John Cowman, CSP’s new chief executive, takes up the post this month. He tells Gary Henson about his career and his approach to leadership
Why did you choose physiotherapy?
‘So, it’s a story of a Sunday afternoon when I decided to go ice skating. There are two things here: firstly, my distinct inability to ice skate and secondly that I had purloined my brother’s Levi’s jeans for the trip. I dislocated my knee and tore my anterior cruciate ligament. I was 13 and when I got to the hospital, they went to cut off my brother’s jeans – I suggested it would be better for me if they cut off my leg!
‘At that point I realised that I have hypermobile joints and it was the first of many knee injuries, resulting in a significant number of surgeries in my teens, and up until my early 20s.
‘So I spent a lot of my time on a physiotherapy couch and fell in love with the profession.’
John described his physiotherapy training at Trinity College in Dublin where he qualified in 1995 as ‘amazing.’
‘I found it to be a really huge privilege. It was a four-year undergraduate programme and had all of the components I think are really important for physiotherapy courses. Our anatomy and physiology training was second to none, and we studied with pre-med and occupational therapy students. It was a really lovely way to study, where you were learning your own profession and your own trade, but alongside those that you would be working with in the health services.’
John’s undergrad research focused on cerebral palsy: ‘I had experienced physiotherapy from the age of 13, always very inclined towards paediatrics.’
Having been offered a scholarship to continue his undergrad research by the university and Dublin’s Central Remedial Clinic, he developed and assessed a novel technique for the non-invasive treatment of hamstring muscle contractures in children with cerebral palsy.
At the same time he took a diploma in statistics and a post-grad in psychology and was awarded his MSc in research in 1998. During this time of extended study John began work in four different roles as a physio – in a private clinic, as a paediatric physio in a CRC school and as a neurology physio in a unit for long-term rehabilitation for chronic neurological conditions. In addition, in a forerunner for FCP in England now, he was approached by the government to tackle waiting lists for physiotherapy in the system.
‘They asked me to establish a private practice in a GP surgery. I set up and managed the practice but was directly commissioned by the Department of Health with the purpose to fast-track patients into physiotherapy rehabilitation, diagnostics, and onward referral. I guess you’d almost call it like first point of contact which is now quite common, but it was the first time it’d ever been done in Ireland.’
Growing as a leader
John moved to England with his then-wife and here he was a lead researcher on the Gulf War Syndrome trial and an international double blinded placebo-controlled study on beta interferon for the treatment of inclusion body myositis. Following this he held clinical roles in paediatrics, learning disabilities and community therapy. He was also a private practitioner in musculoskeletal and a specialist in the treatment of long-term neurological impairment, including traumatic head injury, Multiple Sclerosis and Motor Neurone Disease.
John’s first executive roles were in the NHS where he was responsible for the development of interdisciplinary community service provision across therapies, nursing, and patient flow. He was the lead for 11 of the allied health professions at Havering PCT, working under Ruth May, the now chief nurse of England. In his role to develop structures alongside NHS London, he led on the separation of the commissioning and provider functions of the PCT and the development of the first autonomous provider organisation, the merger of three community provider trusts and ultimately the creation of Outer North East London Community Services.
Whilst doing this, he studied social entrepreneurship at the Skoll Institute at Oxford University, where he developed his interest and passion for the third sector.
His first role in charity was in 2011 as director of health at Young Epilepsy where he was responsible for the health and care services for children and young adults with intractable epilepsy, autism and neurological disability. He participated in the international programme of research conducted with Young Epilepsy, Great Ormond Street Hospital and other key international stakeholders across health and the pharmaceutical industry.
John then held the executive director of operations at the Royal Hospital for Neurodisability in Putney before moving to Mencap where he spent six years as the chief operating officer, accountable for a team of over 7,000 people and the delivery of care and support to over 5,000 people with a learning disability across 750 services in England, Wales and Northern Ireland. He successfully led the care and support provision throughout the Covid-19 pandemic, and with a team of dedicated and passionate care colleagues, maintained some of the lowest mortality rates in the sector.
It was here that he developed his curiosity for modern organisational forms, particularly the Teal philosophies of Frederic Laloux and Dignan and enrolled at Bayes Business School at City University to undertake his PhD, studying the impact of reduced hierarchies and enhanced empowerment as valid structures for health and social care. His studies in this area are ongoing and centre around a ‘3 Fs’ approach to enable people to do their very best work in a structure of freedom, framework and fundamentals.
Describing his PhD as his ‘passion’, his studies very much focus on the empowerment of individuals in the workplace. It examines the philosophies and ideologies of Laloux and his approach to organisations which are founded on the basis of empowerment, ensuring that organisations afford trust and decision making to their employees.
‘Trade unionism is an extension of that philosophy where we want our membership to be able to influence, we want them to be able to negotiate and we want them to be able to establish systems that are most effective, best value, and afford both our members and the patients, or the end users, the greatest impact. Trade unionism is a form of negotiation and empowerment that puts human and employment rights at the centre of relationships,’ says John.
His most recent appointment before taking up the chief executive position at the CSP was as executive director at Royal British Legion Industries, a charity focused on the wellbeing and support of the military veteran community.
Support through leadership
When asked at a party, ‘what do you do?’ John explains: ‘I always say I’m a physiotherapist by background. I’m not a physiotherapist, I’m not registered as a physiotherapist, and that’s a very important distinction.
‘I’ve been asked the question about not being registered and it is because I knew I wasn’t going to spend my life or my career as a clinical physiotherapist and I needed to draw a distinction in my career journey, affording me the freedom to explore executive leadership.
Asked what defines him, he says: ‘The belief that with the right support we can all achieve great things. The definition of me has been really shaped by working with people with the most profound disabilities. I will always remember Brian, a young gentleman I worked with. He had the most severe quadriplegic athetotic cerebral palsy I’ve ever seen, he had very little, if any, control of his body movement. But he could control his head and we provided him with a speech writer where he could tap out letters. In terms of today’s technologies, it was rather rudimentary, but Brian used it to write beautiful poetry. I remember walking away and thinking, people can achieve great things with the right support, training and commitment from those around them. This extends now into my leadership style where I believe giving people the right fundamentals and the right framework can afford them freedoms to achieve in work and in life.’
‘My leadership style is very much personality-driven, people will see me everywhere.
I feel absolutely certain of why I get out of bed in the morning and it’s to really put my efforts into those around me, or those who need me, to be able to offer them the support that they need to be the best they can be.
‘Belonging means something’
Turning to the question of improving the experience of minoritised members, John said one of the things he dislikes in organisations is ‘tick boxing EDB strategies.’
‘Equity, diversity and belonging strategies are the lifeblood of organisations, especially those who represent members, such as the CSP.
‘It’s not about being invited to the party, it is being able to attend and feeling comfortable to come, to socialise, to dance and enjoy the party. That is why I like the belonging phrase and the CSP strategy.
‘We are in a racist and a prejudiced society. And that’s demonstrated far too obviously and far too easily and therefore the corollary that we accepted at Mencap is that if we’re an organisation existing within a racist and a prejudiced society, then our organisation is racist and prejudiced. We approached our ambitions from that perspective. It was a hard journey and one that took a lot of personal acceptance and humility.
‘Our work at Mencap, and my own personal development in strategic thinking, is very much that the only way that you can really embrace this agenda is to develop into an organisation that is anti-prejudiced in every way, anti-racist in every way, anti-ageist and anti-sexist.
I feel proud about my engagement skills. Over my career I’ve developed a really broad range of tools and approaches for how I listen, how I hear, how I engage and how I connect, and I think that’s one of the strengths that I’ll bring to the role.
‘Statements like we will “counter sexism”, do not go deep enough from my perspective. We need to be brave in accepting that some of our behaviours and prejudices as individuals, and as an organisation, need to be explored, understood and change. To be honest, I wouldn’t have joined an organisation where EDB wasn’t as prominent as it is here. The EDB strategy has been front and centre in my recruitment and it is prominent in the thinking and ambitions of the organisation and its membership. That’s the type of organisation I want to be leading. And I feel, like any other organisation, we have much to learn.’
John is keen to be open within the role. His personal life and responsibilities are important to him.
‘I’m a dad first. I love being a dad and being the best I can be as a dad is hugely important to me. I’m also a partner in a very loving relationship. There are three things that bring joy to my life – my kids, my partner and my career.
‘I have two amazingly beautiful children, Jack and Lucy, who I adore and who really shape everything I do. They inspire me, they teach me and they help shape my personal and professional views of the world. They also need me, and I hope the structure and support I give them has helped them achieve all they have, in their social and personal relationships, their sport and their careers. Whilst applied differently in parenting, the 3 Fs approach is as valid in how I love and support them as it is when I am leading organisations.
‘I’m in a same- sex relationship with a very loving man and we’ve had a very interesting journey. David is an ex Royal Marine and so has faced particular dynamics having become public about his sexuality. I’ve been in a heterosexual relationship for many years and married, and as an Irish Catholic, that’s often not easy. I want people to talk to me about those things.
‘This is an extremely important role, and one that I feel entirely privileged to have been offered. I believe I have the skills, the ambition and the lived experiences to continue to develop the organisation into the future. However, I am human, I have lots to offer as a person as well as a professional. I want people to see me as an open book, and to engage me with me on a personal level to the extent to which members and colleagues feel comfortable.
‘I want the CSP membership to know that whatever level of comfort they have in expressing their preferences, in expressing their lifestyle, I am very comfortable, and there’s nothing that people can’t ask me, and I’d like them to know that.’
Engaging with members
‘I think the engagement with the really diverse population of membership is exceptionally important,’ says John. ‘I feel proud about my engagement skills. Over my career I’ve developed a really broad range of tools and approaches for how I listen, how I hear, how I engage and how I connect, and I think that’s one of the strengths that I’ll bring to the role.
‘What’s first and foremost is for us all to demonstrate physiotherapy is a value proposition to the health and wellbeing system – to demonstrate, why physiotherapy as a profession, alongside the other allied health professions, can offer real value, real impact and real change to lives and to the system.
‘I think the innovation and the research that’s happening now is putting us in a really good place for that.
‘We must also offer value to those who are setting policy and to ensure that our members are seen as collaborative partners, especially when it comes to controversial or difficult negotiations including pay, the new NHS Plan, the new NHS Workforce Plan and the treatment of our members in all aspects of their work, whether in the NHS, third sector or private sector.
‘A healthy workforce in physiotherapy, who feel that their rewards are adequate and appropriate to their skill set, will be an empowered profession and that empowerment will enhance the system of health and social care and must demonstrate that rehabilitation is central to personal and societal success.
‘The rehabilitation alliances developed under Karen Middleton’s leadership, alongside the CSP’s work, has to be seen as one of the best value propositions in medicine right now. It can maximise impact. It can maximise value.’
John describes being selected as CSP chief executive as the ‘greatest privilege.’
‘I mean, truly, for it to be asserted that I could be the right person to take this professional body into the future is just something that is beyond a dream for me. I accept this new reality with humility, strength and conviction.
‘I will protect the history and the standing of the CSP and will endeavour without reservation to continue to enhance the work already done. As the leader of a membership organisation I promise that the members will have the influence they deserve, through the council, to ensure that our work, our efforts and our impact are all they need to be to make our profession proud and to ensure that the CSP is seen as a broker of real change, real impact and a demonstrable commitment to equity, diversity and belonging in all its forms.’
Number of subscribers: 2