Leading Insights

Professor Jason Leitch CBE is NHS Scotland's National Clinical Director, responsible for quality in the health and social care system, including patient safety and person-centred care, NHS planning, and implementing quality improvement methods across the government and the broader public sector.  Jason is an Honorary Professor at the University of Dundee and completed a Quality Improvement Fellowship at the Institute for Healthcare Improvement, under the mentorship of Don Berwick.  In this episode, Jason shares his career journey, from Dental School to Scottish Government.  Does the National Clinical Director suffer imposter syndrome?  What challenges him?  What's the best advice he ever received?  Listen in to find out.....

Dr Catherine Calderwood was appointed as Chief Medical Officer for Scotland in March 2015.  Catherine is an obstetrician and gynaecologist and continues to have a maternal medicine antenatal clinic at the Royal Infirmary of Edinburgh. Until her appointment as CMO, she was also the National Clinical Director for maternity and women's health for NHS England.  In this podcast she shares her leadership journey, advice and tells us more about the evolution of Realistic Medicine.

In this episode we explore Angiolina's views on leadership, "making the weather", how she has developed over her career and what motivates her.

In this episode we talk to Shaun Maher, Strategic Adviser to The Scottish Government and champion of person centred care.  Shaun shares his journey from Intensive Care Nurse to National leadership position.  We discuss compassionate leadership, wellbeing, role models and the current COVID crisis as he joins us from NHS Louisa Jordan in Glasgow.  Interviewed by Dr Thomas Lamont and Kate Arrow.

In episode 5 of Leading Insights we speak to Safia Qureshi, Director of Evidence at Healthcare Improvement Scotland.  She tells us about her journey from Academia in to leadership.  From leading the construction of the award winning Jack Copland Building  and using her scientific background to inspire and achieve.  She reflects on the role of evidence in the current COVID climate and her personal learning throughout her career

In this episode we talk to Sarah Davidson, the CEO of Carnegie UK. We hear about her career in the Civil Service and she shares her experience of Organisational expectations vs Personal development. We discuss the power of Mentorship and changing career paths into The Third Sector

Show notesKate Arrow  0:02  Welcome to episode eight of Leading Insights.  Today we're joined by Melis Senova. I'll let her introduce herself.MS  0:15  Hi, thanks for having me. So my current, I don't know if it's a job, my current, let's call it a portfolio of projects. So things that I'm all across, really involves working with people in all sectors, trying to help them think about how they can improve the systems that they're working within from a human-centred perspective and bringing, kind of bringing the heart back to business and to government at all levels. That's kind of what I'm doing and I'm doing that through my firm Huddle which is a human centred design agency, which we started in 2009 and also through my coaching and This Human site, which is the platform that surrounds my book.Kate Arrow  1:16  And tell us a little bit about the journey you've been on to get that kind of portfolio.MS  1:22  So I started as a Biomedical Engineer.  I studied biomedical engineering and I was really interested in neuroscience and the brain and how the brain works.  I majored in neurosciences, and then I had an opportunity to go away and work in a Research Hospital in Japan for a year in between my undergrad and my PhD and that was a Research Hospital for brain and blood vessels. They basically specialised in stroke and they were also an experimental hospital, where they got all of the latest technology so I got to play with some pretty amazing equipment for that time. So this was mid 90s and I was doing functional MRI testing and PET imaging and all of this stuff, just literally looking at the brain.  Then I had this weird dream that was an eyeball trying to see itself in space, like blackness, and then kept thinking "We're using the thing in our heads to try and work out how the thing in our heads works" and I just felt this was like a big, futilely, like we're never ever going to get out of this loop of doing brain research, and that whole thing and set me on a bit of a different discovery....What I was actually interested in was, how do I improve the conditions for people? Like how do I design better services and design better policy to be able to just improve the conditions within which people exist. And that's when I decided to do my PhD in human centred design. So that's how that happened. It was that weird dream that set me off on this other trajectory around design and designing with them for people. And I've basically been doing that ever since I did my PhD in the Defence Department.  There I was working with military aircraft pilots around workload and situational awareness and designing for improved performance. And then I did very similar work in the automotive industry at Ford and Sumitomo, and then I spent some time At Telstra, in the emerging technology space and always working from the persepctive of 'How do we design for the human experience?'.  Then I set up Huddle as an agency to be able to help other organisations do that for themselves, essentially. So that looked like service design and strategic design and we've sort of moved on from there. We started a school called Huddle Academy, we started teaching it, I wrote a book, so it's just kind of it's sort of evolved.Kate Arrow  4:36  How did it feel at that point, when you had that dream for changing, changing your direction?MS  4:45  Well, there's a whole bunch of funny stories actually that led to me, finding myself at the Defence Department doing a PhD in human centred design.  I'm not afraid to explore new pathways. So no matter how quirky and weird they are, in terms of their source, you know, whether it's a dream or odd conversation or...but one of the reasons why I ended up in the Defence Department was that one of the Professors of the University that I was at, was talking to me about doing a PhD. I wasn't actually on board with the idea, I had this sort of, 'I need to get out there and start doing stuff' feeling and 'I don't want to spend more time at university knowing this much about something that's going to be that, you know, a tiny bit relevant'. He asked me; "If you could be anyone who do you want to be?" and I said that I wanted to be Charlie out of Top Gun. I wanted to be in that scene where she was walking down the tarmac, and they introduce her and they say, you know, she has a PhD in AstroPhysics. She works in the Pentagon, you know, the Pentagon, trust her. So usually when I was young, I was probably still in primary school and I just remember going, I want to be her, I want to be her, I want to be that woman. So I shared with him that story. He picked up the phone and called The head of the Air Operations Division, this defence science and technology organisation at the time, and just started a conversation around a potential PhD candidate with a scholarship, would they take her on? Then that's what I did for the next four years. I was a civilian contractor in the defence department working with F18 & F11 pilots, looking at situational awareness. So  I was just kind of, you know, following my nose in a way and it felt, gosh, sounds really exciting.Kate Arrow  6:56  It just shows you that it's worth being honest about  your childhood dreams and  being really transparent about what you think no matter if it's not what you think somebody wants to hear.MS  7:19  Yeah, yeah, for sure. And also, I think that I was in a pretty unique situation in that I, you know the Ph.D wasn't something that I was attached to so it could have happened or it couldn't have happened.  There was nothing at risk for me in that conversation. I think often people resist having those really honest and open conversations because they feel like something is at risk for them. And, and that's one of the lessons that I've actually learned throughout my career, which is to say that I have learned that you never really lose out When you show up 100% authentically and say the thing that everyone perhaps wants to say, but isn't saying,  In the short term, it might feel like you take the heat, but  in the long term, always, always, always, it's the best policy. That's what I have personally learned. So I was acting that way, you know, when I was younger, without that much to lose, really.  I'm grateful that that has kind of carried on in my career.Kate Arrow  8:34  And and was it like Top Gun? Was it as male dominant as Top Gun when you were there?MS  8:41  Yeah. In fact, I haven't reflected on this. I've always worked in male dominated industries. Until I started Huddle, and when I started Huddle  it was mostly women all the time, and we had like the whole reverse scenario which I loved. But it was also quite confusing for me because I had learnt how to work in groups of men. And I hadn't worked in groups of women before in my professional career. So that was actually quite an adjustment in terms of how, you know, work gets organised and problems get solved. And yeah, that was a really massive part of my transition into leadership. Kate Arrow  9:32  You've got a fascinating combination of experience, how did that all come together for you & influence the kind of leader that you are?MS  9:42  You know, in my book, I talk about one of my beliefs, which is that I believe that everything that you're doing is an apprenticeship for the next thing. I think that's true. I think that a caveat to that is that you should approach your life like it's a masterclass.  I think Oprah actually has a podcast something like that Life as a Masterclass. What I mean by that is that  you look at all of the things that happened to you as an opportunity for learn...

Kate ArrowSo welcome to Leading Insights. Today we are joined by the First Minister of Scotland, Nicola Sturgeon. I am Kate Arrow, I'm a registrar in Anaesthesia. Thomas LamontAnd I'm Thomas Lamont, I'm a Registrar in Restorative Dentistry. First Minister, thank you for joining us.  Nicola SturgeonYou’re welcome, lovely to talk to you. Thomas LamontFirst Minister, you started your career as a solicitor in Glasgow before moving into politics and subsequently into leadership roles. A lot of Doctors, Dentists and Healthcare staff don't really see themselves as leaders. What was it that inspired you to move into leadership roles? Nicola SturgeonI'm not sure it was ever a really conscious decision. I don't think I ever woke up one day thinking I want to be a leader. It was just where the progression of my career took me. I certainly didn't go into politics with any ambition or intention of becoming a leader. I went into politics because of what I believed in and what I wanted to campaign for and try to bring about it. But you know, as I progressed through that I got elected to Parliament and found myself being in leadership positions, and I wouldn't say I always felt or feel comfortable with that, but feeling that there was a degree of aptitude I suppose there that didn't put me off. But you know, as a leader, now, there's not a day goes by where I'm not still learning about what it means to be a leader and hopefully how to be a better leader so I'm not sure in any walk of life; I think leadership is something everybody experiences in one way or another whatever they do in life, but it's, it's not something I would necessarily recommend people should have as their primary objective in life. It's something that if you find yourself in that position, and you think you're up to doing it, then you should do but obviously to learn from others too. Kate ArrowWere there key lessons you learn throughout your time as Health Secretary, that have helped you to lead Scotland as First Minister during this COVID-19 pandemic? Nicola SturgeonYes, loads and loads of lessons and I sometimes can find myself wondering what it would be like to be trying to lead the country through COVID as First Minister had I not had that experience as Health Secretary. I'm sure I would be doing it and I'm trying my best to do it, but there's no doubt that being Health Secretary he has helped with that, you know, first and foremost, at a very basic level, it gave me an understanding of how the health and care system works that, you know, I would not have had as directly without the five years or so I spent as health secretary; and during my time as Health Secretary I also led the Scottish Government response to swine flu. And so it wasn't quite the same as COVID has turned out to be but in terms of that pandemic response and some of what has to be done and considered there, I had a bit of a grounding there so there's no doubt you know, not just in the COVID response and so much of what I do in my day to day work as First Minister, that grounding as Health Secretary, which has been really important to me and you know, the job I do just now is the most privileged job in the country but having been Health Secretary is always a job that will have a very special place in my heart. Kate ArrowI'm sure you've not had much time to reflect on the last few months yet, but sort of reflecting on it now, are there things that it's taught you about yourself and about your leadership style? Nicola SturgeonYeah, I think so. But as you say, I've not had the chance to process this sufficiently and hopefully one day I will and might be able to give you a more rounded answer than the one I'm about to give you right now. I think it showed me that possibly even more than I knew before, that I've got resilience and an ability to keep going through, you know, sort of tough times and, and focus very much on decisions that have to be taken there and then and try to do that in quite a methodical way. I suppose I've been reminded, as I so often was as Health Secretary of how the decisions I take, so often can only be taken with the input of lots of clinical and expert and scientific advice and that has been hugely important to me. So there is a need always to think about what it is that only I can do and decide, but what it is I need in order to base those decisions because I'm not a clinician, I'm not a scientist. And so, I'm very dependent on the advice that I get but recognising my responsibility to apply the judgement to that, and it's supposed to take the responsibility and the accountability for it as well.  I suppose one of the things it has taught me though, in a way that nothing else in my political career has is that sometimes, all of what goes with politics and being a politician really doesn't matter. And all that matters right now is just trying to take the right decisions, as best you can, and the need to forget about whether they're popular or not or what they're going to mean, in an electoral sense, that kind of thing is and I, you know, if I turn the clock back six months or so, I may have never believed this would be the case, but that stuff just doesn't really matter in the day to day decision making. And I suppose that's been quite eye opening for somebody who's spent so long in politics in that more traditional sense. Thomas Lamont  A lot of people, following this, are really thinking about what's important in life aren’t they?  Our final year Medical and Nursing students graduated early to support the service. They were as usual full of enthusiasm; across the workforce it is recognised that we all need to do more to prevent burnout and low morale. What advice would you give to people who have to step up into new or unfamiliar roles during sort of uncertain times like these? Nicola SturgeonI would say a few things. Firstly, I want to take the opportunity while I have it just to say such a massive heartfelt thank you to people who did step up into these roles, graduating early taking on more responsibility than they would normally have done that early on in their careers. And, you know, we all owe everybody across health and care, but I think particularly people that position an enormous debt of gratitude.  And before I go on to talk about what my advice would be to individuals I think one of the reflections I will take away from this, and as you know, as you said a moment ago, we've all been reassessing what really matters in life. And, you know, all of us, starting with politicians have to think about how we do value people working in our health service and our social care system. Do we value that enough in the support that is around them, and, frankly, that the financial rewards we give, and while there may be no overnight, immediate way of completely transforming all of that, you know, we shouldn't lose sight of the fact that we've all been reminded of just how dependent we all are on people in these positions.  I suppose my advice to individuals would be and you know, forgive me I'm, I've never been in that position. And you know, no matter what I have to do on a daily basis, it's not the same as stepping onto a busy hospital ward or into a care home or into an ICU Ward so I can’t pu...

Kate Arrow  0:02  Welcome to Leading Insights. Today we're joined by Cat MacAulay. Cat could you tell us a little bit about your role?Cat Macaulay  0:14  Sure. So I'm the chief design officer for Scottish Government's digital Directorate. And that's a fairly new role, I think. Well, I know for Scottish Government. First time we've had the chief design officer. And really what I'm there to do is, I suppose a couple of key things. So one of them is helping to introduce the idea of user centred design, particularly around the design of services, but not exclusively, as as one of the ways of working and thinking that we need in government in the modern government, you know, until, till fairly recently, Scottish Government in particular was a fairly benign kind of government in the sense that it didn't tend to directly deliver many services to its people.  It outsourced the delivery of most services and so it was really more of a policy generating organisation. And that changed a lot with the introduction of a number of the devolved powers around things like social security, tax generating powers and so on. And so suddenly, we had to learn how to design and deliver services ourselves, as well as think about, you know, the role of policy in directing the design and delivery of services elsewhere. So, I was brought in fairly early on as one of the early sort of batch of designers coming in trying to help out with this and took responsibility for growing what was a sort of community, you know, practice community, but also a professional community, but also for helping to think about what bits of design that you know, design methodology that were largely developed in the private sector and what bits of those are really relevant for government work, bits are less relevant and how do we combine the kind of Drive for participatory democracy that is quite embedded in the heart of Scottish Government with design and design thinking as a toolset and a way of approaching service delivery in particular, and bring those two things together and really drive them into the heart of government effectively. So I've been doing that for about five years now, which astonishes me but there you know, time flies.Kate Arrow  2:22  Can you tell us a little bit about your career journey to get to there. Where did you start? Cat Macaulay  2:25  Okay. The first thing I would say is, I've never considered myself to have a career journey. It was a decision I actually made very early on when I was a teenager, because I  read in this book something about the Native Americans of Vancouver Island in Canada having a saying, which basically amounted to you better do lots of interesting things in your life otherwise you will be very boring when you're old and telling stories around the campfire. Who knows how true that is? Or if it's just apocryphal, but anyway it impacted on me and so I Sort of meandered through most of my 20s and early 30s not really thinking particularly about what I was doing, other than following my nose around things that interested me. So I started out as you often do, doing all sorts of juggling three jobs and restaurants and nightclubs and things like that. And I set up a cafe in Edinburgh, I fell into doing that it was the first LGBT owned and run cafe in Scotland, towards the end of the 80s 1980s. And I meandered out of that and into a job in news monitoring for one of the Maxwell Corporation companies, which was entertaining in the late late 80s, early 90s meandered out of that into working in international age during the Balkans war, meandered out of that into a number of other kind of roles in the community sector and then eventually ended up running a small company doing information systems development and design while studying for a master's in a PhD, and then eventually that led me into becoming an academic. And then eventually that led me into becoming a consultant in industry and then that led me into Scottish Government. So it's not really been a career path. It's been a career meander. But the common thread I think, in all of them when I look back has been designed, you know, I've had a, I've had an interest in how we solve problems well, and, and how we build the solutions to those problems. Well, from very early on, and that is, that is a threat I can see in my career, such as such as it exists in the earliest days.Thomas Lamont  4:44  I love your job title. That's my favourite.Cat Macaulay  4:47  Yeah, me too. Thomas Lamont  4:51  What challenges have you experienced across those different roles?Cat Macaulay  5:00   I suppose I should contextualise by saying I'm getting on a bit now. So I'm in my 50s. And I left school and then University in the mid 80s, straight into the teeth of one of the big recessions back then, and came from, you know, well, I suppose most of the challenges that I've faced in my career have more to do with who I am than anything particularly to do with the jobs themselves. Because, you know, I've never really fitted in the world, you know, I was, as a kid, I was definitely odd. I was very, very tall. And I realised quite early on that I was gay. And that had a huge impact. So, you know, first of all, before I came out to live in the world, and then after I came out, you know, for quite a long time, it did impact my job choices and my job opportunities. I still lived during the era when things like section 28 were in force. And when we ran the cafe, you know, it was a time when we just weren't understood or accepted in the way they are today. I remember being involved in one of the first demos in Scotland Against section 28. And it's hard to remember, but this was before pride happened. You know, there was no parade back then. And there was about six of us standing on princess street in a Saturday, chanting about gay rights, and, you know, facing the kind of horrified looks of the passers by. I remember going for jobs and  I always made a point of coming out at jobs because I just sort of thought, I don't want to have to work somewhere where I can't be out. And you know, you would see right away on their faces and that was it. You were either running or not.  When we were setting up the cafe and we went for a loan and you know, we went to several banks to try and get a little startup loan, which was quite normal back then, because there was another recession happening. So there was quite a lot of support for small businesses starting up and you know, literally being told we wont fund perversion and showing us the door. You know, so it, so that impacted a lot of my early experience of, of work, you know, I always saw jobs where I could be comfortably out. And, you know, in many ways that was, that was really helpful and good, because it did allow me to, to live openly, but at same time, it did absolutely limit the things I could do. And later on, you know, that sort of started to flatten out a little bit, but not entirely, and, but then in my very late 20s, I was diagnosed with MS. And that, again, was another complete change for me, suddenly, I was, you know, looking at a life and something that I hadn't really anticipated having to deal with. And at that time, certainly, you know, the kind of the standard, kind of medical response to a diagnosis with Ms was, you know, don't don't exercise don't have any children, you know, prepare to retire, you know, when I was 29 at that point. So, there was very little support, very little advice on how to manage it in your career. So you know, Right away, I needed to jump into a career that had a pension. So I didn't have a pension. And so that's why I started the journey towards becoming an academic. And that's actually just driven me ever since is just holding on to a pension of so...

In this episode we chat to Louise Macdonald, Chief Executive of Young Scot.  In this episode, Louise shares her story of shifting careers from Journalism to The Third sector.  She tells us how her values are core to prioritising work and her several high profile roles and how she balances self-care and professional life.

Dr Navina Evans is the former CEO of East London Foundation Trust.  Under Dr Evans' leadership, ELFT developed their organisational strategy focussed on improving the lives of their patients through Quality Improvement methodology and people participation.  She has recently moved to Health Education England as CEO.  In this podcast we discuss her career from Psychiatry to Chief Executive, the challenges of maintaining momentum and effecting continuous improvement as well as her experience of service co-production with patients and carers

Thomas Lamont meets James Timpson to discuss the importance of kindness, language and autonomy in the success story of Timpsons.  James shares his views on building up a diverse team of colleagues and why he believes delegating autonomy leads to innovative, successful services led by happy and motivated teams.    Listen in to hear how he has achieved this in his own company over the last 20 years.

We need to talk about suicide prevention and postvention. In this episode we speak to Professor John Gibson (Emeritus Professor of Oral Medicine, University of Aberdeen) who describes his journey following the unexpected and devastating suicide of his 24 year old son Cameron in 2019. John was part way through walking Land’s End to John O’Groats to raise suicide awareness and funds as part of #onemanwalkingamilliontalking. John gives insight and advice as to what we can do as individuals, teams and society to prevent suicide and help those affected by it.Visit www.thecanmoretrust.co.uk to support