Steve Russell is the CEO of Harrogate and District NHS Foundation Trust in North Yorkshire. Around 5,000 people in the Trust provide a broad range of health services, with about half embedded in the community. The National Leadership Centre spoke to Steve in September 2020, and this interview reflects his experience at that moment.
What has been the biggest change to your role since the start of the pandemic?
This is my first Chief Executive job. I’ve been in the NHS for 22 years, so I’m a lifer. It’s what I love. Of course, I didn’t plan my year the way it has turned out.
One of the biggest changes has been needing to learn how to lead in a different way, in a very short space of time. In the early days, we did quite a lot of command and control, which was quite uncomfortable and it isn’t how I prefer to work.
As time went on, and we remained in a national incident, command and control went on for a long time. It weakened what we normally had, which was broad, diverse thinking. That was quite hard.
The pandemic meant I couldn’t be visible everywhere. I enjoy spending time learning and watching, because it helps ground your decision making and leadership. You understand things just by being present. In the crisis, huge swathes of colleagues ended up at home.
I find leading through a computer is a bit of a challenge. It has been hard to do and I’ve missed people. I miss being able to pop along and see people for a chat.
What have those changes meant for your organisation on a day-to-day level? Has there been quite a shift away from business as usual?
The pandemic has affected everything, of course it has. Thinking about leadership challenges, to take one example, turning a conference centre into a Nightingale Hospital in ten days required a completely different style.
I remember feeling really daunted by the whole project.
I was leading a team I had never worked with. We got a phone call on Saturday, worked all day on Sunday on it, and then the hospital was running by Monday. We just had to get on with it. But through that, we became a very close team as colleagues and friends.
In uncertainty, you want to try and keep a grip of things, but it was completely impossible to do so. In the early days, there were nearly 500 people working on the site, 24 hours a day, 7 days a week. And I had absolutely no idea what they were all doing. I had to become comfortable with that really, really quickly, which was quite hard, because if I’m responsible for something and it’s important, I do like to know what was going on. So working in that environment was really difficult given the pressure and pace we were being asked to deliver stuff.
How has it felt being a leader during this period?
Most people in the NHS have a pretty collaborative style, and as you become more senior you know a lot less, and you rely even more so on people who do the work for the answers to the problems we’re trying to solve. My normal style is to listen a lot, ask a lot.
Command and control was really different. It was incredibly quick, but there was much less dialogue and discussion. And decisions had to be made really, really promptly. You can do that for a short space of time, but it’s really not a very effective way to make decisions or to lead teams in the longer term.
It was quite testing for those leading in that way and those colleagues in receipt of it. It was really quite stressful. Normally people are the checks and balances on your decisions. I would go home and think “I’ve made twenty important decisions, and I haven’t had the opportunity to check it with other people.”
I think this hindered good people. People were being asked to pass everything up for a decision. In normal times, they would have done that themselves and made the right judgements, made decisions on their own. That was quite disempowering. But we all got used to it, and going back takes a bit of calibration.
In addition, we broke down silos and people from different teams solved problems together. And as you go back to business as usual, you see silos coming back in. I’m sure your next question is how do you keep that going?
I don’t know what the answer is! I think it is about talking and actively listening.
There was also a very clear aligned sense of purpose and goal, as it was a crisis and life was at risk as it were. It was very simple and compelling – scary, but compelling. We didn’t do only one thing, but we focused on a goal that was one thing. This liberated and enabled more collaboration.
The problem in normal times is you can’t just focus on one goal – it’s not realistic. In the real world we have multiple goals which don’t align all the time. How do we adapt what was the energising, aligning, simple one goal? How do we adapt that to ‘real life’?
What have you learned about yourself as a leader during this period?
One of the things which has been fantastic has been seeing people step up and step forward who might not always have had the opportunity.
I’ve learned that I’ve been reminded of why I came into the NHS. I’ve never been prouder to be an NHS colleague and a public servant.
I’ve learned that the things which make all of our lives possible are the things we don’t normally pay attention to. There is a huge swathe of people across the country on whom we depend and rely who don’t feel valued by us. The key workers. I hope we don’t lose our focus, attention, thanks and respect for them.
One of the things I found most distressing was the language that got used about colleagues in social care being unskilled. Everyone was told to stay at home, but there were vulnerable people at home. They were supported, looked after, cared for and were on the minds of our community and social care colleagues every day. I’m sure I will have used similar language in the past. But you learn a lot about what you should stand for yourself and as a society.
I’ve learned that I’m a much more emotional person than I thought I was. I learned that you always go into these situations thinking about looking after everyone around you and not yourself. This applies to everyone in the organisation. You realise you have to do both. I find myself being quite emotional from a pride perspective but also when you reflect on what people have been through.
Read the full Public Leaders Report: Supporting the NHS in its hour of need · Collaborating places · Extraordinary resilience and service · What do we know about public sector leaders · Looking ahead to 2022