Stability. Certainty. Safety.

I ventured into the humanitarian sector, managing and leading teams in countries with fluctuating stability, uncertainty a part of daily life, and where careful planning was essential for staff and patient safety. On returning to the NHS, I look for ways to apply what I learnt in humanitarian settings to my everyday work. Are there similarities between these different working environments and lessons that can be transferred? This blog reflects on my journey from working in countries dependent on humanitarian aid to returning to one of the largest healthcare systems in the world.

Situation

Joining a humanitarian organisation as project pharmacy manager took me far beyond the healthcare system and cultural context in which I had trained. I travelled across thirteen countries, transiting through sixteen airports, three train stations, and one golf course for helicopter evacuation. 

The realities of one country may never fully reflect those of another – these differing worlds may only ever meet in the mind of the traveller. My experiences broadened my perspective, strengthened my adaptability, and enhanced my competence to develop solutions to problems, despite the context.

Task

In the humanitarian sector, the pharmacy team is responsible for medical stock management, from medication to needles, cannulas, dressings, scrub uniforms, crocks, laboratory test kits, hospital beds, oxygenators. On each assignment, I adapted to the context – the country, the project, the team, the times, and to rapidly changing priorities. The teams I worked with had weathered storms before me and inspired the teamwork necessary to persevere in humanitarian response, offering a new perspective to what it means to endure in adversity.

I subsequently returned to the NHS. Here, military tanks rarely pass by the hospital entrance, and staff induction need not include guidance on avoiding stray bullets or kidnappings. Yet, the NHS faces challenges of its own. My role has not been to compare or diminish those challenges, but to understand them, identify the underlying problems, and learn how to contribute meaningful solutions given the current context.

Action

Stability and communication

Similarities exist between joining a new team either in the humanitarian sector or in the NHS. I acknowledge the importance of listening and understanding the established team dynamics. Allowing some time to regain team stability after joining a team as a new member also proves important – particularly before introducing any new ideas or a further case for change. 

As expectations form around what I should or could accomplish within an NHS team, I balance expectations with a realism of what is possible in that given context. Clear communication helps navigate expectations and becomes the means through which to build trust and conditions for a team to thrive.  While the way we communicate varies, the need for communication remains constant; it transcends language, culture, and professional roles. Teams can move forward through meaningful communication and constructive feedback.

Structure and collaboration

One notable difference between humanitarian and NHS teams is their structure. In the humanitarian setting, staffing was lean due to resource constraints and the need to operate strategically in complex environments. Responsibilities were sharply defined, interdependence was highly visible, and accountability was shared, as the team’s success depended on every member contributing effectively according to their scope.

Although NHS teams are often larger than humanitarian teams, effective teamwork still depends on clear roles, defined responsibilities, and good communication. In complex organisations, responsibilities can sometimes become blurred and accountability less visible, particularly where multiple teams and layers of process are involved. Maintaining clarity about individual roles, decision-making responsibilities, and how each contribution supports wider organisational objectives is essential for effective teamworking. 

Humanitarian work taught me the importance of role clarity, professional boundaries, and shared responsibility. Returning to the NHS, I apply these lessons by ensuring I understand the expectations regarding my role, responsibilities, and the boundaries within which I work. I also make a conscious effort to communicate the values and principles that guide my management and leadership approach. This transparency can help build trust, align expectations and create a strong foundation for team collaboration.  

Result

Resilience and change management

My experience in humanitarian healthcare strengthened a range of skills that have translated directly into NHS leadership and service development. Working away in complex and unpredictable environments strengthened my resilience, adaptability, and confidence to lead through uncertainty whilst maintaining a focus on patient safety and quality of care.

It also taught me how to bring structure to complexity. In resource-limited settings, innovation was often essential, and I saw healthcare professionals find practical solutions using the resources available to them. These experiences reinforced the value of initiative, professional autonomy, and empowering teams to solve problems creatively while maintaining high standards of care.

Whether working in humanitarian settings or within the NHS, I found that while the context may differ, core principles of effective leadership remain the same: transparency, accountability, reliability, humility, and a commitment to continuous improvement. As the French proverb reminds us, plus ça change, plus c’est la même chose—the more things change, the more they stay the same.

So, was it worth it? The travel, the challenges, the uncertainty, and the lessons? Absolutely. Rather than returning as the person I was before, I return with a broader perspective, greater resilience, and a deeper appreciation of healthcare’s shared purpose. The experience continues to shape not only my professional practice, but also my leadership journey.

Author

Eleanor Harvey

Eleanor Harvey is a clinical pharmacist and registered member of the General Pharmaceutical Council with Independent Prescriber annotation. She has experience across general and teaching hospitals, public health settings as Chief Pharmaceutical Officer’s Clinical Fellow at the UK Health Security Agency—with a focus on antimicrobial stewardship and infectious disease outbreaks—and overseas in humanitarian health projects. She is an Editorial Fellow for BMJ Leader and currently works for the NHS in the Bristol area. Her professional interests include healthcare leadership and management and research on pharmaceutical care in migrant populations.

Declarations of Interests
I have no interests to declare.