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Come in – the water’s lovely

New leadership roles are opening up all the time.

Yet many physios are wary of jobs where they will have to manage other professions. Daloni Carlisle talked to two who are happy they stepped up to the challenge.

The advent of multi-professional teams, in which a leader may manage a range of professionals, and the move towards competency-based job descriptions are opening new opportunities for physios.

Frontline talked to two physios who have taken on senior leadership roles, one as a modern matron and the other as a deputy chief executive, to find out how they influence services, manage professionals from other disciplines and what advice they have for others wishing to follow in their footsteps.

Shane Degaris

is deputy chief executive and director of operations at Epsom and St Helier University hospitals trust, a role he took on two years ago.  He qualified as a physio in Australia in 1990 and moved to the UK in 1996 where he worked in management roles at North Middlesex University hospital trust and Barnet and Chase Farm hospitals trust.

What is the best thing about your current job?

The best thing is the mix of strategy and operational management.   At the moment I am looking at how A&E services can best be provided in this part of Surrey as well as making sure we hit the four-hour target consistently.

How have you used your influence to improve patient care?

Recently it’s been helping the trust to deliver all the key government standards. We have improved our performance in A&E, delivered the 18-week referral to treatment waiting times and cancer waiting times. These are things that make a real difference to patients.

What first inspired you to move into this job?

I was working in an outpatients department in Australia and it was a shambles. I was dealing with patient after patient who had been kept waiting or had not had information about their appointment and I thought: I could do better than this. Moving into management meant I could make a difference to a group of patients at a policy level.

What have been the best and worst moments?

One of my best moments was when I moved into my first substantive management job outside physiotherapy. It was very exciting but also very daunting. More recently it has been being part of the team that delivered the best ever > performance at this trust as measured by the Care Quality Commission ratings.  The worst moments are reading something negative in the local papers,  especially when it is not accurate. It really affects morale as staff take it very personally.

What were your expectations about managing other staff? Were there any surprises?

My biggest fear on moving into a general management role was managing consultants and professions such as nursing. In fact, I have found being a physiotherapist very useful as I have credibility as a clinician. I’m not seen as a bureaucrat. Until I moved here to Epsom and St Helier, in Surrey, I had been based in north London. I had a big network of contacts and relationships. I knew everyone. What surprised me when I arrived here was how long it took to establish those key relationships.

What is your advice to physios thinking of putting their toe into the leadership water?

There are lots of opportunities and you have transferable skills and clinical credibility  so take a chance. Try a secondment so you don’t have to give up your clinical job. Talk to people like me and find out what it’s like.

Vicky Jarman

is modern matron for orthopaedics and rheumatology at Basingstoke and North Hampshire trust. She has worked at the trust for 21 years and took on her current role three years ago.

What is the best thing about your current job?

The best thing is being able to relate directly to patients and staff on a daily basis. Although I manage over 100 staff, I am also very visible to patients and part of my job is to make their experience of being in hospital as good as it can be.

For example, I recently worked with a family that was very concerned about their mother being in hospital. They were worried about her feeding in particular and I was able to show them the systems we have for helping elderly people feed and reassure them.

How have you used your influence to improve patient care?

I have been in this role for three years and over that time I think the biggest contribution I have made to improving care is to get the staffing levels up by using objective measures such as throughput, length of stay and dependency levels. I think physios are very used to being objective and using evidence and that helps when it comes to presenting a case for senior managers.

I have also employed a rehabilitation practitioner. She is a band 5 physiotherapist working in the orthopaedic trauma unit delivering care to patients with a fractured neck of femur. It is a combined nursing and physio role which means she works as a member of the team and she can discharge patients. Part of her role is to reinforce what physios do, demonstrating to nurses that we can walk someone to the toilet rather than use a commode. The role has significantly improved our continuity of care.

What first inspired you to move into this job?

I was invited by the head of nursing. It was quite a radical move and at first I undertook the role on secondment as I had no idea how it would work out and whether I would be accepted by the junior nursing staff. It did not take long for me to realise that this is a lovely role where you can take part in everything without leaving the coal face. I even do some hands on clinical work.

What have been the best and worst moments?

The best moments are direct patient involvement, whether that is spending time with patients and a family or sorting things out to make them feel good about the whole experience of being in hospital.

I don’t think I have had a ‘worst’ moment although certainly there have been some challenges. The biggest one  and one set to become more important  is supporting staff  trying to deliver a high quality service in a challenging financial environment.

What were your expectations about managing other professions?

I was asked to apply for this job so I knew I had the backing of senior nurses. I anticipated that there might be some resentment from junior nurses but there wasn’t. They are a super lot.

What is your advice to physios thinking of putting their toe into the leadership water?

There is no doubt that physios have the capability to be leaders. From the word go, we lead patients and help improve people’s lives. So whether you are doing it as a clinician or as a manager you use the same strategies.

My advice would be have confidence that you have the skills and work on how you are going to consolidate them into something measurable so you can show other people that you can move on. fl


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Daloni Carlisle

Issue date

21 April 2010

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