From NHS to private sector, profile of Michelle Ford by Emma Dent
Profile of Michelle Ford, Director of Business Development, Medical Services
By Emma Dent
As a former nurse, midwife and health visitor, Michelle Ford once assumed her career would unfold in an acute hospital setting. What her career has actually seen to date has been a succession of roles largely based in primary care that track not just the NHS and the third sector but also the commercial sector. In themselves they track the recent history of how commissioning and procurement in the NHS has evolved and features both commissioner and provider roles.
“After 15 years working in a clinical setting I took a move into community based work, working for the then primary care trust with deprived and vulnerable communities in Hastings in Sussex,” says Michelle. “I then became a Sure Start director in Chatham in Kent, which taught me a lot about stakeholder engagement and partnerships and working with both health and social care.”
After three years in that post, which was local authority funded, Michelle went back into the NHS in 2007 as head of commissioning at Shepway PCT in Kent.
“Working with partnerships and on service redesign was an eye opener, about what did and didn’t work. Being a commissioner then was about block contracts at cost and value, with no targets. We knew very little about outcomes, or about contracting. In the last eight years the NHS has been through quite a turnaround in those terms. We are now commissioning with far more expectations.”
She had not been in post long before a director went on long term sick leave and Michelle became director of commissioning at the PCT during the time it merged with three others to become part of Eastern and Coastal Kent PCT.
“From being at one of the smallest PCTs in the country I went to being at one of the biggest; from a population of about 120,000 to a population of about 765,000, so it was quite a change.”
In the merged organisation Michelle was the lead commissioner for the specialist services of cancer and ambulance services before becoming assistant director of contracting and procurement.
She says living in the patch she was commissioning for helped her keep a sense of accountability to local people.
“We were the purse keepers and I wanted to make a difference. But I have always wanted to make a difference; even now I am always thinking about the patients,” she says.
“But to go from purchasing to putting services out to tender [was for me] a big change. It was all about getting providers to work differently.”
However Michelle says there was often confusion in the NHS about the journey the service was going on – both culturally and in terms of service provision.
“As the NHS we need to be clear about what we wanted but commissioners were still working towards knowing what was wanted and we were still sometimes told what to do, regardless of whether it was a fit for the area. For instance, we had to procure a range of services including one of the first Darzi centres (walk in centres, known as Darzi centres after the former health minister who devised them). I didn’t know if we needed one but we were told we had to have one.”
Later, with the emergence of clinical commissioning groups in 2012, Michelle says she knew a lot of efficiencies were due to be made, but chose not to stay and face likely redundancy – despite the redundancy package that would have come with it.
“A lot of corporate memory was lost when PCTs were wound down,” she says. “I had been in the NHS since I was 18 and waiting for redundancy would have been the easier option. But it felt immoral. Instead I was head hunted to do business development for an organisation that was carrying out an out of hour’s service that I had tendered.”
Michelle’s next move, two years later, was to be for another provider, this time a charity delivering care for people with dementia.
“I had never worked with people with dementia before and also I really wanted to see what it was like to work for a charity,” she says. “I wanted to see what the drivers for the organisation were and what the differences were between working with non-executive directors in the NHS and with charitable trustees, as the latter have no financial reward for the work they do.
“The culture was certainly different, especially in areas such as terms and conditions for employees. Some staff had not had a pay rise in three years.”
After many years working in Kent, Michelle decided her next career move should be for a national player – and learnt a valuable lesson along the way.
“I wanted to make a change and work in London so I joined a large private provider in a business development role. I was attracted by working for a well-recognised and large corporate organisation but it did not take long to realise that this not for me,” says Michelle.
Within this role it was apparent that I would never have been responsible for the implementation of care, and this is something that I struggled with but I had to make that move to learn that lesson. Sometimes you have to do that.”
Although the wrong one, the move helped Michelle realise that rather being in a very large organisation, what she prefers to be is “a big fish in a little pond.”
Realising she needed a new job, Michelle rang Linda McCue at executive search and selection specialists Acertus.
“By happy coincidence my current role had come in that very morning,” laughs Michelle. Now at Medical Services, whose non-emergency patient transport service vehicles will be familiar to many in the areas it serves in England and Wales. The firm also provides ambulances for critical care triage services and repatriation care.
Her role as director of business development is to “expand the business, developing new opportunities and develop business and income streams. Most patient transport services are now contracted out. Having worked as both commissioner and provider I can understand some of the cultural differences. I can understand what we can and can’t deliver – for example if the performance indicators don’t align with the wants and needs of our patients”, she says...
"I can suggest solutions without being difficult about it,” she says.
Having been at Medical Services for less than a year, Michelle admits she misses interacting with patients and would eventually like to be a chief executive officer, perhaps in the field of palliative care or care for the elderly.
Written by Emma Dent. Emma has specialised in health policy for over ten years and is a former features editor of HSJ, a former Norwich Union Healthcare Medical Journalism award winner and a former MIND journalist of the year.
Msheireb Enrichment Centre
Not long back from a visit to Qatar where we had the time to visit the Msheireb Enrichment Centre, very interesting exhibition housing historic artifacts and explaining how how these will be incorporated into the architectural vision for Doha. We were taken around the exhibition by a very informative and friendly guide who kindly showed us the Majlis - view from this room below. Thoroughly recommended!
Mary Tourette - a candidate perspective on a move from the NHS to HMC, Qatar
Mary joined Hamad Medical Corporation in November 2014 as Assistant Executive Director of Business Development, she joined from Chelsea and Westminster Hospital NHS Foundation Trust where she was Head of Research and Development. Read her account of how the role came about and her personal experiences of the move.
Mary Tourette’s experience of making the transition from the UK to Qatar:
I was contacted by Acertus Search and Selection about a role in Qatar whilst I was working at Chelsea and Westminster Hospital. Having never worked overseas, I had always found the lifestyle to be attractive and was pleased to have been approached by Acertus. The process started with an informal interview with Acertus to talk about the role and discuss whether I would be suitable before being put forward. This was followed by an informal telephone interview with Hamad Medical Corporation (HMC). Shortly afterwards, I was invited to Qatar for a face to face interview with various people, and a formal panel interview, all of which were organised by HMC. Once selected for the position, an offer was made and accepted and references were taken.
The logistical side of the move can be a lengthy process and includes organising a work visa, bank accounts, health care, resident visa, temporary accommodation, furniture shipping, copies of passport, and proof of qualifications and police clearance. HMC assist with many of these requirements however you will need to provide various documents and some of these will need to be attested by a Notary. You can expect the recruitment process from Offer to Start Date to be around 6 months in duration.
Acertus were very supportive throughout this whole process and I also found the following resources to be useful:
Don’t They Know It’s Friday?” by Jeremy Williams
“Qatar Residents Guide (Explorer)” by Explorer Publishing
During my visit to Qatar I was able to visit the hospital and meet some of my colleagues and I think this is important if you are able to do this before you start the role. I also talked to a variety of people living and working in Qatar who had moved from the UK. Some of these people I had met whilst visiting Qatar and others through networking. This was really helpful in gaining different perspectives on work and life in Qatar. It’s good to have a clear objective and realistic expectations when you make the move to Qatar and also to have a plan for when you return to the UK.
Depending upon your plans after Qatar I have been advised by several people that it is always a good idea to keep your UK knowledge up to date and to maintain your professional networks especially if you intend to return to the UK to work.
When you first arrive in Qatar, you are assigned temporary accommodation before being placed in your permanent residence for the duration of your contract. Your own furniture can be shipped to Qatar from the UK and HMC assist you in the logistics of all of this.
In terms of culture, the area surrounding the hospital feels very American in style. The hospital is very diverse and has a fresh perspective and, although HMC is very forward thinking, they still need support to develop further. The Arabic approach is very different to the UK and I found the Arabs to be very friendly, personable and interested people. Business meetings usually start with a good deal of conversation surrounding family before getting to the business aspect. English is the business language used in the hospital and the dress code is slightly more formal than the UK, for women particularly.
In summary, I had had a very good experience of making the move from the NHS to Hamad Medical Corporation in Doha, Qatar. My extensive research and investigations, coupled with the support of a forward-thinking and internationally focussed hospital made the transition much easier for me. I fully understood what was expected from me in terms of the role and I adapted quickly to the cultural differences, like getting used to the weekend being on a Friday and Saturday!
Acertus are uniquely placed to assist your transition to Qatar due their deep knowledge of HMC and the NHS and their own personal experience of living and working in Doha.
Acertus can be contacted on 01730 266208 and their website is www.acertus.co.uk
Patrick Mitchell, Director of Programmes, Health Education England discusses GP and Emergency Medicine Recruitment
Patrick Mitchell is currently leading programmes at Health Education England (HEE). The organisation responsible for the education, training and personal development of all NHS staff, HEE oversees the Local Education and Training Boards which have themselves replaced medical deaneries and includes a number of advisory boards that oversee different healthcare professions. (HEE was established as a Special Health Authority in June 2012 and took on full operational responsibilities in October 2013). HEE’s work includes programmes for working on improving recruitment to areas including general practice, emergency medicine and psychiatry. Other programmes of work are on issues such as human factors and patient safety, genomics training, preparation for seven day working.
HEE programmes include managing an international recruitment campaign where successful candidates from the initial long-listing against national standard criteria were invited to a Skype interview. Those who also passed that were invited to one of 2 international recruitment centres held in Delhi and Dubai, where again selection was carried out using the UK national assessment standards and processes. Further interviews are due to take place in London for those who could not make the overseas interviews. Many overseas training competencies for emergency medicine do not matched UK standards, making it traditionally harder for overseas doctors to be recruited to the field. Those recruited will be provided the opportunity to complete the College of Emergency Medicine’s professional exams before returning to their home countries after 2 or 4 years.
General practice is another key area for recruitment, as trainee rates choosing the speciality have gradually fallen in recent years. The sector needs around 3250 trainees a year to meet demand and though numbers in recent years have risen it has been challenging to reach 3000.
Patrick came to his role having most recently been chief operating officer (COO) and deputy chief executive at St George’s Hospital in south west London. When the then Chief Executive left suddenly, Patrick spent some weeks acting up in the Chief Executive role. Despite having previously applied for a number of Chief Executive roles in other trusts, he quickly realised the role was not the right fit for him.
“It took what happened for me to realise I did not want that type of role and that there was something else more suited to my skill set. I had been at the trust for three and a half years and it was physically and mentally exhausting. Once I had made that decision I was not going to apply for the Chief Executive role then it was time to review my position and look for new ventures” he recalls. "I made that decision very public before the CEO role even advertised in order to squash any rumours."
“I spoke to (then NHS London Chief Executive) Ruth Carnell and she suggested going to the Department of Health to gain a more strategic view of the service. I went through NHS IMAS (Interim Management and Support) who were excellent and was appointed to 2 Director roles which then became combined between Medical Education England and DH leading the Better Training, Better Care programme and the National Medical and Dental Education and training Team. This role then emerged into Health Education England in late 2011.”
Patrick believes his background in NHS management means he is well placed to understand the issues of a system that still often struggles with the idea of putting training and education needs at the heart of strategic thinking.
“I can talk about it from the ground I have walked on. It has been interesting to bring an operational perspective to the educational side of the work. Consultants are both delivering services and training but not seeing how these areas join up. Whereas a COO I was concerned with a doctors’ New Deal banding, not with how their training could influence the improvement of services. Managers need to see that workforce planning isn’t just something that can be left to HR at the end of the business plan.”