It feels like the time of year when people start new things in their lives, new jobs, new courses, new career paths. So many people I’ve been speaking to lately are moving onto bigger and better things, with many of them starting their journeys as senior leaders both within academia and the NHS. I’ve spent some time talking to them about what I found might be different and some of the challenges about stepping up into a leadership role. Now, my journey to consultant and Lead Healthcare Scientist was not particularly linear so I may have some thoughts about this that aren’t universal, but after doing some thinking the below are what I’ve come up with in terms of how I think senior leadership roles are different and how my thinking has changed whilst in post.

It’s no longer all about you

First and foremost this is the most important thing that I feel is at the heart of what I try to make my leadership decisions based on. I’m now out there representing more than myself, I’m representing a team or even a whole workforce and sometimes therefore my wants and needs will have to take a back seat. I’ve been in meetings where I have given up something I want because actually it enabled something to happen for the wider good of my workforce. I personally don’t think there’s a place for selfishness once you are in a band 8 + position, although I’m also sure that I’m not perfect and probably don’t always make the best calls, it just means I make a conscious effort to keep it in mind. That doesn’t mean that sometimes things don’t work out so you get the best of both worlds, but when you are representing more than yourself you have to do exactly that, represent.

It’s no longer all about doing

One of the things that I think can be especially challenging when stepping up into a senior role, when you are more used to an operational or service provision role, is making the switch from being the person who does to being the person who sees. What I mean by that is that a lot if my job is about constantly having one eye to the future. Where are we going next? What are our current strengths and weaknesses and how do we manage them moving forward? What are the challenges coming down the road and what can we do now to prepare as much as possible? Not only that but once I have a path in mind I have to develop how we are going to get there and communicate that vision as broadly as possible. Obviously this isn’t done in isolation, it needs to always be an inclusive process, but a lot of the thinking sits with me. If you continue to only have an operational view, it can rabbit hole you into the present, it can then be a struggle to emerge for long enough to do that vision piece. So, although it may be comforting to get back to the bed side or to the bench, you have to make sure you’re doing it to maintain skills when needed rather than avoiding seeing the landscape laid out in front of you.

It’s no longer about picking and choosing who you work with

We all have people we love working with and some people where, because we don’t necessarily share the same vision, it is more challenging. As you become more senior you have less and less choice about who you work/collaborate with, those decisions are made due to the work and not due to personal preferences. This may sound odd but I genuinely believe that this is not only right but a good thing. If you only work with people who are easy, who see the world the same way you do, are you really working to reflect the wider attitudes of your staff? Although not easy some of the best project outcomes I’ve had have come from working with people who have very different attitudes, values and objectives. If done well and professionally these relationships enable you to have constructive challenge and see work or scenarios in a way you never would alone. They may not lead you to change your direction but they will always help your thinking as to why, and often help you to develop and articulate your arguments in a way you may have not gotten to on your own. Best case, you’ll get an outcome you couldn’t have achieved on your own, worst case you’ll have clarified your thinking. This doesn’t mean that I don’t (as someone who likes to be liked) find this a particularly challenging aspect of leadership, it’s just that I also really see the value in it. Hiding is no longer an option.

All those people you thought were on top of it probably weren’t

If you are like me you probably spent a lot of time in previous roles being amazed at how productive your seniors were and at how much they achieved. Now I’m probably biased here, but rather than judge myself harshly I’m going to extrapolate instead that all those people I looked up to just covered up their failures better than I do. My experience of stepping up to leadership is that you will have more work than you can manage at any one time, you will never clear the decks and you probably won’t ever ‘finish’ anything. That’s because you will move from a task based role to one that is much more far reaching and often conceptual. Some days I really miss just being able to spend a Friday doing 16S rDNA sequencing, unless I screwed it up I knew that at the end of the day I knew that I would have achieved something and that I would then action a patient result. Now most of my days are moving things forward by inches, or if I get to the point where I get a task off my list it is so rapidly replaced by something else I barely notice it, let alone have satisfaction as a result. This isn’t to bemoan this way of working, it’s just different and if you come from a very task orientated role it can be a little demoralising at the start as it can be hard to see progress. It’s really worth therefore finding other ways to track your progress so that you can still find a way to visualise it. I sometimes try an annual wish list for instance where I check in over a period of months rather than days to see how things are coming together.

You will spend more time than you thought possible on emails and calls

It’s currently 6pm and I’m just trying to get some words down here before I leave work. I have spent since 8am this morning trying to recover from the email backlog from 3 days off work last week, I’m proudly down to 283 which need actioning. Email is the quicksand of my working life, when combined with days that often have meetings back to back from 8 – 6, they are almost impossible to keep on top of. The main thing I’ve tried to develop are some tools to try to ensure that I don’t miss anything devastating and urgent. That said if it is devastating and urgent you should probably be calling rather than sending me an email. I’m quite up front with people. If your email comes in whilst I happen to have a window and I’m staring at an inbox you will probably get a response within 5 minutes, if not it could be 5 months. If you need a response send it at least 3 times, preferably with a red flag and then at least it will get to the top of my to do list. At the height of SARS CoV2 I was getting upwards of 600 emails a day, thank god that’s reduced, I just couldn’t keep up. Over time I’ve also tried some strategies to protect my diary where I can. My fab IPC team suggested a 1.5 hold in my diary every day for urgent meetings so that they should (almost) always have a slot which they know is theirs to put it meetings when needed. I also try to go to less meetings that are just for information and not for action, otherwise to be honest I would never manage to eat or go to the bathroom. Feeling out of control is therefore pretty normal and it’s about strategising so you keep on top of the key things. You will also develop language that will help you cope and politely deflect some of the things that could be handled by someone else. I used to feel bad about delegating, but actually a lot of the time it offers development and learning opportunities for others. If done appropriately it will not only buy you a little breathing space but it will enable others to continue their own career journeys.

Sometimes it’s your job to be the shield

One of the things that comes with being the one to develop the vision is that you also (often) are the one that can see the storm approaching. This one for me goes hand in hand about the role no longer being all about you. Sometimes it’s my job to stand in the front and take the hit, sometimes that’s being shouted at by a family for the tough call, sometimes it’s dealing with the response of other senior leaders. This is why it is sometimes lonely being in a senior role and you will need support for you as an individual. Senior roles are often not that linked up and so you won’t necessarily have someone who is doing the same post as you, you will therefore need to be pro active in building your own support networks. These will also help with the visioning piece as the more connected you are the more pieces of the jigsaw you will see. The more you understand the drivers of what is going on in any particular situation the more you will be able to respond with understanding, and the greater the chance of improving a situation rather than making it worse. There is no getting away from the fact however that sometimes you just have to don your big person pants, stand your ground and deal with whatever has come your way with as much integrity and grace as you can muster.

There are weights you don’t see

I recently took hubby away for his big birthday to Disneyland Paris. Towards the end of the holiday I looked at him and I suddenly realised how different I felt. For 6 days I had not been Dr Cloutman-Green, I’d just been Dream. I’d made no decision bigger than what I wanted to eat/drink or what ride I wanted to go on next. I felt stones lighter and so much freer. I hadn’t realised the weights I’d been carrying with me. I don’t know how much of this is COVID but I find there is an unseen, and some days unbearable, weight that I carry with me and that I don’t even realise it’s there until I put it down for a while and take off my healthcare hat. This may just be a me thing, it may be a pandemic thing, but if you get afflicted you have to make sure you that you put the weights down from time to time and do whatever it takes to make you feel free again, for me it was going to a mad hatters tea party!

You will always be more than your job, you will have other roles (mother, wife, carer, sister, father, son, brother etc) and we can’t always sacrifice these for a job that can become all encompassing if we let it. In the long term it will make us poorer both at the job and as human beings. Some of these weights we will put upon ourselves and so need to work on ourselves to resolve. You will not have all the answers on day one in your new role, you are constantly going to learn and develop, in fact I hate to break it to you but you will never have all of the answers. You will fail at things more than you’d like. This is part of life, it’s part of leadership and it’s part of learning. It’s OK. The sooner you come to terms with that the sooner you can remove an unnecessary thing that might weigh you down.

I for one didn’t realise any of the above, in fact I didn’t even really realise I was a senior leader, it kind of just snuck up on me. I think the capacity to influence and lead change is worth so much more than the challenges that come with it. For me as a Trust Lead Healthcare Scientist I get the immense privilege of seeing so many people develop and flourish, who will hopefully one day give me a job, I wouldn’t change it for the world. If you have just stepped into a senior post or are thinking about it I hope the above helps and makes your realise you are not alone in the challenges you face and that overcoming them makes us better, even if the path is sometimes bumpy. For those of you not yet at that point I give you the advice that I wish someone had given me, enjoy the freedom, enjoy focussing on you and your career pathway, enjoy making choices that are your own and don’t be in too much of a rush to get to the top of the mountain.

All opinions on this blog are my own