Leading an NHS membership organisation for commissioners
Dr Steve Kell explains what it takes to get a leadership role at NHS Clinical Commissioners, and what it’s like to face GP and patient scrutiny over commissioning
Dr Steve Kell
Location Bassetlaw, North Nottinghamshire
Role GP, co-chair of NHS Clinical Commissioners and chair of NHS Bassetlaw CCG
What’s the best thing about leading NHS Clinical Commissioners (NHS CC)?
I’m passionate about the local health services, and enjoy working with managers and clinicians to improve outcomes for patients. NHS Clinical Commissioners gives me an opportunity to do this, to influence policy and raise concerns on behalf of members.
What’s the most challenging aspect of your role in NHS Clinical Commissioners?
Being part of the system locally, and at the same time having to push back on a national level can be challenging. I try to work to the principles that I always say what I believe, that it’s right to raise concerns when they are genuinely felt and that collaboration is always better than confrontation.
I’m a managing partner in a large practice and rely heavily on an accurate diary and much improved organisational skills. Time is always an issue, and I always seem to have another place to be. I’m conscious that my time in front of patients is the real part of my job, and I still do at least 5 clinical sessions per week.
How did you get your job?
I was elected by the leadership group, as was my co-chair. The job share has worked really well – it was a deliberate decision to have two of us as it can be challenging and we discuss issues regularly.
Without naming the figure, how much remuneration do you get for your NHS CC work?
Personally, I receive no remuneration. Travel expenses and some backfill funding is provided but this is paid to the CCG to support clinical engagement.
What are the main tasks of an average week?
The NHSCC role is variable, and mainly involves emails, calls and meetings in London. I do a lot of correspondence by email, as we all do. There are frequent teleconferences and meetings with the Leadership group and other CCG leads. This increases when there are ‘hot issues’ such as legacy debts for CCGs. I meet the NHS England commissioning team regularly, as well as representatives from the Department of Health.
I then do five sessions a week as a CCG chair and at least five clinical sessions at the practice, plus extended hours surgeries.
What’s the most common assumption GPs make about your role?
I’ve been accused of seeking to privatise the NHS by leading a CCG and of being naive in my optimism for the future of clinical commissioning (neither are true).
What’s the worst thing a patient has ever said to you?
I’ve been threatened a few times, but the worst was being called ‘Stalin’ in a public meeting for not having held a local full public election for the CCG Chair role. We were having a public review of local services at the time and clinical commissioning was new – hopefully they feel different now.
At work, what makes you happiest?
I enjoy looking at systems and how they affect patients. We have made some real differences at NHSCC, and our manifesto sets out changes CCGs need to continue to succeed.
Days at the practice are my most satisfying, but are definitely getting busier.
What makes you angry?
I’m working on it but I do get stressed when not punctual. The occasional need to be in two places at once is the most frustrating.
What one trait do you most deplore in your colleagues?
There are GPs and hospital doctors who think patients should ‘deserve’ to have a consultation, and see them as an inconvenience. Fortunately this isn’t an issue in Bassetlaw
What’s the best piece of advice your GP trainer gave you?
If you’re going to worry about it, discuss it with a colleague, then go with your instinct. I’ve had patients who had significant illnesses but nothing more than gut feeling pointed to it. It’s difficult to describe to trainees, but it’s been invaluable advice.