147,019 members

Skip to content. | Skip to navigation


Big job, small office: how to spot a top manager


Blog headlines

  • Structuring a PCN Social Prescribing Service for the post COVID world
    25 February 2021

    This week we have a blog by Nick Sharples.

  • Community-Oriented Integrated Care
    18 February 2021

    The blog this week is a short extract from a paper considering an approach primary care networks could use to move towards community-oriented integrated care.

  • Strategy Unit releases opensource model for planning vaccine centre capacity
    11 February 2021

    This week's blog is from The Strategy Unit who are sharing an opensource model to help with vaccine centre capacity planning.

  • Time to talk day
    4 February 2021

    A small conversation about mental health has the power to make a big difference.

  • Supporting Staff: the emergence of ‘long-covid’
    28 January 2021

    As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

  • Link of the week: Clinically-Led workforce and Activity Redesign (CLEAR)
    21 January 2021

    This week we are sharing a link to the Clinically-Led workforce and Activity Redesign (CLEAR) site that is funded by Health Education England.

  • So much more than an extra pair of hands
    14 January 2021

    The introduction of the additional roles reimbursement scheme for primary care networks has started to grow capacity in general practice to address the unsustainably high workload that has put so much pressure on GPs.

  • Primary Care Networks – how did we get here?
    7 January 2021

    This week we are sharing a blog by PCC’s chairman David Colin-Thomé.

  • A year like no other
    17 December 2020

    On 5 July 1948 the NHS was born, over the last 72 years challenges and changes have been remarkable but the service has probably never been tested as much as in the last nine months. There have previously been numerous re-organisations, multiple changes to hospitals, mental health services and a shift from the family doctor towards more integrated primary care services delivered by a range of professionals. However, rapid transformation of services to embrace digital technologies, and a shift change to work differently has been forced upon all areas of the health service this year.

  • Guest blog: David Hotchin
    11 December 2020

    This week we have a guest blog that was submitted to us by David Hotchin, written by a retired friend....obviously, he's used a little poetic licence.

  • What now for commissioning?
    3 December 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What now for primary care
    4 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • Boosting your resilience
    30 October 2020

    The last year has been a difficult one, who would have imagined last Christmas that we would have been in lockdown, with the NHS seriously tested by a global pandemic. So much change has happened and the resilience of people working in and with health and care services has been seriously tested. Resilience is our ability to deal with, find strengths in and/or recover from difficult situations. Its sometimes referred to as “bounceabiliy” – but bouncing in what way?

  • Link of the week: National Cholesterol Month
    23 October 2020

    Every month or week of the year seems to be an awareness week, October has more than its fair share.

  • New redeployment service offers talent pool of motivated, work-ready individuals
    15 October 2020

    People 1st International have shared some of the work they are doing to support people displaced from industries due to the Covid-19 pandemic. There is an opportunity for health and care services to benefit from this workforce.

  • Link of the week
    9 October 2020

    Article published in the BMJ looking at the ability of the health service to quickly bounce back to pre-Covid levels of activity and considers if it is desirable.

  • Virtual Consultations– the patient perspective
    2 October 2020

    This week Jessie Cunnett, director of health and social care at Transverse has shared this article.

Friday, 26 April 2013

Big job, small office: how to spot a top manager

Allison Pearson of the Daily Telegraph has never met an NHS manager. In a column whose main purpose is to suck up to nurses, she depicts managers as people who “skulk in their offices with luxuriant pot plants”.

Most NHS managers do not have offices with or without luxuriant plants, but gloomy partitioned spaces and euphemistically named “hot desks” in draughty cubbyholes. Even PCT chief executives generally had meagre quarters – something the size of a walk-in wardrobe considered the height of opulence. 

One PCT chief executive occupied a structure resembling a badly constructed garden shed, leading colleagues to suspect that he had built it himself over a weekend. 

If you Google Portakabin you will find that NHS trusts feature prominently in the company’s promotional literature. Oldbury and Smethwick PCT occupied a 72-unit complex of top of the range duplex modules.

St Martin’s Hospital in Kent turned to Portakabin to expand three busy wards and NHS Oldham commissioned the company to provide a primary care centre.

There are plenty of other NHS examples on the company’s website – so many that if some future government succeeds in closing the NHS, it will have the demise of a great provider of temporary buildings on its conscience – something for the secretary of state to think carefully about before embarking on further reforms.

As chief executive of Tower Hamlets PCT, Alwen Williams occupied a dingy office situated over an underground line. Guests had about 30 seconds to make their point before being interrupted by the rumble of a passing train. The uncongeniality of the surroundings may explain why Alwen’s meetings were short and why she had a reputation for getting things done. There were no luxuriant plants or other incentive for skulking in the office. 

As a rule, the success of an NHS chief executive is inversely proportionate to the size of his or her office. Those who inherit large offices usually convert them into walk-in centres or refuges for the homeless and move into the nearest cupboard. This demonstrates the selflessness and humility one would hope to find in a public servant, the attitude of someone whose priorities are the right way up. It marks them out for greatness.

Such managers will unfailingly usher you into their cramped accommodation, apologising for the state of the furniture or the lack of it, the absence of natural light and the presence of the primary care team “who have nowhere else to meet today” huddled round a flipchart in a corner. Any embarrassment is purely for your benefit, the shabbiness of the surroundings a sign of professional pride.

Their lesser colleagues can be identified by large, newly decorated spaces with air-conditioning, glass walls, panoramic views and tasteful furniture.  The occupant will be out of a job within the year, partly because their choice of office signals questionable judgment and partly because there is nowhere to hide when things go wrong. 

The inverted snobbery of the NHS is often mistaken for hardship by the media. The hospital that recently erected a tent to accommodate patients from its overflowing wards was not in distress but showing off. It would have been easier to build a new wing or send patients home, but this is not the NHS way. The chief executive of the trust in question probably lives in a small tent all year round – not as a matter of necessity but of choice.

All of which may serve as a salutary lesson to CCG leaders, the new breed of NHS manager, as they move into their offices. Fortunately for their career prospects, those tempted by the trappings of power will be thwarted by their pitiably small budgets. 

But if you spot a CCG accountable officer eyeing up luxuriant plants in the garden centre this weekend, do them a favour: call security and have them thrown out. They will thank you for it in the long run.

kirstie.clements@stgeorges.nhs.uk says:
Apr 26, 2013 04:56 PM
I'm shocked at these comments, I work in a London hospital and share my 8ft by 7ft office with another manager within my service. If we get up from our desks at the same time we end up in a battle of the chairs. As for luxuriant plants with no window or air con in our pokey office they usually within a few days. Myself and my "roomie" have let the staff we manage have the nice large offices with views of the outside world, as to increase motivation and morale. A window is probably the only perk of working in the NHS for most!
pam.swift@nhs.net says:
Apr 26, 2013 05:08 PM
The paragraph about the office under the underground brought back some wonderful memories of the MHHP meetings. As for the rest, I needed a laugh on a Friday afternoon!
les@wilki023.fsnet.co.uk says:
Apr 26, 2013 07:44 PM
If this is the level of topic reporting and debate, which is engineered just to provoke argument, it's time to close this network! With all that's going on in the NHS, there are important and worthwhile issues out there.
stephanie.clarke@cht.nhs.uk says:
Apr 27, 2013 03:10 PM
The comments are right, she has obviously not seen NHS offices, she has not seen unwindowed working areas, she has not seen small converted toilets, she has completely the wrong perception of NHS management accommodation. You may well think the reality of small acc. is inverted snobbery, I think not. It is the reality.
sarahbealey@damerham.demon.co.uk says:
Apr 28, 2013 03:17 PM
Loved this one and the irreverent tone too I'm afraid - rang very true and made me laugh. Many of the best leaders I've worked with over the years are those who outwardly and always put their needs into perspective against those of their staff. Sadly, in my experience of NHS management in general, those who show a bit of humanity, honesty and humility are also the ones who frequently seem to end up being out-politicked by the pot-planters! A good sense of humour also helps mark out the top bods in addition to their lack of office foliage - they are always ready to praise and smile.