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The NHS manager: ‘More a career wander than path’

Dr John Nugent, clinical director at West Glasgow Community Health and Care Partnership, explains how he took the step into NHS management.

How did I get into this position?

By accident! When I was younger, I realised I'd probably find it difficult to resist burn-out in my deprived area of Glasgow if I tried to stick simply to my GP job full time for 40 years. With 10 years under my belt, I decided I would also need to become involved in something else. By then I had become interested in health in a wider sense, above the individual and practice level.

I had become involved in local medical politics and put myself forward for the position of GP lead at the Local Health Care Co-operative, and from there moving via chair of the board at the LHCC to associate medical director, then clinical director, in a Community Health and Care Partnership – more a career wander than path.

I'd advise GPs to get involved – it's not always easy but choose something, stick your toe in, get out of your comfort zone. You won't always get it right first time but you should always learn.

What does your role involve?

There is lots of managerial stuff - meetings, emails and papers (to read and write)! But I get a chance to influence local developments and address performance issues. I help develop local enhanced services, work with and support local practices, and link this work with national developments. I lead and influence in a major way, get early notice of new developments and a sight of the bigger picture. The downsides are the hours (two part-time jobs add up to more than one full-time one), and also the speed of change, which can vary from too fast to frustratingly slow.

What is the pay and workload?

Pay is roughly comparable to average practice income at approximately £12,000 per session (nominally four hours), which I do instead of a practice session. However, the work often involves emails, papers and preparation on top of this, as well as a degree of ‘on-call' – for example during pandemic flu or major incidents.

Can the position effectively lead change?

Yes, if you manage to take colleagues with you. The biggest barrier to change is often consultation with colleagues, or more accurately the ownership of change. Get this right and change is can be smooth and successful. Get it wrong and it can become a negative and frustrating experience.