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Hello, I’m Domhnall MacAuley and welcome to this BMJ leader conversation.
Today I’m talking to Emma Challans-Rasool. Emma, you’ve had lots of senior roles in healthcare but I want to take it back to the very beginning. Were you always interested in healthcare? Take us way back.
Emma Challans-Rasool: I’ve been in healthcare probably for about 25 years now, but I certainly did not see it as an industry that I wanted to work in. When I go back to my school days, I was very interested in sport, anything that involved activity. I played football from age nine to 25 years old. Back then women’s league football wasn’t as popular as it is now, although I am pleased that its now so popular. I always knew I wanted to do something that involved people, to be part of a team, something that tested me mentally and physically. I left school straightaway at 16 and joined the fantastic National Youth Training Scheme, if anyone remembers that in the UK. I didn’t have a clue what I wanted to do, where I wanted to be but I thought, I need to get out there and get me a life. So that’s when I started work in an accounts department in a local company and then moved on to different administrative roles. I finally landed in an international purchasing company who did a lot around manufacturing and that’s where I was introduced to ‘lean techniques’, ‘time and motion studies’ and, within a year, I found myself going from being a PA to leading a department. I had this way where I could engage with people, communicate with people, and I wanted to get the best for the customer. And the organisation favoured this style and approach. Over the next two years I worked in that manufacturing space and I learned a lot about standards, compliance, working with customers, and clients. So, at 18 or 19 years old I found myself leading the conversation with some big international customers. It was quite daunting, but I just embraced it.
I wanted to go and work in a big city and I went to live in Sheffield. I set out to get a job there, and I got a job in the NHS where I was a PA in a project office for “Agenda for change”, and quite low down in the career ladder level. And then I got hooked. Working in the learning disability division of a community health trust, I just loved the difference it made for people. We worked with families, patients, carers, and I quickly found that I enjoyed it. I wanted to work where we look to improve people’s experience, whether in health or care support. I just went on from there, working in different roles in the NHS, looking at clinical audit, effectiveness, best practice guidelines, and evaluation. I loved it, and I ended up managing the program for the whole of Sheffield. I was fascinated by it.
From there I went into the improvement transformation space, learned a lot around culture change, leading change – through people and not done to people – worked with the Improvement Foundation and then moved into the private sector, the ‘dark side’, some may say. But, I wanted to learn and experience the wider healthcare industry so I worked as a consultant across the UK and Europe, with different health providers and sectors, learned a lot and got into human factors with management.
I decided I wanted to go back to the NHS and I went into operational management and leadership. Over many years I worked my way up the career ladder, becoming a director of operations at the chief operating officer level for large acute hospitals and community health trusts. I was always in the guise of transformation, change, culture transformation, and that’s what I loved. Culture, how we design and think about organisations, systems, and people. but what I really value in that I understand just about every part of the health and care system.
DMacA: It wasn’t just about being hooked or loving it, there was more to it than that…So for someone who’s aspiring to follow your career, how would you advise them? What were the key steps along the way that made it a success?
E C-R: When I look back, I realise that my anchor is my values and that I personally need to feel fulfilled in my role. I often check back with myself if all those values are being met, and do I feel that I’m using the skills that I think I’m best at? So, for someone following their career, look at that, what makes them tick, what gives them that energy, what gives excitement, joy, satisfaction, vision. And how do I bring all of that together? Does a role exist? Does it not exist? I’ve carved out a pretty good career over the last number of years, because I’ve moved away from chasing a title and seniority and looked at what it is that I need to do that is going to give value back to others? I’ve really leaned into myself and been curious with myself over the last ten years, and I think I’m pretty much where I want to be now in those jobs.
DMacA: Over the last ten years, many of those roles have had the word ‘culture’ in their title. So, talk to me about culture in the NHS.
E C-R: It’s a fascinating subject. People think of culture in many different ways, whether it’s about how people behave, lead, their leadership style, whether it’s the culture of the community, the citizens that live in it, the people that work in it. For me, culture is number one because if we don’t work hard, be relentless, engage in listening and understanding, we will set ourselves up to fail. Creating the right conditions, the right climate where people continually feel safe, trust the people they work with, feel part of a team, feel involved, listened to, respected, and have a chance to help change the future. If we can’t get the climate right for people to bring their whole selves to, we will not transform and change the way that we work. So for me, culture is number one. Whether it’s in senior operational roles, national roles, organisations, systems, it always comes back to the people. We need to be deliberate and relentless, engage and involve people.
DMacA: As we talk about engaging with people, tell us about your current roles.
E C-R: My current roles is as Director of NHS Horizons. https://horizonsnhs.com/about/ Horizons was created by Helen Bevan almost 25 years ago and Helen still works very closely with myself and the leadership team. We do a lot around large scale, complex change. We particularly support system change, the national programs, where they want to create something different and hone in on convening people and enhancing that social movement in that space so that you bring the socio technical elements together We work about bringing together the social interactions, engagement, convening, but also coupled with the technical tools, guide processes. We do a lot around large scale change across the NHS, with Sport England, the Department of Health, and we also support some international programs and projects. And, I’m also the founder and director of Proud2bOps https://proud2bops.org which was founded almost ten years ago, when I was in a senior operational manager role in an NHS trust. It is a network for operational managers and leaders across health and care, predominantly from provider organizations in England. We’ve a network now of thousands of operational managers across the country where we come together to help energize each other, to connect people with their peers, to develop the people who are part of the community, whether it’s around operational skills, knowledge, leadership styles. We’re an independent network and are really the professional body for operational managers. We therefore do a lot of influencing upwards to the Departments and government bodies, and we work very closely with them. We like to see ourselves as a critical friend where we raises issues and problems, together with solutions.
DMacA: Let’s take a little diversion in the conversation because you mentioned that Horizons works with Sport England, which brings you right back to your initial interest in Sport. Tell us about the parallels between the NHS management and the world of sport.
E C-R: When I think about the NHS, I think of a team of teams. There is so much teamwork that is required to make large scale change. I recall my days as part of the football team, and one of the most precious things I learned is about how to lead a team, how to be a team, how to learn from your mistakes, learn when things go wrong, celebrate when things go well. You only win as a team, not as an individual. And I see that as one of the greatest opportunities for the NHS. Our work around physical activity with Sport England, is very much within the ethos of convening a team of people, and there may be multiple teams, but we’re all guided towards that one ambition, those goals. We’ve a good shared understanding and expectations of each other and we’ve created the conditions where that is a driver. There is something really heavily connected about being in teams. Its also about giving back to the communities that we serve. So that everything we do in Horizons and Proud2bOps is about giving back to the people that live in the communities because they’re the ones who really benefit. And we live in those communities, so we’re going to benefit as well. It’s about really paying attention to that and it means for the people in those communities.
DMacA: You’ve written about management and the NHS, and there are parallels with sport, in the sense of the criticism that the NHS is over managed, bloated management, and that it would be better if it was all stripped away. What are your thoughts on that?
E C-R: There are a lot of unkind and ill-informed perceptions and assumptions about NHS managers. We convene thousands of people across this management landscape on a weekly and monthly basis and what I see are very passionate people who really want to make a difference to people’s lives, love the role that they do, who work endless hours, and often feel quite battered and bruised by what is publicly projected about managers. When you do look at national and international statistics, the NHS is one of the most undervalued, in terms of people, compared to most international health care systems.
We want to try and change that perception so people look differently, really understand what these people do, why they do it, and get a bit more of an insight into the day and day in the life of an ops manager. Believe me, I’ve been there, and it can be a 15-16 hour day. You’re always on call. You are never really off. We’re asked to provide a lot of information. It’s a very reactive space whilst, at the same time, we’ve got to provide services to people. Its not that managers want pity and for people to say, poor managers. It’s not that. Everyone is a grown up and worked in the system long enough so that when we get things wrong we say it. There is a lot of projection that everything is due to managers. That’s not right. It’s the system and the conditions and the processes we’ve got that we really need to pay attention to and think differently about. I think it’s quite unkind and ill-informed as I see so many incredible managers who love what they do and are so passionate. People need to see that well and recognise it.
DMacA: In that context, you’ve also suggested that you feel morale is very fragile in the NHS.
E C-R: Its very fragile at the moment. As we go back to the culture of the NHS, I think that’s something that’s been in trouble for a number of years. And again, if I’m honest, I don’t think the media projections actually help. They just fuel it. That said, I see some organisations that are doing brilliant and really changing the culture, changing the way that people think and behave. We’ve got major change coming across NHS England by the Department of Health and Social Care, with estimates that 50% of jobs may go. A lot of people will just fill in the gaps even more. And it’s about delivering the health mission in a safe and supportive way that takes the people with us. Morale is low in many areas but I continue to see the camaraderie of NHS people in not giving up. They want to work with people and bodies and governments and organisations to make things better. However, I think it’s going to be a hard and long process to get to a point that it is an improvement on where we are today.
DMacA: Let’s finish on a positive note, because you had a very positive message for everyone when you released a video this morning. Tell us about your message.
E C-R: Today marks the first day of Mental Health Awareness Week, and the focus this year is on our communities. I thought quite a bit about this over weekend around what that means for my world, but it also relates back to the power of movements, social movements, and interaction and engagement. Its about the communities that you lead, work with, engage with, and I’d really like people to think hard about your communities, and where you go to for support, for involvement, for energy. With my communities, I get a lot of energy from them, it really drives me each day but I also get to share when things aren’t going so well and people help me with solutions and ways forward, and you get that through the power of communities. So, yes, this week is a focus week around how you are taking care of yourself. Look around you, what is going on around you, what you’re noticing, what can you be more deliberate in paying attention to. And, importantly, beyond this week, where are your communities and your spaces and your people that you can go to help you be the best that you can be and for you to feel safe, supported, and live a much better, happier, healthier life.
E C-R: Emma, thank you very much. It’s been wonderful talking to you, and it’s been a great inspiration and encouragement to see what you can achieve through the love of what you’re doing, your commitment, and your enthusiasm for the job. Thank you very much indeed.
Emma Challans-Rasool
Emma is Director of Horizons and Founder and Chair of @Proud2bOps a National Network of Operational Managers and Leaders. As a Director in Horizons, Emma leads at national level and is proud to have built a strong professional presence and credibility across health and care and supporting business sectors. Proud2bOps is a multi-award winning network, leading and supporting under represented professionals; Ops, Managers and Administrative Professionals. She is an entrepreneurial leader, continually striving to bring innovative solutions to improve people lives.
As an experienced board level director and systems leader within the health and care sector she is a values driven leader centred around people, continually striving for innovation and improvement that enhances patient, colleague and customer experience. Her career includes senior positions with portfolios of organisational development, culture, operational management, quality improvement and large scale movements. She has experience both in the public and private sector, in both commercial and public facing businesses. With extensive non-executive director experience in citizen facing organisations, organisational effectiveness and continuous Improvement is at the heart of everything.
She is a qualified coach & mentor committed to enhancing people’s performance and satisfaction. A very family orientated person and she values time with my friends and family, loves the outdoors, being creative, and enjoys fun holidays and adventures.
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none