To round off the posts about different opportunities for Healthcare Scientists outside of the laboratory/clinic this week for National Pathology Week I wanted to end by discussing opportunities for Healthcare Scientists as leaders.  Now leadership is obviously possible at all levels and there are lots of different options, but as I accepted my Trust Lead Healthcare Scientist position 5 years ago this week I thought I would focus on that.

What is a ‘Lead’ Healthcare Scientist?

To continue the theme of this week, from my experience no two Trust Lead Healthcare Scientist jobs are the same.  I share my post with the wonderful Dr Stuart Adams, and even our experience of the post is different because we lead on different things.

The main theme that I have been able to discern across Trusts is that the role of the Trust Lead Healthcare Scientist is to provide professional leadership for the Healthcare Science (HCS) workforce across specialism boundaries and to provide representation for the workforce either at, or to exec level, in order to ensure the integration of healthcare science provision across patient pathways.

In the role we have at GOSH there are three main areas of responsibility we share for the Healthcare Science workforce:

• Research
• Workforce development
• Education

We report to the medical director and have a committee called the Healthcare Science Education Working Group which we work collaboratively with in order to try to get representation from across healthcare science involved and engaged in decision making.  We also work really closely with the GOSH Learning Academy or GLA, which is probably why in all honesty I feel like we are making more headway currently with workforce and education.

The long term aspiration has always been to make these roles analogous to a Chief Nurse or Medical Director position but for now, just having a seat at the table is key.

How it started

These roles have come into different Trusts at different points and there are still a number of Trusts who do not have HCS representation at or to board level.  My first awareness of this role even being a possibility was due our education lead in 2015, who I’d been working with on other things as part of my PGCert. She emailed me to see if I would be interested in working with others to set up a HCS group in order to have a cross Trust forum.  This idea was a revelation to me.  I’d worked at GOSH for more than 10 years and had met HCS from outside pathology on leadership courses and as part of trying to organise Reach Out for Healthcare Science, but we had never had a forum where we could regularly meet as a group, get to know each better and establish links, as well as identify shared barriers and opportunities.  It was as part of this work that the Healthcare Science Education Working Group (HSEWG) was established.

Prior to the establishing of this group I also had no idea about the strategic set up of HCS outside of GOSH. Alex Milsom and Ruth Thomsen came to present to this new group about both Trust Lead HCS and the work being done of the CSO office and NHS England, suddenly my world increase in size. The HSEWG started to work towards creating a Trust Lead HCS post. As we had no funding we were hoping that we could at least get a named post that had recognition by the board and a defined remit. At this point however I had no intention of applying for such a post myself, there were so many others who were more qualified, better experienced and better placed.

Not long afterwards a letter went out from Chief Scientific Officer Sue Hill to all Trust CEO’s and in 2016s Lead HCS jobs started to be advertised (see above).  Many of the posts, like ours being prepared, were unfunded.  At the same time as these were being developed we got a new energised and inspiring Head of Education (Lynn Shields) who in her interview from the outset was determined to represent all professional groups.  She found £15000 a year in development funds for HCS and from that created a 1 day a week band 8B Trust Lead HCS post. Thus the GOSH Lead HCS post finally became a reality in 2017.  By this time I was about to start my NIHR Clinical Lectureship and had become so engaged and excited by the possibilities of what the HCS workforce could achieve that when it was advertised I ignored my fears and went for it.  The complication was that I was also about to go on sabbatical for 2 months to Boston Children’s Hospital and so it was proposed that the post was split into 2 0.1 WTE roles.  This was the best thing that could have happened, my co-lead and I have very different skills sets and I love not having to do what can be a challenging role in isolation.

Where we’re headed

The one thing I’ve learnt in this post is that nothing can be achieved well in isolation. The job is in itself all about collaboration and involves working both with GOSH and across the system to drive change and improvement. It took me a some time to really grasp the difference between an operational (doing role) and a strategic role. Lead HCS in my experience is definitely strategic, it’s about working out the vision for where you want to get to and a rough road map, but really working with others to actually achieve it. I think we (the HSEWG) have a good idea of where we as a team would like to get to, but in a world where we have clinical and other commitments delivery can be a little more challenging.

The vision that we have can’t exist in isolation however. There is amazing HCS leadership at regional level. I’m fortunate enough to have continued to work with Ruth Thomsen as our regional lead for London. She has taught me so much, listened to my woes and is a constant source of inspiration.  I can’t advise enough finding out who your local leads are and building relationships with them. The ones I know are all both top notch scientists and top notch people. Even if you are not in a leadership position yet they can help orientate you to the world of HCS outside your Trust and if you’re lucky mentor you to help you achieve your potential.

Not only are there regional HCS networks but there are also national ones. Obviously most of us are aware of things linked to our specialisms but it’s definitely worth linking into the national work being done by the Chief Scientific Officer and her team, they even have a twitter account to make it easy.  There are regular webinars and an annual conference that can be a great way to find out what is happening national at a strategic level and how it’s likely to impact you and your Trust.  Current important themes like the implementation of ICS boards as well as HEE joining NHS England will filter down and impact us all.  By being aware of this we can make sure we are part of the conversation rather than an after thought.

NB. Talking about orientation outside of your Trust now is also the time to find out a little more about Integrated Care Systems (ICS) as these come into play from the 1st July and will really impact on how we deliver services, what our training funding and support potentially looks like and where some of decision making occurs.

Why is it important to have these roles?

That brings me onto not only why I enjoy the role but also why I think it’s key that HCS at other Trusts see if they can bring in equivalent posts.  This isn’t because I believe that I am in any way amazing, in fact there is lots that I wish I could do better and so much more I wish that I could achieve.  That said, even if I struggle to get us where I want to during my time in post, I have managed to get a seat at the table.  A lot of the time I get to be in the room when items are discussed and I can say ‘have you thought about how this will impact the Healthcare Scientists?’.  This is especially true with new patient pathways or with new builds.  Have they thought about the fact that opening X number of new beds will lead to X number of new samples, and so they can’t just increase the establishment on the ward but also need to increase numbers in diagnostics.  There are also times when I can provide a solution that no one else in the room may have conceptualised, linking to triage or changes in flow, because I can suggest a rapid test or a modification.  As Shirley Chisholm said ‘If they don’t give you a seat at the table bring a folding chair’.  Once you get into the room, a chair will follow.

It’s also about visible leadership, this week we’ve talk a lot about different roles but if we are not out there and visible, both to our own profession and others, we limit both our own trajectories and our wider impact.  Leadership roles are really common in nursing and medical disciplines and increasingly common for Allied Healthcare Professionals (AHP), but we will never have the same input unless we are seen and active in breaking down silos and fostering collaboration.  I hope that by being seen and by being open about the benefits and challenges of these roles that others will feel inspired to see this as a route they would want to follow.

I have one more possibly contentious point that I’m going to mention here because it’s something that I really believe in, although others are free to disagree.  I think using the collective name of Healthcare Scientists is key for us to have a voice in a lot of these conversations.  I am a proud Clinical Scientist, I’m proud of the work I did to get my state registration and to get on the HSS register as a Consultant Clinical Scientist.  However I switch the title I use based on the audience I’m speaking with and who I’m representing in that conversation.  Using the term Healthcare Scientist helps as many senior people within the Trust don’t know the difference between a Biomedical vs Clinical Scientist. This is of course something that we can address over time but is often not necessary for the messaging we are trying to do.  Registration titles are, currently, still also quite pathology linked, whilst using Healthcare Scientist can span so many other disciplines across the Trust.  Registration titles also mean that we exclude our unregistered workforce from being included in these conversations or under the umbrella of the discussion. Using specific registration titles can therefore introduce unnecessary barriers to communicating key messages in the moment.

Numbers and representation matter.  At GOSH HCS represent over 13% of the workforce and we have the numbers to get listened to if we discuss HCS using those numbers as a whole.  If I start splitting us into smaller groups I lose impact, when someone says ‘how many people will be disadvantaged by that?’ me replying ‘4 ophthalmic visual scientists’ isn’t the same as ‘over 700 Healthcare Scientists’.  At a national level it’s even more challenging as we are only about 5% of the workforce and are advocating and challenging for the same pots of funding or prioritisation as much larger groups.  Yes we have have impact across pathways, but numbers do count.  It is much easier for me to say we need to have a Healthcare Scientist on this group than to say we need to have a bioinformatician and a BMS and a Clinical Scientist, and a physiological scientist etc……..suddenly we are asking for 5 seats when we are more likely to succeed when we act together and ask for one and then show what we do with it.  So I’m a Consultant Clinical Scientist working in Infection Prevention and Control but I am also a Trust Lead Healthcare Scientist representing all of the Healthcare Scientists within my Trust.

The potential of our work force to create and support change is immense, but to do that we need to be in the room and part of the conversation. Leadership matters, representation matters, being seen matters, so lets advocate for ourselves, get into the room and change the world!

All opinions on this blog are my own