in conversation with….

Episode 2: Nicky Ingham


Jack Mazzina  0:32

Welcome to the second episode of our ‘in conversation with’ series; a new programme of videos, podcasts and transcripts designed to give you the opportunity to hear directly from those influencing our NHS. This can be done while enjoying a coffee, a walk, or just some time away from your emails.

If you’ve already watched or listened to our last episode with Dean Royles, we hope his views on remote working in the NHS provoked some thought for you and you were able to take some ideas away. My name is Jack Mazzina, and I’m the Business Development Director at the Liaison Workforce. In this episode, I spoke to Nicky Ingham, Executive Director of HPMA.  Nicky shared her thoughts on professional development initiatives in order to progress NHS careers. I started the conversation by asking Nicky what makes a career in the NHS a “people profession”, as Nicky recently described it.


Nicky Ingham  1:23

Thanks, Jack. And thanks for the opportunity to talk with you today. The NHS is a people profession because it’s all about the people. As simple as that. People are at the heart of everything that we do in the NHS, whether you be a staff member, whether you be a patient, service user, a relative, a carer, or wider family member, it’s all about people. No matter what role that you do in the NHS, you’ve always got connection with people that have hands on patients.

So, if you’re in an admin function, for example, you have a direct impact on the patient’s experience, therefore, it is about the people. And it is an old adage, I think Michael West says it…It is true, that happy staff, happy patients and patient care is much improved – staff feel happy and rewarded and recognised in their role.


Jack Mazzina  2:16

It’s absolutely right. If you look at the way technology has been adopted by the NHS, even more so in the last 12 months, there’s no single piece of technology that can take away that personal touch and which is at the heart of patient care.


Nicky Ingham  2:33

And I suppose I can speak with personal experience at the moment because as you’re aware, my mum’s still in hospital. And we can’t visit because of COVID. Although I’ve now managed to get my dad the ability to visit because my mum suffers with dementia. But the lack of face-to-face contact for my mum with me is really affecting her emotional wellbeing, that she can’t physically see me or talk to me, we can do over the phone, but it’s just not the same. So although technology enables connectivity, there’s nothing, like you say, that beats that face-to-face connection.


Jack Mazzina  3:10

It’s not the same and will surely impact the recovery.


Nicky Ingham  3:15

Yeah, definitely.

Jack Mazzina  3:18

Many people start a career in the NHS and or in HR with ambitions to progress and develop their career. For anyone who’s looking to start that career. Is there any advice you’d give them?


Nicky Ingham  3:31

Yeah, I’ve given myself a lot of advice over the years. But the one thing I would say is be curious. So don’t stop being interested in finding out more about things that you’re interested in, or things that you don’t understand. And by that, I mean, knock on doors that aren’t open. Be curious about what people’s roles are. Be curious about what happens in a surgical theatre. Go and observe a consultant doing what they do best in the operating sphere. Believe you me, they will love it because they’re very egotistical. They love to be demonstrating their skills, particularly to people that are sort of new and not associated with that particular area of expertise.

So seek forgiveness, not permission, is what I always say, go and talk to people be curious. But always make time for your development. To talk to colleagues that are perhaps in a similar role or in a role you’re aspiring to be in, ask if you can shadow them, whether that be for the day, whether that be for the week, and not necessarily in your own organisation that you’re working in, actually go out and seek opportunities across the system. As we’re moving into system working and integrated care systems, there’s more opportunities potential in those systems. So do you know what happens in those systems? Go and find out for yourself – not to make a nuisance of yourself – but just be ambitious, be wanting to understand more and really passionate about what it is you want to find out. I would say development and progression relies on relationships. So it’s about being seen and being noticed. So that’s not about making a nuisance of yourself, as I said earlier, it’s about actually being curious about what goes on being passionate about wanting to make a difference, whether that be to your area of expertise or otherwise, but also centred around the patient, because that’s what we’re about. It’s all about the people.

As I said earlier, the best piece of advice I had was, push yourself into something that you’re uncomfortable with. Because you will find yourself flourishing from the opportunity; you become innovative, you get creative, and you make new networks, new connections, new relationships. And as I said, it’s all about connections, relationships, and people that you know, people that you work with people they know of you as well, not necessarily knowing you personally. But knowing that you’ve been into the system, you’ve done this piece of project work, we’ve delivered on this particular piece of corporate responsibility.


Jack Mazzina  6:21

I can certainly resonate with that advice, Nikki, and I’m sure I’ve certainly been given that at some point in the past, and you have almost got to become comfortable with being uncomfortable. You’ve got to accept that state, that “I feel uncomfortable. This is okay, this is good for good for my development.”


Nicky Ingham  6:38

Yeah, I remember a Director I worked for a number of years ago who wanted me to lead on a particular project across the organisation, which was about new junior doctors New Deal (that’s showing how old I am!) and leading on that and leaving something else that I was more comfortable with. So I said, “I can’t possibly do that for the organisation, that’s a big responsibility. My division needs me to focus on them not focusing on other things”. And she said “No, you’ve no choice to do it, you got to do it, because I believe that you will be a really good representative for the organisation. So I want you to move into that sort of role for a corporate function, leading on a medical workforce challenge, that’s a major issue for the organisation.” So, I didn’t have any choice. I had to be uncomfortable. I had to go to regional meetings and represent the whole Trust. Bearing in mind, I felt I was a junior member of staff at that time. However, the development I got from that was significant, and I can never look back from that, because that helped me develop and move into a more senior role quite soon after. So never look a gift horse in the mouth, as they say, even if you’re going to feel uncomfortable with it, just embrace it. As long as you’ve got the support around you, you’ll be fine.


Jack Mazzina  7:57

What a great story. And I suppose anyone listening should take that advice, and see how we could help them progress their careers.


Nicky Ingham  8:05

Yeah, I mean, sometimes you learn that actually you don’t like that sort of thing. So you don’t do it again. Sometimes negative experiences can be a whole lot of learning for you as well. So, if it doesn’t go as well as you anticipate, take the learning from it and move forward.


Jack Mazzina  8:23

That’s it. I like to think of myself as being a positive person. And you’ve got to take that in any negative situation – take the positive that I’ve learned from this, and I’m going to make sure this doesn’t happen again.


Nicky Ingham  8:36

I’ve learned a lot of things that I would never do again!

Jack Mazzina  8:41

Haven’t we all! I’m sure there’s plenty of that in an NHS career. I wanted to ask you about how line managers and senior managers can better support professional development with within their teams and the staff they’re responsible for?


Nicky Ingham  8:56

I think, particularly during COVID, we’ve lost a lot of the opportunity for development because of the pressure on the workforce to respond to the global pandemic. For me, it’s acknowledging professional development is a necessity – it’s not a ‘nice to have’, it’s a ‘must have’. And creating time for your team and permission for your team, to allow them to do professional development. It doesn’t need to cost money. Some development does cost money, however, like I said before about being ambitious and wanting to learn more about your professional career that you’re in.

Look for opportunities for your workforce, for your team to shadow and visit other areas, because not only will they benefit, but you as a function will benefit. So an example would be when I was in a director role, but as an organisation, the execs took a lead on a particular specialty. So I, because of my mum’s background, she had cardiac surgery about 10 or 12 years ago, I wanted to go into theatre and see cardiac procedures. Initially, I couldn’t quite build up to watching what my mum’s operation was. But I went to see vein harvesting, which sounds gruesome (it was quite gruesome, to be honest, that’s probably the worst thing I saw). But seeing a thoracic surgeon review the lungs, looking at what cancer unfortunately looked like for that patient, we’re actually seeing the theatre team working as a team. Then I watched a heart bypass, and seeing what it felt like not to have your heart pumping, but to be being held alive, if you like, kept alive by a machine was pretty awesome.

Then, just talking to staff in terms of how it felt in theatre; it’s quite warm, there was quite some unusual smells, should I say? Those types of things that the workforce have to work with every day, and they really appreciate it. A surgeon, showing his ego, showing his skills. But also the importance of team working at that level. I’d encourage any line manager to encourage your workforce to again, be curious, allow them to go and find out for themselves, bring it back to the team.

What it meant for me at the boardroom table is that I could speak with conviction, with passion about a specialty I knew a lot more about.  And you’ll be able to do that similarly, in any sort of clinical role, talk with your team about what you found out about a particular area. If you think about A&E patients – they come in, then they get progressed, hopefully to a ward area, then admitted or discharged home. Do you know what happens to them after they’ve gone out of your A&E? Sometimes it would help improve flow, improve productivity, improve efficiency, but most of all, improve the experience for the patient. But you need to really make time to commit to it. And make sure that you act as a role model as a line manager, that you do professional development. As it doesn’t need to cost money, it doesn’t need to be a Master’s programme or a PhD, it can be a webinar. And you know, we’ve done a lot of webinars at HPMA on various topics with our partners that are really interesting, innovative and informative.

We’re developing an area on our website that will hold a lot of interesting articles for anyone to access, who’s a member of HPMA. It’s carving out time, ensure you team have resources, permission, so that you are very open about expecting them to do professional development, or update their skills, but also update their knowledge, their wider exposure to the NHS and the system. And, yeah, just do it.


Jack Mazzina  13:12

And it’s easier said than done, particularly with the pandemic – it is really difficult to do that. But as you say, it’s so beneficial just to take that time, even if it was 30-minute webinar or an article, just to take that break from what you’re absorbed in to reflect and think about, actually – there’s other things going on, we could be doing things differently, we could better ourselves in in particular way.


Nicky Ingham  13:47

I think we do face a massive challenge in the NHS around retention. The workforce is absolutely exhausted, it’s on its knees. But those organisations that have continued to develop and invest in their workforce will be in good stead for what happens going forward. But yeah, I agree. It’s easy to say, hard to do. But is it really hard to do? It’s a necessity. So you should carve that timeout for the wellbeing of your workforce as much as anything. As well as their development, it’s actually supporting them to feel they are vital to what’s happening, and that they are important enough to be invested in in terms of a 90-minute webinar or for an article, to have time in the diary to read it. It will make them undertake their role more effectively, and support patient care going forward. So why wouldn’t you?


Jack Mazzina  14:40

Absolutely. From what I’m hearing, it sounds like it’s almost as important as any task you could have in that day job…It’s making that time for development.


Nicky Ingham  14:51

Yeah, it’s been it’s being on the top of your game and having the latest information, evidence based, to be able to do your job because the world of work is changing so rapidly because of COVID, which is a really good thing, but it’s hard to keep up with that if you haven’t got the time allocated to be on the top of your career, your development, your specialty, your clinical role, it’s vital.

Jack Mazzina  15:14

Do you have views on how managers need to adapt their approach to supporting professional development during the pandemic? Because obviously, there’s a lot more remote working going on, people are less there in person…Is it that the managers need to adapt the way that they promote professional development within their teams and staff?


Nicky Ingham  15:34

Yeah, I think the pandemic has brought us many, many challenges, which I think the NHS has responded to very positively. And I think the agility of our workforce, where they work from, has really created more innovative, fast paced change. So it’s embracing that. You talked about it before; the technological platforms that exist now to embrace those, not just for ways of working in terms of day to day meetings, whatever tasks that you have to do, but actually using online platforms to support development.

So it’s how do you create that informal professional development, I suppose. Because people are part of a team when they’re working in isolation at home, they perhaps don’t feel as much part of that team. So how can you create events using digital platforms that really develop the team and bring them together on a regular basis? Perhaps it’s talking about a particular area of challenge or wicked issue that you might have as team, or perhaps inviting someone to come and give some thought leadership about a particular area, again, that will help develop the team and them feeling invested in.

An example is a colleague of mine, because of the work their HR workforce team has undertaken through the pandemic, is putting on a development day for their team, with various topics throughout the day, using Teams. They’re having their HR director speak, having someone from HPMA talk about the benefits of being a member, but also then talking about particular topic areas that have benefit to their team. And that’s about thanking their team for what they’ve done. Recognising with authenticity the impact they’ve had on getting through the pandemic and, hopefully, continuing with whatever the new normal is going forward. So I think it’s, embrace the technology but don’t shy away from investing in time for you to do professional development.

The pandemic has brought its own development opportunities with staff perhaps moving areas, going back to clinical roles from areas that they’ve moved into. And it’s also exposed some skills that people had that they weren’t really shouting about, and building on those. So it’s getting to know your team for who they are not what’s job title they have, but what skills they bring to the party, and really embracing that and supporting that through the pandemic.

Jack Mazzina  18:14

If you were Sir Simon Stevens for a day, what would be the first thing that you change in the NHS?


Nicky Ingham  18:22

I wouldn’t like his job. That’s the first thing, regardless of what goes on nationally, he’s got a very tough job. One thing I would change, I think, is reflecting on COVID.

At the start of COVID, I was in an interim HR Director role, so at the thick of it. And phase one, if we call it phase one, because COVID was new and no-one knew what we were facing,  there was very little command and control from the centre. I felt that really created innovation and creativity, and senior managers probably felt trusted to do the right thing for the patient and for the population at that particular time. So I think bureaucracy is what I’d remove. You need some bureaucracy from a governance point of view. But actually, I think there’s a thing about trusting the NHS to do the right thing. And I know we’re a political football, but actually when we’re at our best, when we can be creative…there are still rules, but the red tape is looser than it used to be. And this was the case in the first phase of COVID because it was new. People did the right thing. They did what they felt was the right thing and things went as well as they could during that first phase. However, once more became known about the pandemic, about the virus, command and control started to come in. The number of returns that colleagues had to complete on a daily basis, to satisfy and assure the bureaucrats and the politicians that we are improving things. I get it. But is that a good use of time? No. Does it take people’s time away from the patient? Yes.

I would say it’s about that trust. Trust is a big word – easy to say, again, hard to do. But the more workforce staff are trusted to do the right thing, the more creative and intuitive they are. And they can implement things at speed. And we’ve seen that through COVID. It has taken years to get flexible working in to the extent we’ve got it into the NHS. It has taken years and there was always excuses not to, yet we’ve had to and it’s worked. So how do we keep the good ways of working that have come out of the pandemic as we go forward and not throw the baby out the bathwater. So get rid of bureaucracy.


Jack Mazzina  21:01

I couldn’t agree more Nicky. I don’t work in the NHS, but as someone who has worked closely with the NHS for nearly 20 years, I’ve seen first-hand where bureaucracy has held back innovation and probably stopped organisations from doing things that could result in more efficiency, better patient care, a better workforce. So yeah, I couldn’t agree more with you.


Nicky Ingham  21:28

It links back to the professional development conversation, because the more the workforce feel they can innovate and create improvements for patient care for a particular disease, a particular population and health inequality, that has surely got to be beneficial. To not got to go through so much red tape. It takes years to implement new ways of working, new approaches to things. The vaccination has been developed within a very short space of time, has gone through the process of approval…Why would we revert to what we had previously? So it’s people who feel they have opportunities to be innovative, to be creative, who really feel invested in and they can develop personally, as well as developing, you know, massive solutions and inroads to improving health inequalities for the population.


Jack Mazzina  22:31

Absolutely. Well, Nicky, I just want to take this opportunity to say thank you so much for taking the time to talk to us on this really important subject. We were really privileged to have you and your views here. I feel like I’ve learned a lot from this conversation, so I hope that our listeners do as well. And I think for me the biggest takeaway is taking time, which I know, particularly in the NHS in the last 12 months has been really difficult, but it feels like something that we all need to do, whether it’s scheduling that in and being really strict with ourselves to take time away to develop.


Nicky Ingham  23:11

I’ve worked in the NHS all my life. And I know, perhaps I am older than a lot. But it’s a precious gift, the NHS, let’s embrace this legacy, and let’s start to be truthful with ourselves about what is doable and what’s not. And rather than keep sweating the asset, and keep the pressure on…all the workforce in the NHS want to make a difference – allow them to do that. Trust them to do that. And give them time and capacity to do that.


Jack Mazzina  23:45

Couldn’t agree more. And it feels like with everything that’s happened in the last year, everything we’ve learned from, not just in the NHS but all over the world, it feels like now is the opportunity to make that change.

Nicky, thank you very much. We really appreciate having you. So I just want to thank you very much for your time. And hopefully, we’ll get to do this again soon.


Nicky Ingham  24:17

And thank you, Jack, for the opportunity. It’s been really cathartic; we don’t really take the opportunity or time to reflect. Having had a 20 plus year career in the NHS, and in the role I undertake now, very much connected back into the NHS, you take it for granted. I think when you sit back, it’s quite therapeutic to see how fantastic and fabulous the NHS is, how its responded through COVID. But how it is generally, without the COVID pandemic, it is just a massive, brilliant, super institution. So thank you very much for the opportunity. It’s been really, really good. Thank you.


Jack Mazzina  24:57

You’re very welcome. On behalf of everyone at Liaison Workforce I’d like to thank Nicky for giving her time to this in conversation with series. If you’d like to continue to conversation, get in touch with us using the contact details on this page. We’d love to hear if you would have asked Nicky anything different, or what questions you’d like to put to future NHS leaders. Also, if you’d like to take part in a future edition of the series, please get in contact. Thank you for joining us.