10 Minutes of Inspiration with Tom Patterson, Head of Healthcare Research, Global Healthcare Practice
Inspire interviews Tom about about the role he's played in supporting women to Board level positions within the NHS.
Tom has worked as a head-hunter for nearly a decade since leaving university with a focus primarily on executive and non-executive appointments within the public sector and NHS.
As Head of Healthcare Research in the Global Healthcare Practice at Harvey Nash, he's been responsible for some of the highest appointments within the NHS and has played a pivotal role in supporting female candidates through to Board level positions.
What is unique about the healthcare sector?
The NHS touches everybody's lives in a way unlike almost any other sector, which means it's far more visible, political and scrutinised. Some of the people I have transitioned into the NHS can be immensely surprised by the level of scrutiny and 'red tape' as compared with the private sector.
There is also a different sense of values and culture that exist within the NHS and, finding people that understand the focus on the end product of the patient outcome as opposed to financial reward is critical.
The NHS as a whole is a highly complex entity, and has a focus on sustainability with limited resources and a myriad of competing demands. The sector is seeking to respond to complex challenges facing healthcare including but not limited to a £30 billion funding gap and constant expectation from local populations, political influencers and regulators to continually improve the quality of care alongside significant problems with staff recruitment and retention. Underpinning all this is the need for more skilled and diverse leadership.
What has been the biggest shift in the healthcare sector in your view?
Specifically with regards to the diversity agenda and its impact on boards, it's been significant. Until recently, diversity hadn't been a priority but events such as Mid Staffordshire and the Keogh review into mortality rates has been a massive catalyst for change and has impacted organisations thinking about the importance and need to broaden out the skillsets on the board.
The NHS has been slow on the uptake relative to the private sector however a recently formed organisation called NHS Improvement, which is the amalgamation of a few different regulators and oversight bodies, is becoming one of the most influential bodies in the sector. The chairman, Ed Smith, who was formerly on the board of Lloyds has thrown his weight behind achieving equality on boards in the NHS. It's clear that individuals like Lord Davies have been a massive influence and the sector is in a unique position to do something exciting.
From a client perspective, we've seen a noticeable shift in the leadership style required for major organisations, towards a focus on more collaborative and systemic leadership rather than a "macho/crisis" leadership style.
It can be said that the public sector is seen as a traditionally female dominated sector. How would you describe the current diversity picture in healthcare?
The NHS is the fifth biggest employer in the world, and of its 1.3 million employees, 77% of those are women - that's over 1 million women. Yet only 44% of chief executives are female and across the whole of the NHS between 30-35% of board positions are held by women. The figures are probably enviable when compared with other sectors but when viewed through the prism that over two-thirds of the sector are women and only a third make it to senior leadership or board positions, it's not great.
The NHS is at the start of its journey. The launch of Ed Smith's initiative was in December 2015 and it's only now starting to gather momentum. The NHS is seeking to understand how it develops talent and the pipeline to the boardroom. The position the sector is in currently means that a gender focused campaign and initiative is needed to find and encourage female candidates into board level roles.
What is Harvey Nash doing to promote diversity?
Our role is to find interesting leaders that aren't just from the Trust next door. We look deep and wide using our established relationships with very senior level individuals and our broader networks including Inspire and Engage. We are also working to develop a senior level pipeline of diverse leaders, ensuring the board directors of the future are being engaged now.
In the past 12 months, we've appointed 72 board directors to the NHS, the split was 35 men and 37 women (49% and 51%) - something we're very proud of.
We have the advantage of a strong team in Healthcare - three directors who have worked at board level in the NHS, so therefore understand what it's like to operate at that level. More critically, two of those worked in the private sector before transferring to the NHS and understand what type of approach, values and skillsets would move into the NHS effectively.
We have extensive experience in transitioning individuals from the private sector to non-executive director roles and a strong track record of recruiting diverse candidates to executive positions. For example, towards the end of last year, we supported the children's hospital Great Ormond Street - one of the most renowned hospitals in the world - to appoint the CFO and the Deputy Chief Executive - two attractive but demanding roles.
Into the CFO role, a post which is held by men in 74% of NHS organisations, we placed a woman who had never worked in the NHS before, but had been working for a different healthcare system overseas. We felt she would bring a completely different perspective to the role and broaden the capability of the NHS as a whole. The second appointment, to the Deputy Chief Executive post, was Nicola Grinstead, who came through a competitive field of many established COOs and wider board director candidates, and stepped into her first board level role in the NHS. Part of our role was to encourage the board to think about different options to the traditional profile.
How do you work with individuals that don't always tick all of the boxes, including board experience?
In the case with Nicola, coaching, supporting and developing was critical. First, there is the positioning of such a prestigious role for somebody that may opt themselves out. We consider the fact that men will apply when they qualify for just 60% of the criteria whereas, women feel they need to tick all of the boxes. For this role 'board experience' was a requirement on the job description, so you might find a number of female candidates look at this and not consider applying if they were unable to demonstrate the relevant criteria.
I worked closely with her until we got to long list stage. That gave me two advantages, firstly being able to work with her to ensure she submitted a very strong application that showcased who she was, what she could bring and that she had the talent and potential to cover off the areas she couldn't demonstrate such as, board level experience. Secondly, our relationship had developed sufficiently that in presenting her application to the chief executive and chairman, I could give a compelling case for why she should be shortlisted over and above candidates that might appear to have more experience on paper.
Then, critically, we had to ensure she was fully prepared for interview. We arranged for her to have a Harvey Nash assessment interview and gave her coaching and support from the management team and Associates to provide her with an independent perspective and make sure she was prepped and motivated as she could be for this interview.
It's these examples in the 37 female appointments from last year that show a different skillset are being promoted that have tangible end results for patients. We recognise that it's in everybody's interest in the NHS to bring forward these sorts of talented individuals that offer a different perspective, and that diverse boards have real benefits for patients. And I think the drive toward this is incredibly refreshing at the moment.
What is your favourite part of the job?
I genuinely feel passionate about the sector I work in. It's incredibly emotive and constantly in the news. On the back of that, the people that you engage with on a daily basis are influential opinion formers and ultimately, the individuals that are shaping the future direction of the NHS. Secondly, it feels like there are many tangible outcomes at the end of our successful search processes, particularly when you place someone with a different and much needed skillset within a challenged organisation - they are making a difference to patients, to care and to health of that community.