 00:05:15

certainly didn't know I wanted to be a Chief Exec. So I think

Unknown: 00:05:18

it's really important that I let people know who are watching and

Unknown: 00:05:20

listening, I did not set out on this path, I was given an

Unknown: 00:05:23

opportunity, and people believed in me and five months into this

Unknown: 00:05:27

role as chief exec, other people will judge me, I still don't

Unknown: 00:05:30

know if this is what I want to do longer term or not, we will

Unknown: 00:05:32

see, because I didn't really set out on this path. This is where

Unknown: 00:05:36

I really ended up. So I think, just bear that in mind as you

Unknown: 00:05:39

go. You don't have to set out on a path and have an end

Unknown: 00:05:41

destination. It's about what feels right for you pushing

Unknown: 00:05:45

yourself constantly, and making sure you're happy doing what

Unknown: 00:05:48

you're doing. And as I really has had been a director of

Unknown: 00:05:51

comms, certainly for the last 1520 years, I realized that I

Unknown: 00:05:55

was taking on things above and beyond comps, so different

Unknown: 00:05:58

projects, bigger projects, strategic projects, different

Unknown: 00:06:01

pieces of strategic work, if you like my portfolio grew and grew

Unknown: 00:06:05

and grew probably without knowing it in the end. And after

Unknown: 00:06:08

being a director of comps for quite a long time. So I think

Unknown: 00:06:11

that's when I was offered the opportunity to become deputy

Unknown: 00:06:14

chief exec, which I took. And that's when really I had a much

Unknown: 00:06:18

bigger portfolio, things like culture, corporate strategy,

Unknown: 00:06:21

systems, strategy, digital information, just to give a few

Unknown: 00:06:24

examples. And initially, I thought, I have never done this

Unknown: 00:06:27

stuff before, how can I possibly do this, but again, people said

Unknown: 00:06:30

you can do it. And actually, underlying all of those things

Unknown: 00:06:33

is really great comes in engagement. When you really

Unknown: 00:06:35

think about it, project management and knowing how to

Unknown: 00:06:38

fix things, take people with you and get results. And that's why

Unknown: 00:06:42

I really believe directors of comms are well positioned to go

Unknown: 00:06:45

on to do whatever they want to do, whether it's chief exec

Unknown: 00:06:48

work, whether it's Chief Operating Officer work, I think

Unknown: 00:06:51

the world is our oyster really, as a director of comms and love

Lee Griffith: 00:06:54

that you said that wasn't in the plan to be Deputy

Lee Griffith: 00:06:57

CEO or to be CEO. And you don't even know if that's the longer

Lee Griffith: 00:07:01

term thing for you. What's going to be your litmus test, I

Lee Griffith: 00:07:04

suppose that it is the right thing.

Unknown: 00:07:06

I guess a few things, I think, always ask for feedback.

Unknown: 00:07:09

I asked for feedback every single day, I'll ask people, How

Unknown: 00:07:12

did you do in that meeting? What do you think? Give me some

Unknown: 00:07:15

honest feedback. So that constant feedback, am I

Unknown: 00:07:19

performing? Well, am I doing well, in my role as the things I

Unknown: 00:07:22

can do better, because we are learning every minute of the

Unknown: 00:07:24

day. And that's constantly at the forefront of my mind, I

Unknown: 00:07:27

think getting results for the organization, but fundamentally

Unknown: 00:07:30

getting results for our patients, local community and

Unknown: 00:07:32

stuff. And we're clear what that looks like. And I will be

Unknown: 00:07:35

measured against delivering on the corporate plans, strategy,

Unknown: 00:07:38

clinical strategy, and contributing to the system

Unknown: 00:07:41

strategy. And then I think, finally, do I enjoy what I'm

Unknown: 00:07:44

doing? For me, it's a package of those things around results,

Unknown: 00:07:48

what people think and feedback, because we are judged on that,

Unknown: 00:07:50

whether we like it or not, and then I'm happy doing what I'm

Unknown: 00:07:53

doing. Do I truly think I'm adding value? And

Lee Griffith: 00:07:56

have you had to focus on anything in particular,

Lee Griffith: 00:08:00

to support your development, as you've moved into, as you say,

Lee Griffith: 00:08:04

new areas of your portfolio that perhaps you hadn't managed or

Lee Griffith: 00:08:07

been responsible for before? As you've moved into more senior

Lee Griffith: 00:08:10

roles and stepped away from your area of expertise, your comfort

Lee Griffith: 00:08:13

zone? What if you had to really focus? Have you done any

Lee Griffith: 00:08:16

particular training? Or have you have in particular areas where

Lee Griffith: 00:08:19

you felt like you needed to do more to feel comfortable?

Unknown: 00:08:23

I think a few things. I never feel comfortable. And

Unknown: 00:08:26

people always say, How can you be ultra confident, you always

Unknown: 00:08:29

look like you're on your game. I am constantly outside of my

Unknown: 00:08:33

comfort zone. So I think people think in these jobs, do you have

Unknown: 00:08:36

this invincibility about you just me, I worry about things

Unknown: 00:08:40

every minute of the day. I think just keeping grounded is really

Unknown: 00:08:43

important in that regard. So I think a few other things, really

Unknown: 00:08:47

deputy chief exec in my previous role in Norfolk, put me in

Unknown: 00:08:50

really good stead because I had a bigger portfolio. And it

Unknown: 00:08:53

really tested me but what I really realized is it's not

Unknown: 00:08:56

about being an expert in those things, whether it's digital

Unknown: 00:08:59

strategy, improvement, transformation, or whatever the

Unknown: 00:09:01

equivalent is, it's about knowing how to ask the right

Unknown: 00:09:03

questions. You have heads of service, you have others around

Unknown: 00:09:06

you, certainly in larger trust. And I think it's about trusting

Unknown: 00:09:10

those colleagues to be the experts and subject matter

Unknown: 00:09:12

experts. But as the director lead or deputy chief exec, no

Unknown: 00:09:16

chief exec, being able to ask the right questions and holding

Unknown: 00:09:19

those colleagues to account. So I think that's the first thing I

Unknown: 00:09:22

think the second thing is I am big, big believer in always

Unknown: 00:09:25

appoint people better than you. You're only as good as your

Unknown: 00:09:28

team. Never ever see colleagues who are better than you as a

Unknown: 00:09:31

threat. I always constantly thinking that when I'm

Unknown: 00:09:33

recruiting, because we are only as good as our teams and we

Unknown: 00:09:36

should never lose sight of that. And I think the third thing

Unknown: 00:09:39

really is I have loads of people around me who I work with,

Unknown: 00:09:42

whether it's coaching mentoring people, I just pick up the phone

Unknown: 00:09:46

to and say, What do you think? Can I share this run this by?

Unknown: 00:09:48

You know, in Scotland, there is an absolutely fabulous network

Unknown: 00:09:52

of Chief execs nationally. We all support each other every

Unknown: 00:09:56

day, every week and a combination of all of those

Unknown: 00:09:59

things We don't know the answers to everything. But we've got a

Unknown: 00:10:02

really fantastic peer network. And I know the comms director

Unknown: 00:10:05

network is really strong as well. And people should really

Unknown: 00:10:07

tap into that.

Lee Griffith: 00:10:08

Yeah, yeah, absolutely. Your network, as

Lee Griffith: 00:10:11

you've alluded to changes and shifts as you grow and develop

Lee Griffith: 00:10:15

in your role and the types of people that you need around you

Lee Griffith: 00:10:18

might need to change and you shouldn't feel bad about that

Lee Griffith: 00:10:21

people can feel guilty.

Unknown: 00:10:23

Absolutely great. I think also, learning from your

Unknown: 00:10:25

own mistakes, don't repeat mistakes. I think back to

Unknown: 00:10:30

different chapters of my career, when big things have happened,

Unknown: 00:10:33

smaller things have happened, but constantly thinking,

Unknown: 00:10:35

actually, let's learn from that, because there are themes,

Unknown: 00:10:38

trends. If we look back at certain moments in your career,

Unknown: 00:10:41

I regularly returned to those things and think actually, what

Unknown: 00:10:45

did I learn? Let's not repeat that mistake. So I think it's

Unknown: 00:10:48

just keeping those things in your locker and thinking, even

Unknown: 00:10:51

in the last few weeks of things I've gone back to and thought,

Unknown: 00:10:53

okay, Lucy, let be case is a really good current example. If

Unknown: 00:10:58

you look back up big events in the NHS, there are themes that

Unknown: 00:11:02

we will all be able to relate to as directors of comms. So really

Unknown: 00:11:06

thinking through what is my role in this? What have I learned

Unknown: 00:11:09

from my own career? Because I think there's things within all

Unknown: 00:11:12

of this, that would resonate with us.

Lee Griffith: 00:11:14

Yeah, yeah. How is your leadership style changed

Lee Griffith: 00:11:18

over the years as you've moved into different roles, different

Lee Griffith: 00:11:21

organizations, I

Unknown: 00:11:23

think my confidence has grown massively. I mentor a lot

Unknown: 00:11:27

of people. And one of the big things to say certainly to

Unknown: 00:11:29

directors of comms is is the director of comps, you're not

Unknown: 00:11:32

just there at the table to talk about comps things, you should

Unknown: 00:11:35

be at the table talking about anything around that board

Unknown: 00:11:39

table. So I think my confidence has grown massively, the thing

Unknown: 00:11:43

that's probably changed over the last two or three years for me

Unknown: 00:11:46

is being comfortable in my own skin. And when I took this job,

Unknown: 00:11:50

I took a really deliberate decision to be nothing other

Unknown: 00:11:53

than myself. Because I think sometimes people come into these

Unknown: 00:11:56

jobs thinking, I will be what I think that organization wants me

Unknown: 00:12:00

to be. And I have stayed really true to that. From the moment I

Unknown: 00:12:03

was interviewed to now running the organization, I am entirely

Unknown: 00:12:07

consistent and be myself. You know, how I behave, how I talk

Unknown: 00:12:12

about what I believe in. I'm completely consistent. And I'm

Unknown: 00:12:15

really comfortable with that, rather than being somebody that

Unknown: 00:12:17

I think the organization wants me to be, if that makes sense.

Lee Griffith: 00:12:20

Yeah, it does. Can you draw on any examples where

Lee Griffith: 00:12:24

perhaps you didn't feel in the past that you haven't felt? I

Lee Griffith: 00:12:28

suppose what are you actively doing differently now to them,

Lee Griffith: 00:12:31

when you didn't feel you perhaps being as authentic,

Unknown: 00:12:34

I think not feeling my voice was as valued compared,

Unknown: 00:12:37

for instance, to a medical director to a chief operating

Unknown: 00:12:40

officer to achieve nurse, for instance, I think there are

Unknown: 00:12:43

still occasions when thinking about my director of comms days

Unknown: 00:12:46

where you think, actually, I'm lower down the pecking order.

Unknown: 00:12:50

And absolutely not comms professionals can add value in

Unknown: 00:12:53

so many ways. And I think, in some ways, even more ways,

Unknown: 00:12:56

because you've got that helicopter view of the world.

Unknown: 00:12:58

And it's our job to hold the mirror up to the organization.

Unknown: 00:13:01

So I think absolutely being clear, your voice is as powerful

Unknown: 00:13:05

as anybody else's around that table. And I think one of my

Unknown: 00:13:08

many regrets is I looked back and thought I could have added

Unknown: 00:13:10

value in that conversation. But I chose not to, I chose not to

Unknown: 00:13:13

be part of it, because actually, clinical colleagues in that

Unknown: 00:13:16

instance, took precedence. But actually, my voice was as

Unknown: 00:13:20

powerful as anybody. Whereas now I wouldn't hesitate. And

Unknown: 00:13:23

probably easier for me to say, because when you're chief exec,

Unknown: 00:13:25

you can probably get away with more things in many respects.

Unknown: 00:13:29

But I do look back thinking I could have added value the most

Unknown: 00:13:32

definitely, yeah,

Lee Griffith: 00:13:33

I've been following with interest your

Lee Griffith: 00:13:36

first 100 days as chief exec in NHS Orkney, one of the things I

Lee Griffith: 00:13:40

do with leaders I work with is help them with looking at making

Lee Griffith: 00:13:44

sure they've got a really clear plan of action, when they step

Lee Griffith: 00:13:47

into a role. Often leaders can feel there's a pressure I

Lee Griffith: 00:13:51

suppose to show their value from day one, and therefore get into

Lee Griffith: 00:13:56

this place where they can overwhelm themselves and the

Lee Griffith: 00:13:59

organization because there's lots of newness that they feel

Lee Griffith: 00:14:02

they need to bring in. Obviously, there are exceptions

Lee Griffith: 00:14:04

when you have people that come in, in that fixer mode and might

Lee Griffith: 00:14:08

have to execute in that way. But I would say in most cases, the

Lee Griffith: 00:14:12

bravest thing to do when you start a new job is to not do

Lee Griffith: 00:14:16

anything, and to invest time and energy into getting to know the

Lee Griffith: 00:14:21

place and its people. And I know you've done that in abundance,

Lee Griffith: 00:14:24

and you've been really open and communicative not only within

Lee Griffith: 00:14:28

your organization, but externally as well. If anyone's

Lee Griffith: 00:14:30

interested, I can follow you on LinkedIn and whatever to see

Lee Griffith: 00:14:33

your progress. But I'm interested in your thought

Lee Griffith: 00:14:36

process as you began to think about how you were going to

Lee Griffith: 00:14:40

approach this role. And I suppose what steps you took and

Lee Griffith: 00:14:43

that kind of conscious decision of how you are going to enter.

Unknown: 00:14:47

I think a few things Firstly, I took time, probably

Unknown: 00:14:50

good three or four months before I started in post to speak to

Unknown: 00:14:53

other very seasoned and experienced chief execs to get

Unknown: 00:14:57

their thoughts on they've gone into new roles many new to If

Unknown: 00:15:00

exec rails, what was their approach, that's where I,

Unknown: 00:15:03

amongst other things, got the idea around the 100 day plan and

Unknown: 00:15:06

how I would approach that, I think secondly, I heard loads of

Unknown: 00:15:10

feedback about what people thought again, before I even

Unknown: 00:15:12

arrived in this building and in alchemy about what people

Unknown: 00:15:15

thought about certain colleagues where the organization was. But

Unknown: 00:15:19

I made a really conscious decision that I would make my

Unknown: 00:15:22

own mind up. And that I would do that by listening to stuff about

Unknown: 00:15:26

what it's like to work here, listening to our partners and

Unknown: 00:15:29

stakeholders about what it's like to work with us, and

Unknown: 00:15:31

listening to our patients about what it's like to receive care

Unknown: 00:15:33

here. And that I would formulate my own view, I didn't want to

Unknown: 00:15:37

come in and have already a fixed view. So I was very clear, I

Unknown: 00:15:41

will make up my own mind. And I've got a really clear formula

Unknown: 00:15:43

for doing that. And that's precisely what I've done by

Unknown: 00:15:46

really taking care to listen over the last four to five

Unknown: 00:15:49

months in particular. So I could really set out my store based on

Unknown: 00:15:54

evidence, not based on anybody else's opinion,

Lee Griffith: 00:15:57

what surprised you most in your first 100 days?

Unknown: 00:16:02

I don't think there was anything that I perhaps didn't

Unknown: 00:16:04

already know about based on the recruitment process, the

Unknown: 00:16:07

homework I done about NHS Orkney, I think what really

Unknown: 00:16:11

saddened me is that many of the things we're not getting right

Unknown: 00:16:14

in the organization at the moment are actually quite basic

Unknown: 00:16:17

things, frustrations, where things don't move forward, staff

Unknown: 00:16:20

don't hear back from certain colleagues in the organization

Unknown: 00:16:23

and things go into a bit of a black hole, or just stuff not

Unknown: 00:16:27

feeling listened to. And actually, all of those things

Unknown: 00:16:29

are really basic and fundamentals. For me, I think it

Unknown: 00:16:31

was the fact that on a really basic level, we were and still

Unknown: 00:16:34

are today, let's be really honest, letting stuff down. And

Unknown: 00:16:38

for me, that's a complete home go. Yeah, and if

Lee Griffith: 00:16:41

you had to change anything, in your approach, from

Lee Griffith: 00:16:46

where you thought you perhaps needed to be beginning, I think

Unknown: 00:16:49

I've had to really take time to understand the culture

Unknown: 00:16:52

here working for an island board. And just for context of

Unknown: 00:16:56

me has a population of 22,000 people, it is a really different

Unknown: 00:17:00

culture. And I think understanding that really taken

Unknown: 00:17:03

time to get underneath the skin of that you have to understand

Unknown: 00:17:06

the backstory to things, why the culture is what it is,

Unknown: 00:17:10

specifically being part of an island community in a remote and

Unknown: 00:17:13

rural area, that's really important to truly understand

Unknown: 00:17:16

that before you try to make changes that perhaps are not

Unknown: 00:17:19

going to land because that's open, he has a certain way of

Unknown: 00:17:22

thinking doing things. And there's always a history and

Unknown: 00:17:25

backstory that I think is important that we all

Unknown: 00:17:27

understand.

Lee Griffith: 00:17:29

Yeah, and people can, I'm assuming that it's

Lee Griffith: 00:17:32

almost that family feel in some places, and you've come in from

Lee Griffith: 00:17:36

the outside, there's that sense of it will take time to build

Lee Griffith: 00:17:40

that trust when it

Unknown: 00:17:41

very much so. And that's why it's really important

Unknown: 00:17:43

that we relocated, bought a house here. And actually, as I

Unknown: 00:17:46

regularly say, I'm part of the local community here, this is my

Unknown: 00:17:50

hospital. It's my local community, it's my home. And I

Unknown: 00:17:53

think that message was a really important one. But I think being

Unknown: 00:17:56

part of such a small community, everybody doesn't know everybody

Unknown: 00:18:00

talks about a goldfish bowl probably never been more true

Unknown: 00:18:03

than living and working in opening. And that does take some

Unknown: 00:18:06

getting used to.

Lee Griffith: 00:18:07

I shall ask you now. So the goldfish bowl was

Lee Griffith: 00:18:10

really interesting. And I've interviewed a chief executive or

Lee Griffith: 00:18:12

local council and that sense of you, you live and breathe that

Lee Griffith: 00:18:16

local area you absolutely do as well with the roll that you did

Lee Griffith: 00:18:20

and where you're based. How are you finding that? How do you do

Lee Griffith: 00:18:24

the switch off, I suppose between home life and work life,

Lee Griffith: 00:18:27

when as you say you are in that goldfish bowl,

Unknown: 00:18:30

I don't think that is hugely challenging. I think I'm

Unknown: 00:18:32

still getting used to it. I had a taste of that when I lived and

Unknown: 00:18:36

worked in Norfolk, which, as you will all know, is quite a rural

Unknown: 00:18:39

area. But this takes it to a whole other level. I think it's

Unknown: 00:18:42

fair to say because you are constantly on show, whether

Unknown: 00:18:45

you're going into the shops, where you go into the co op to

Unknown: 00:18:47

Tesco, you always see people who you know, and I think you've

Unknown: 00:18:51

really got to understand we're all human at the end of the day.

Unknown: 00:18:53

And we all have a right to have a personal life and a private

Unknown: 00:18:56

life as much as we need to. But actually, it's even harder here

Unknown: 00:18:59

because everybody knows everyone. So I'm still getting

Unknown: 00:19:02

used to it, I must admit, but I think it's knowing whether a

Unknown: 00:19:06

professional boundaries and where you say this is work. And

Unknown: 00:19:09

actually, I can still be me, but this is home as well. And that

Unknown: 00:19:13

is tricky. It's really hard. Yeah.

Lee Griffith: 00:19:15

So I read your report on your first 100 days,

Lee Griffith: 00:19:20

which as a side note, I'd recommend to anyone who wants to

Lee Griffith: 00:19:23

learn how to enter into an organization and to do that

Lee Griffith: 00:19:27

listening piece. And importantly, close the loop

Lee Griffith: 00:19:29

around around what they've heard. What came across was the

Lee Griffith: 00:19:32

themes. And you've touched on some of this around culture,

Lee Griffith: 00:19:35

leadership, retention, getting the basics right, as you

Lee Griffith: 00:19:38

mentioned, and they are probably themes that feel familiar to

Lee Griffith: 00:19:42

many leaders in their own organizations, but often they

Lee Griffith: 00:19:46

can get overlooked for maybe the sexier or the shinier stuff or

Lee Griffith: 00:19:51

they get lost in the overwhelm of operational pressures or

Lee Griffith: 00:19:56

general things that need to get tackled to the point you may

Lee Griffith: 00:19:59

that I really loved in the plan was the plan needs to be the

Lee Griffith: 00:20:04

plan. And we can't have all this other stuff coming in thrown off

Lee Griffith: 00:20:09

course. So I'm interested in how you're going to approach staying

Lee Griffith: 00:20:14

on course control, I suppose

Unknown: 00:20:17

this is something I'm really, really hot on. And I

Unknown: 00:20:20

really learned in my last row Queen Elizabeth Hospital when I

Unknown: 00:20:22

was deputy chief exec in Norfolk, in the NHS, we have a

Unknown: 00:20:26

real tendency to start off with a set of priorities, keep adding

Unknown: 00:20:29

to that set of priorities. And before you know it, it's really

Unknown: 00:20:32

unclear what the priorities are, I am absolutely crystal clear

Unknown: 00:20:36

plan is the plan. That's the plan for the year, we are clear,

Unknown: 00:20:39

then we even split it up into quarters. That's what we've got

Unknown: 00:20:42

to achieve by quarter and we report back on a quarterly

Unknown: 00:20:45

basis. How are we doing against that plan? Where we're off

Unknown: 00:20:48

track? What are we doing about it, so we've got line of sight.

Unknown: 00:20:51

But as my chair knows, every day, I challenge when something

Unknown: 00:20:55

gets added to the pile, I say the plan is the plan, we either

Unknown: 00:20:59

take something off the pile and stop doing something we can't

Unknown: 00:21:02

keep adding to the plan, because otherwise we lose focus. And we

Unknown: 00:21:05

lose our own credibility in the organization by setting out with

Unknown: 00:21:08

a set of priorities, but then changing the goalposts as they

Unknown: 00:21:11

go, if the goalposts change because of your policy change

Unknown: 00:21:14

your strategy change, or a national director, for instance,

Unknown: 00:21:17

that is different. But actually, I think it's having the

Unknown: 00:21:20

discipline to stick with the plan and measure progress in

Unknown: 00:21:24

really quite a relentless way. And

Lee Griffith: 00:21:26

how personally can you make sure that happens? You

Lee Griffith: 00:21:30

can't be everywhere, I suppose. So what's what's going to be

Lee Griffith: 00:21:33

your approach to make sure that everyone knows the plan is the

Lee Griffith: 00:21:37

plan.

Unknown: 00:21:37

So I think a few things really communicating that and

Unknown: 00:21:41

getting sign off from the board fundamentally, because that's

Unknown: 00:21:44

getting permission to agree that is the plan in the first place.

Unknown: 00:21:47

What we do here is aligned, every single agenda in the

Unknown: 00:21:51

organization is under our strategic objectives. So it's

Unknown: 00:21:54

crystal clear, why are we talking about this, and it's not

Unknown: 00:21:57

linked to the strategic objectives, it does not get on

Unknown: 00:21:59

to the agenda, to give you that rigor and discipline to really

Unknown: 00:22:03

stick with the priorities. Again, going back to the

Unknown: 00:22:05

strategic priorities of the organization, I've taken that a

Unknown: 00:22:08

step further, Lee, every single bit of internal communications

Unknown: 00:22:12

we do sits in relates back to our strategic objectives. So

Unknown: 00:22:15

again, crystal clear, we're talking about this, because we

Unknown: 00:22:18

told you it was a priority. And indeed, you told us it was a

Unknown: 00:22:21

priority to improve in these areas. So you get that golden

Unknown: 00:22:24

thread from board down to agendas in the governance in the

Unknown: 00:22:27

organization down to the staff communications as well and don't

Unknown: 00:22:31

deviate from that. It's about being disciplined. And

Lee Griffith: 00:22:34

it sounds like you've probably had to do quite

Lee Griffith: 00:22:37

a lot of work with your board and the senior executive team so

Lee Griffith: 00:22:40

that they're aligned with you on that. How have you approached

Lee Griffith: 00:22:45

getting that alignment and buy in? And I know that's something

Lee Griffith: 00:22:48

that you've talked about, it's been a priority at the

Lee Griffith: 00:22:50

beginning. Firstly,

Unknown: 00:22:51

relationships are everything in everything we do,

Unknown: 00:22:53

aren't they? Let's be really honest, especially in these

Unknown: 00:22:55

roles, relationships with a chair, absolutely key, certainly

Unknown: 00:22:59

for Chief Exec relationships with your exec team and building

Unknown: 00:23:02

a strong exec team in relationship with a non execs

Unknown: 00:23:05

and I think, really chunking it down to understand what

Unknown: 00:23:08

relationships do we think we need? And actually know where we

Unknown: 00:23:11

start from? And what do you want time? Do you want to invest? Not

Unknown: 00:23:14

just in the formal set pieces, as I call it? Actually, it's the

Unknown: 00:23:18

informal conversations that are the most important in my

Unknown: 00:23:21

experience. So relationship building and investing time in

Unknown: 00:23:24

that I think, been really clear with the board. And this is what

Unknown: 00:23:28

I've tried to achieve through my 100 day plan. Do we all agree

Unknown: 00:23:32

that change is necessary in the first place before you go off

Unknown: 00:23:34

down a route? And that's what I've really tried to do with the

Unknown: 00:23:37

100 day report. It's not my plan, and report. This is the

Unknown: 00:23:41

board's report. And we've all got to take this forward. So

Unknown: 00:23:44

it's about how do you get that collective ownership as a single

Unknown: 00:23:47

board or a unitary board? To really evidence? Do we all sign

Unknown: 00:23:51

up to this because no individual can deliver this, including

Unknown: 00:23:55

myself. And I've been really clear on that. And I think it's

Unknown: 00:23:58

about no surprises, and being brutally honest at times. And I

Unknown: 00:24:02

know that can be hard to hear. And people sometimes struggle

Unknown: 00:24:06

with directness and honesty. But actually, organizations don't

Unknown: 00:24:09

move forward without that. Yeah,

Lee Griffith: 00:24:11

there was a line in your report that struck me,

Lee Griffith: 00:24:15

which was acknowledging that not everyone's gonna agree with your

Lee Griffith: 00:24:18

approach and might have different opinions have you had

Lee Griffith: 00:24:21

much challenge? I

Unknown: 00:24:24

really haven't actually, I think not challenged

Unknown: 00:24:27

because people have really agreed with the content of the

Unknown: 00:24:29

report, both our staff and our external partners and

Unknown: 00:24:32

stakeholders. I think the nervousness if I'm really honest

Unknown: 00:24:35

with you was around how brave the report was in the content of

Unknown: 00:24:39

it. What I fed back is I'm not prepared to dilute anything

Unknown: 00:24:43

down, because this is my own credibility on the line. This is

Unknown: 00:24:45

what people have shared with me and I have a responsibility to

Unknown: 00:24:49

be authentic in my approach, and I'm not prepared to deviate from

Unknown: 00:24:53

that. So I think there was a nervousness around how will

Unknown: 00:24:55

people take this has it gone too far, but actually, I'm

Unknown: 00:24:58

comfortable that I have mine I don't have my own brand on that.

Unknown: 00:25:01

You've

Lee Griffith: 00:25:02

touched on authenticity quite a bit in our

Lee Griffith: 00:25:04

conversation. And I know from conversations we've had in the

Lee Griffith: 00:25:07

past and seeing the types of things, you talked about social

Lee Griffith: 00:25:10

media, you're a really strong advocate for women's rights and

Lee Griffith: 00:25:15

women leadership, LGBTQ plus rights, black and ethnic

Lee Griffith: 00:25:19

minority disability. So equality and inclusion really matter to

Lee Griffith: 00:25:23

you. And that comes across. I'm interested in how your approach

Lee Griffith: 00:25:27

to advocacy might have changed as you've progressed in your

Lee Griffith: 00:25:32

career, and maybe some of the challenges and barriers that

Lee Griffith: 00:25:35

you've worked to overcome during your career as well, if you

Lee Griffith: 00:25:39

don't mind? No, of course. And

Unknown: 00:25:41

you're absolutely right, I am hugely passionate

Unknown: 00:25:43

about equity, and creating an inclusive culture in the

Unknown: 00:25:46

organization. And I think some of this really goes back to

Unknown: 00:25:49

basics again, for me, Lee, in terms of no matter what role you

Unknown: 00:25:53

play in an organization, whether you are the top consultant, the

Unknown: 00:25:56

chief exec, or reporter, or cleaner, we all bring something

Unknown: 00:26:00

different to the table. What I tried to do through my

Unknown: 00:26:03

leadership is really break down those barriers, and hierarchies

Unknown: 00:26:07

and actually demonstrate we are all people and human. At the end

Unknown: 00:26:10

of the day, we all have feelings, and we all have our

Unknown: 00:26:12

own strengths that we can bring to the table. And if we actually

Unknown: 00:26:15

embrace those will be a fantastic team. And I try to do

Unknown: 00:26:18

that in different ways. Every day of the week, drawn on my own

Unknown: 00:26:23

experience.

Lee Griffith: 00:26:24

How does that manifest itself? I suppose,

Lee Griffith: 00:26:26

because it can. And I'm not saying this of any

Lee Griffith: 00:26:29

organizations, you've worked in witnessing it myself in

Lee Griffith: 00:26:32

organizations, they can become tick box, or they sit with some

Lee Griffith: 00:26:36

a certain person within an organization. So how have you, I

Lee Griffith: 00:26:39

suppose, challenge that

Unknown: 00:26:41

you're absolutely right. It's about meaningful

Unknown: 00:26:43

engagement. So through meaningful engagement being

Unknown: 00:26:46

clear, how do we listen to feedback and involve others, and

Unknown: 00:26:50

lead to a better experience for patients or staff at the end of

Unknown: 00:26:53

the day, it translates into the power to move from conversations

Unknown: 00:26:56

to results. And what's different at the end of the day, rather

Unknown: 00:26:59

than just talking about things and not moving forward. I'll

Unknown: 00:27:02

give you an example. Tonight, I'm going to one of the youth

Unknown: 00:27:05

cafes here in Kirkwall to meet the LGBT group after work. I

Unknown: 00:27:09

will spend a couple of hours with those colleagues about

Unknown: 00:27:12

what's it like for you to receive care in Orkney at the

Unknown: 00:27:15

moment, what do we get right? But what needs to change and I

Unknown: 00:27:19

will commit not to change in the world because I can't because we

Unknown: 00:27:22

haven't got the money to do that, or the ability to do that.

Unknown: 00:27:24

But well, I'll be honest about that. And to I'll pick a couple

Unknown: 00:27:27

of things that I know are changeable for the better for

Unknown: 00:27:31

LGBT community. And I'll commit to following that through. So

Unknown: 00:27:34

I'm not just paying lip service to it and going tonight for a

Unknown: 00:27:37

cup of tea and a nice piece of cake. I'm going to actually

Unknown: 00:27:40

genuinely listening to make positive change without

Unknown: 00:27:43

promising the Earth.

Lee Griffith: 00:27:45

I'm also interested in I don't know much

Lee Griffith: 00:27:48

about the Orkney as you said, you've got a population of

Lee Griffith: 00:27:51

20,000. There's lots of little islands, aren't there? Yeah. My

Lee Griffith: 00:27:56

geography is not great. But I wonder what it's like when you

Lee Griffith: 00:28:03

work somewhere as remote as that. So I'm thinking when you

Lee Griffith: 00:28:09

work in maybe a rural organization in a city, you have

Lee Griffith: 00:28:13

people who have a lot of choices about where they want to work,

Lee Griffith: 00:28:18

there's competition and different things that might pull

Lee Griffith: 00:28:21

them. When you work in in more rural places, or more remote

Lee Griffith: 00:28:24

places. Perhaps the reason people choose your organization

Lee Griffith: 00:28:28

to work out, I'm not motivated in the same way. So it could be

Lee Griffith: 00:28:32

more lifestyle than a career or profession. And that I would see

Lee Griffith: 00:28:37

perhaps causing issues with how you keep them motivated, how you

Lee Griffith: 00:28:41

engage them with the strategic stuff, because maybe the job

Lee Griffith: 00:28:44

isn't as important to them. I'm being really broad brush with

Lee Griffith: 00:28:47

that comment, because I know that won't be the case all

Lee Griffith: 00:28:49

across the board. So how do you start to build a culture and

Lee Griffith: 00:28:53

tackle some of that when people might be in a different place to

Lee Griffith: 00:28:57

you in how they view the organization and their place in

Lee Griffith: 00:29:00

it?

Unknown: 00:29:01

I think you've hit the nail on the head. It's hugely

Unknown: 00:29:03

challenging. And you're right. The geography is quite unusual

Unknown: 00:29:06

here. So we have a context there about 70 islands in Orkney, just

Unknown: 00:29:10

under 20 of those are inhabited. And there's everything from a

Unknown: 00:29:13

few dozen people living on those HomeLink dials to several 100.

Unknown: 00:29:17

So firstly, I am trying to go out to many of those aisles as I

Unknown: 00:29:20

can. In fact, tomorrow I'm visiting Westray with our chief

Unknown: 00:29:24

officer to meet colleagues because I think it's not

Unknown: 00:29:26

actually out on the hours you realize how challenging it is,

Unknown: 00:29:30

in terms of delivering great patient care, just the setup

Unknown: 00:29:33

there in terms of primary care, access to secondary care. But

Unknown: 00:29:36

also there are lots of skilled practitioners and single 100

Unknown: 00:29:39

practitioners working there who feel really detached from the

Unknown: 00:29:42

world. And that's before we even get into technology and

Unknown: 00:29:44

connectivity and so on. And the challenges of when ferries are

Unknown: 00:29:48

canceled. Some of those remote islands have air applying for

Unknown: 00:29:51

that link. So for instance, I'm getting the ferry across

Unknown: 00:29:53

tomorrow and I'm flying back and that's like getting the bus

Unknown: 00:29:56

here. So it's just the very nature of it is totally

Unknown: 00:29:59

different. I think when you have people here, like, you know,

Unknown: 00:30:02

opening, I'm generalizing again, Lee, but the vast majority will

Unknown: 00:30:06

spend their whole career here, what we have to do is work

Unknown: 00:30:09

doubly hard to think. Okay, how do we make sure we keep up with

Unknown: 00:30:13

clinical standards upskill stuff offer stuff opportunities to go

Unknown: 00:30:17

to the mainland. So other territorial health boards in

Unknown: 00:30:19

Scotland, whether it be Aberdeen, Glasgow, or Edinburgh,

Unknown: 00:30:23

to keep their skill, set up support with innovation, learn

Unknown: 00:30:27

from other colleagues, because when you are so remote, there's

Unknown: 00:30:30

a real risk that we do skill stuff, and naturally don't

Unknown: 00:30:33

invest in that training and development. So you've just got

Unknown: 00:30:35

to think about things a little bit differently. But equally, I

Unknown: 00:30:39

think, because of our remoteness and uniqueness, actually, we are

Unknown: 00:30:43

a testbed for innovation because it forces us to think and work

Unknown: 00:30:46

differently, for instance, with Shetland or the Western Isles,

Unknown: 00:30:49

because actually, Ireland boards should be that kind of hub of

Unknown: 00:30:52

innovation, if you really think about it, because if we can do

Unknown: 00:30:54

it in some of the smallest health boards, then we should be

Unknown: 00:30:57

able to upscale that innovation to the larger territorial health

Unknown: 00:31:00

board. So I think it's, it's all of those things. But it is an

Unknown: 00:31:04

extra challenge. And I think, probably the final thing, and

Unknown: 00:31:06

this will come as no surprise to you, there's a lot of resistance

Unknown: 00:31:10

to change here in terms of that we have always done things for

Unknown: 00:31:13

however many decades. And I think it's just trying to move

Unknown: 00:31:16

that agenda forward. But doing it in a respectful way, in a way

Unknown: 00:31:20

that takes people with you. And you

Lee Griffith: 00:31:22

mentioned you came from Norfolk before you move to

Lee Griffith: 00:31:25

the Orkneys. And I'm assuming it won't necessarily be exactly the

Lee Griffith: 00:31:29

same. But it also again, a more rural communities, perhaps not

Lee Griffith: 00:31:34

the same opportunities than those based in bigger city

Lee Griffith: 00:31:37

organizations, what learning from your experience might be in

Lee Griffith: 00:31:41

the back of your mind, I suppose as you as you go forward,

Unknown: 00:31:44

a whole heap of learning. I think one because

Unknown: 00:31:46

it's the reality of if Norfolk and you may recall, when myself

Unknown: 00:31:50

and the team went into Norfolk, we were the worst performing

Unknown: 00:31:53

hospital in the country on every single indicator. I'm not

Unknown: 00:31:56

suggesting that's where we are from an auditing perspective.

Unknown: 00:31:58

But there are certainly room for improvement when it comes to

Unknown: 00:32:01

organizational culture, improvements, improving staff

Unknown: 00:32:04

engagement and experience our financial position. And I think

Unknown: 00:32:07

some of the recruitment and retention challenges we've got

Unknown: 00:32:10

what comes with that, especially with such a high proportion of

Unknown: 00:32:13

agency, staff, and locums, you have that transient workforce.

Unknown: 00:32:16

So building that culture and stability, you have to work

Unknown: 00:32:20

doubly hard and differently to do that, recognizing, for

Unknown: 00:32:23

instance, here, we'll have some consultants who are here doing a

Unknown: 00:32:26

list this week, they won't be back for four or five, six

Unknown: 00:32:28

weeks. So you have real transience here, that it just

Unknown: 00:32:31

takes a little bit of getting used to really, but some

Unknown: 00:32:34

similarities in those areas that I could certainly bring to the

Unknown: 00:32:37

table here. But equally there is just as an island board, there

Unknown: 00:32:41

are some real unique factors that I've known learning from

Unknown: 00:32:44

other island boards, including us have said Shetland and

Unknown: 00:32:46

Western Isles here, but elsewhere in the UK,

Lee Griffith: 00:32:50

is it less about getting them bought into big

Lee Griffith: 00:32:53

strategy staff for more about I hate the phrase, but improving

Lee Griffith: 00:32:57

their working lives and their practice? I

Unknown: 00:32:59

think it's got to be a bit of both. One of the things

Unknown: 00:33:01

I've really learned and I think we've probably all learned

Unknown: 00:33:04

coming through COVID is there's a real tendency in the NHS to

Unknown: 00:33:07

focus on the here and now constantly, what are we doing in

Unknown: 00:33:09

the next day, we'll never mind the next day or the next week or

Unknown: 00:33:11

the next month, you have to do the here and now. But balance

Unknown: 00:33:14

that with looking at the next five to 10 years. And that's

Unknown: 00:33:17

what I'm really trying to do here, future proof this

Unknown: 00:33:19

organization to make sure we have a sustainable future whilst

Unknown: 00:33:23

tackling the challenges of today. And that's hard, but I'm

Unknown: 00:33:25

really forcing myself to do that. Otherwise, we will never

Unknown: 00:33:28

get on to some of the strategic issues that are really

Unknown: 00:33:31

important. And that will impact on the health care of people in

Unknown: 00:33:35

Orkney for the next decades to come. So I've already started

Unknown: 00:33:38

turning my attention as I'm dealing with the issues here.

Unknown: 00:33:41

And now improving culture being as visible as I can, trying to

Unknown: 00:33:44

make sure I spend the time on the strategic issues that are

Unknown: 00:33:47

going to take us forward in the decades to come. One

Lee Griffith: 00:33:50

of the things that struck me in your report back on

Lee Griffith: 00:33:53

your 100 days actually was the sense of recruitment and

Lee Griffith: 00:33:55

retention but with a view to leadership development, and how

Lee Griffith: 00:33:59

do we identify the leaders of the future because they are

Lee Griffith: 00:34:02

going to be homegrown and perhaps more there than anywhere

Lee Griffith: 00:34:05

else. So that really struck me very

Unknown: 00:34:07

much. So and I think again, it comes back to basics,

Unknown: 00:34:10

really thinking through leadership development programs

Unknown: 00:34:13

and personal development, but succession planning. So we've

Unknown: 00:34:16

already started that, that started with the exec team, it

Unknown: 00:34:19

will then cascade down to the rest of the organization.

Unknown: 00:34:22

Because what we can't afford to do here, probably more than

Unknown: 00:34:25

anywhere, is lose really great people. We talk about

Unknown: 00:34:28

recruitment and retention. I'd actually say retention here is

Unknown: 00:34:31

even more important than recruitment, if I did say that

Unknown: 00:34:34

in many ways. Yeah. I

Lee Griffith: 00:34:36

want to briefly explore the reality of being a

Lee Griffith: 00:34:39

Chief Exec. So there's the perception that you get to make

Lee Griffith: 00:34:43

all the decisions and you've got ultimate control but obviously

Lee Griffith: 00:34:47

with that comes a lot of responsibility. How do you

Lee Griffith: 00:34:50

manage the day to day Enos of being Chief Exec.

Unknown: 00:34:55

The first thing is the level of responsibility so when

Unknown: 00:34:59

you have a pot polio, and you can wrap your arms around that

Unknown: 00:35:02

portfolio. That's a big enough responsibility isn't it sat at

Unknown: 00:35:05

the board with that level of responsibility. But I remember

Unknown: 00:35:09

Lee and I tell the story quite a lot. When I was Deputy Chief

Unknown: 00:35:11

Exec. I remember that morning, I was driving to work, and my

Unknown: 00:35:14

chief exec was off on holiday for two or three weeks, for the

Unknown: 00:35:17

first time, I was stepping up to Chief Exec. And I remember

Unknown: 00:35:20

driving into work thinking, Oh, my gosh, the book truly stops

Unknown: 00:35:23

with me. And I know it sounds really stupid and really

Unknown: 00:35:26

obvious. But it's not until you have to do it, that you realize

Unknown: 00:35:29

the level of weight and responsibility on your

Unknown: 00:35:31

shoulders. If that makes sense. What it really makes me do is

Unknown: 00:35:34

just pause around any decision I'm making. Am I doing the right

Unknown: 00:35:38

thing? Am I truly putting the interests of patients and stuff

Unknown: 00:35:42

first, can I sleep in my bed, if I make this decision, that night

Unknown: 00:35:45

are asleep as well as I can do at night anyway, it's that sense

Unknown: 00:35:49

of responsibility as accountable officer that is completely

Unknown: 00:35:52

different. However, you have to rely on your exec team, because

Unknown: 00:35:55

you can't do everything as Chief Exec. Now we are the smallest

Unknown: 00:35:58

territorial health board here in Orkney. So I haven't chosen to

Unknown: 00:36:02

have my own portfolio to demonstrate I've got to deliver

Unknown: 00:36:05

as much as anybody else. But actually, the role of the exec

Unknown: 00:36:09

team is absolutely critical in terms of that delivery. And then

Unknown: 00:36:13

of course, building that capacity and capability further

Unknown: 00:36:15

down the organization.

Lee Griffith: 00:36:17

Hmm. So what does a typical day look like for you?

Lee Griffith: 00:36:20

No, two

Unknown: 00:36:21

days are the same. I think it's fair to say. And for

Unknown: 00:36:24

me, the other thing I'd say is I really underestimated just

Unknown: 00:36:27

before we get into that answer, I really underestimated the

Unknown: 00:36:30

difference between England and Scotland, it is very, very

Unknown: 00:36:33

different. It's obvious, but even more different when you're

Unknown: 00:36:36

in the system doing the job, in most cases for the better.

Unknown: 00:36:41

Because there's fewer layers. If you look at the governance and

Unknown: 00:36:43

the setup here, there's just a lot to get your head around. And

Unknown: 00:36:46

there's more differences than perhaps people might think

Unknown: 00:36:49

between the English NHS system and the Scottish system. But no

Unknown: 00:36:53

two days of the saying here, there will be days when I'm

Unknown: 00:36:57

chairing lots of meetings, senior leadership to meetings,

Unknown: 00:36:59

we've got board meetings, we've got our board subcommittee

Unknown: 00:37:01

meetings, and you will know as well as anyone you've got to be

Unknown: 00:37:04

on your A game all of the time in these jobs. But even more so

Unknown: 00:37:07

when you're in those formal settings. Lots of system

Unknown: 00:37:10

meeting. So we have integration joint board meetings here with

Unknown: 00:37:13

our local authority partners, and I sit with a number of other

Unknown: 00:37:17

public sector chief execs on different groups so that I can

Unknown: 00:37:20

really add the NHS voice into making Orkney a better place to

Unknown: 00:37:24

live and work. So probably lots of responsibilities out with my

Unknown: 00:37:27

health hat, if that makes sense so much more about how we really

Unknown: 00:37:32

focus on local community here in Orkney, and also real focus on

Unknown: 00:37:37

reducing health inequalities and improving outcomes and opening

Unknown: 00:37:40

is a place to live and work. It's really out of the day to

Unknown: 00:37:44

day I suppose what I would call the acute pressures. Don't get

Unknown: 00:37:47

me wrong, it's still there. Because we've still got an a&e

Unknown: 00:37:49

but a small a&e. But what that means is the work I can do is

Unknown: 00:37:53

much more about improving society here. And its broader

Unknown: 00:37:56

sense. It's so it's it feels like a broader portfolio, even

Unknown: 00:38:00

though it's a small organization. Yeah.

Lee Griffith: 00:38:02

And how do you split your time? Because you

Lee Griffith: 00:38:03

talked a lot about visibility, getting out talking to people,

Lee Griffith: 00:38:07

and obviously seeing the clinical settings at work,

Lee Griffith: 00:38:09

you're visiting the different islands, what's your split of

Lee Griffith: 00:38:12

time? How are you protecting the time to do that?

Unknown: 00:38:15

I don't have any hard and fast rules about that. But I

Unknown: 00:38:18

try every day if I can to make sure I'm visible out and about

Unknown: 00:38:22

as much as I can whether that's within the walls of the Belfer,

Unknown: 00:38:25

which is the main hospital here or out in the community, or out

Unknown: 00:38:29

in the URL. So I really like to make sure that I'm in touch with

Unknown: 00:38:32

what I call the heartbeat of the organization. And that kind of

Unknown: 00:38:36

reality check for me around am I grounded? Do I truly know, the

Unknown: 00:38:41

kind of pulse of the organization at any one time, if

Unknown: 00:38:44

I feel out of the loop on that, I feel like I've got to put

Unknown: 00:38:47

myself back in it and really make that effort even more. So

Unknown: 00:38:50

it's one thing being in meetings all the time, and we all have to

Unknown: 00:38:53

do that. But actually, if I'm too much in those former

Unknown: 00:38:55

meetings, I have to do a walk about to get out to say because

Unknown: 00:38:59

I'm representing the views of stuff and a lot of these

Unknown: 00:39:01

meetings and I want to know that I'm legitimately an

Unknown: 00:39:05

authentically representing when I say this is how stuff feel. Is

Unknown: 00:39:08

it truly how stuff feel. And I can only know that if I'm really

Unknown: 00:39:11

visible and out and about, I just tried to be as on the

Unknown: 00:39:15

ground as much as I can. Yeah,

Lee Griffith: 00:39:17

what's the hardest part of leading for you?

Unknown: 00:39:21

Or the pace of change? Those people who know me, well,

Unknown: 00:39:24

I am very impatient. I work at real pace. Sometimes though, I

Unknown: 00:39:29

go too fast. And I'm very alive to that. And I've tried to

Unknown: 00:39:31

really slow down because otherwise there's a risk. I

Unknown: 00:39:34

don't take people with me because I work too fast and

Unknown: 00:39:37

think too fast. But I think I get frustrated. If things take

Unknown: 00:39:41

so long. That pace isn't right and therefore we don't move

Unknown: 00:39:45

forward and make things better for patients and stuff. Because

Unknown: 00:39:48

fundamentally at the moment, we are letting some people down

Unknown: 00:39:50

here so I have a duty to change that. And as usual, I'm really

Unknown: 00:39:54

impatient around that.

Lee Griffith: 00:39:57

What do you do to keep yourself in check then you

Unknown: 00:40:00

Be very honest with stuff. So I've just had a

Unknown: 00:40:02

meeting with a colleague this morning, she is really unhappy

Unknown: 00:40:04

here. She said, there's no change, not going quick enough.

Unknown: 00:40:08

And I said, Look, I can't change this overnight. I need you to

Unknown: 00:40:12

give me time. But I am committed to making change. And I've given

Unknown: 00:40:15

us some examples of things that have been worked on, that I

Unknown: 00:40:18

perhaps haven't talked fully about to stuff at the moment,

Unknown: 00:40:22

but to give her confidence, things are happening in that

Unknown: 00:40:24

change is coming. But it has to be done in the right way without

Unknown: 00:40:27

promising the Earth.

Lee Griffith: 00:40:29

Yeah. So my final question is, what's the one

Lee Griffith: 00:40:33

piece of advice you would give to anyone aspiring to be chief

Lee Griffith: 00:40:39

executive?

Unknown: 00:40:41

I think I'd have a couple of strands. Actually, if

Unknown: 00:40:42

I might take the liberty of having more than one. I think,

Unknown: 00:40:46

firstly, always be yourself. Secondly, if I can do it, anyone

Unknown: 00:40:50

can interest me because it's about learning from brilliant

Unknown: 00:40:54

people and been in that position where you're given the

Unknown: 00:40:56

opportunity to lead and people taken a bit of a punt on you, I

Unknown: 00:41:01

think, but honestly, if I can do it, anyone can always appoint

Unknown: 00:41:05

people better than you and lead with kindness. If people

Lee Griffith: 00:41:09

want to follow your journey as you settle into

Lee Griffith: 00:41:14

NHSN will be or they want to share their thoughts on the

Lee Griffith: 00:41:17

interview and say thank you for the things they've learned. How

Lee Griffith: 00:41:20

can they follow you? What social media are you on?

Unknown: 00:41:23

I'm on pretty much everything but probably Twitter

Unknown: 00:41:25

is the most sensible. So it's at Laura underscore Scaife.

Lee Griffith: 00:41:29

Brilliant. Well, thank you again so much for your

Lee Griffith: 00:41:32

time. It's been brilliant having a chat with you.

Unknown: 00:41:34

Thank you. I really enjoyed it. Thanks very much.

Lee Griffith: 00:41:39

If you enjoyed this episode, please let me know

Lee Griffith: 00:41:41

on Apple podcasts or on app of choice and drop me a line over

Lee Griffith: 00:41:45

on LinkedIn. You can find me at Nick Griffin. I'll be back with

Lee Griffith: 00:41:48

the next episode in two weeks time for in the meantime,

Lee Griffith: 00:41:50

remember to sign up to my newsletter at Sunny skies.com

Lee Griffith: 00:41:53

for further insights on how to lead of impact. Until next time,