Name: Dr Mike Knapton
Role: Associate medical director (prevention and care) for British Heart Foundation, salaried GP and non-executive director, Cambridge University Hospitals Foundation Trust
Location: London and Cambridge
I´m a generalist in a specialist’s world. I trained as a GP, and though I did do six or seven years as a cardiology assistant at Addenbrookes, I´m not a cardiology GPwSI.
I came to the BHF after some years as an interim medical director and PEC chair and before that I was chair and accountable officer for a primary care group (PCG). After VTS in Cambridge I was a GP partner in South Cambridgeshire for nine years, and then had a spell as a locum before being elected to the PCG. I have also spent some time as GP tutor and VTS course organizer in Cambridge.
I´ve been working for the British Heart Foundation (BHF) since 2006. It is the leading national charity fighting heart and circulatory disease – the UK’s biggest killer. We fund research, education and life-saving equipment and help heart patients return to a full and active way of life.
We rely on donations to continue our vital work. Last year we spent about £88 million on research. However, my direct responsibility is for our prevention and care programmes. These accounted for about £35 million of our charitable expenditure last year. I work with our Programme Director, Catherine Kelly, and a team of 85 staff to make sure our programmes and resources are best suited to the needs of heart patients.
As there are only two doctors employed by the BHF, I´m also called on to act as medical spokesman for the charity both in terms of media work and also in terms of external relations. I will represent the BHF along with others on external committees and stakeholder groups. For example I´ve been a members of the national advisory committee on heart disease for Scotland and the end of life strategy advisory group in England.
The work is across all four nations which gives a wide and comparative perspective. For example I recently attended a meeting with Welsh health minister Professor Mark Drakeford for the launch of a heart disease initiative there, and have had an opportunity to contribute to the cardiovascular health service framework in Northern Ireland.
I´m a salaried GP one day a week at the Nuffield Road medical centre in Cambridge. My BHF work takes up three days and my non-executive director position one day.
My three roles in primary care service provision, working in the third sector and providing governance and accountability in secondary care all overlap and are complementary.
I bring a clinical medical view as a generalist to all my areas of work. That includes experience of the realities patients, the public and NHS staff face at a coalface level. It helps me bring the real world view to the higher level perspectives of the BHF and the hospital board.
My national work at the BHF and contact with medical leaders, politicians and senior managers gives me a much better understanding of what´s actually going on and greater confidence in understanding what´s happening behind the headlines. That helps me focus on trying to improve outcomes for patients and how best to achieve this.
In a world where we are facing shrinking public sector investment in real terms, there is a real question over how best to provide for society´s most vulnerable people. I don´t think the solution will come from one sector alone and having experience of three sectors gives me a breadth of vision that I wouldn´t have otherwise.
With three diverse roles, it´s a constant challenge to keep across the detail in all three. Another big challenge is diary management. Even though I have nominal days, the only one constant is my general practice work on a Friday. Time-wise, there´s a lot of ‘robbing Peter to pay Paul’.
It´s also a challenge to find my own voice in in new areas of work. The only job I have been formally trained in is general practice and I constantly question my credentials for working at, say, board level. Still, someone´s got to do it and I try and make sure that I use the skills I do have to try and complement those of others around the table.
My fundamental skills are medical and clinical – I´m a doctor. However, I am sure that self-awareness and awareness of others are vital skills to have. Leadership is another, although I not entirely sure what this means. To me it is being able to articulate a ‘narrative’ – say, about heart disease – that makes sense to people. My job is then about allowing them freedom to take action within that framework.
I´m not sure I could go back to full-time general practice. When I did it, I found the demands of the job meant that the milk of human kindness ran out about Wednesday afternoon. I´m compelled by the other work I´m doing now, by the combination of roles and the potential to improve health and health care. However, I have no illusions about what I might achieve.
Dr Mike Knapton is medical director at the British Heart Foundation