>New Shoes! Healthcare; Moving from the NHS to the Private Sector


Today we have a guest post from Cathe Gaskell, Managing Director of The Results Company whose motto is “extracting the best from your business”  
Cathe started her career in the NHS as a nurse within mental health.  She has worked in healthcare for nearly 30 years going on to be Director of Nursing, Deputy Chief Executive and Chief Executive before leaving the NHS to found her company. She holds a BSC in Professional Issues within Healthcare.
Here she gives a personal and very honest view of her experience of moving from the public to the private sector. 
When I left the NHS in 2003 it was like taking off a pair of well loved, comfortable but now outdated shoes, I had spent the preceding 12 months wrestling with paperwork and producing lists for different groups of Inspectors  from various monitoring groups with challenging initials  from CHI, SSI, Peat.  
All this was seemingly replication, “bean counting” and measuring activity”! The problem was that very little activity got done in the hospital as a lot of manpower was taken up in evidencing and measuring what we were supposed to be doing!
I was relieved to leave what had begun to feel like a very round and black hole with me becoming “square peggish” by the hour!
The NHS I discovered upon leaving had many faults shared undoubtedly with other Public Sector services, my top three being :
1)      Meetings to discuss meetings and plans which invariably did not happen, as one CEO announced, “good ideas in the public sector were lured into a cul- de- sac and murdered by committee with regularity.”
2)      A nodding relationship with budgets, but very little accountability applied in day to day working. Teams hired at will, staff and equipment were replaced as required and generally little care was taken of existing equipment so front of house was invariably tatty.
3)      An attitude of “20 minutes to hire – 20 years to fire” prevailed so poor performers were accepted as part of the system. HR depts. were in general reluctant to tackle, or be particularly innovative in managing out, poor performers, preferring to focus on award ceremonies and the more pleasant face of personnel (slyly renamed as organisational development during the 90’s) which ensured union co-operation and generally a quiet life all round.
So it was somewhat of a shock to enter the private sector of healthcare in 2007 and find another universe existed providing similar services but in a completely different way.
1)      Meetings, if they happened, there had to be a proven cost benefit attached and increasing profit line improvements was generally the end point of any meeting.
2)      Your annual budget was a possession prized above rubies and meeting that  annual target meant leaving no stone unturned, focussing on finding better efficiencies , analysing costs in detail for every area of spend. The skills of a hostage negotiator combined with sniper were expected in managing the team and woe betide anyone not appearing to give 100% to the company.
3)      HR if they existed were small and very rarely seen, therefore  limited organisational development existed and the key function was disciplinary advice which generally was of two preferred options 1) Suspend 2) Dismiss.
Unions were not tolerated, nor were special circumstances and personal development was for sissies!
Ok I accept I have painted a colourful and exaggerated picture of both sectors but there is a foundation of truth in both scenarios and also clear benefits for working in the Public and Private sectors.
If you prefer autonomy with challenge and a fast pace at work and feel comfortable developing commercial awareness then the private sector is a better match, plus it may suit anyone with an entrepreneurial streak.
  • Decisions are taken quickly, flair and hard work can be rewarded financially and responsibility is given willingly.
  • What you won’t have  is the camaraderie that the public sector provides and almost definitely less personal development and training opportunities.
  • Coaching and Mentoring are rare but they are a personal investment worth considering to keep yourself supported whilst working in a demanding environment.
If you prefer a work environment with more structure and more agreement, consensus and team work then the public sector is a better fit. 
The NHS and other public bodies are generally more supportive to work for, more fair with established policies and procedures and transparent systems. You are also working with professionals and established clinicians in most cases.
What you won’t have, generally in the public sector, is the delegated responsibility!  Although this is changing with far more emphasis is on budgetary control and analysis, as Trust’s move towards Foundation status.
Anyone moving into the private sector needs 3 essential skills:
1)      The ability to work to strict and unrelenting deadlines and there is less ability to get team support, so ensure that you are resourced from the “get go”.
2)      Develop Commercial Intelligence, who are your competitors and what differentiates them from your company, understand sales and marketing techniques quickly and what works in your respective areas.
3)      Develop and maintain exemplary Customer Care, it’s central to everything you do and will soon affect your performance as complaints about care delivery are taken very seriously and, rightly so, reflect on the team as a whole.
There is potential to be very successful by making a strong combination – marrying some of the great skills inherent in public sector staff, such as their recent clinical knowledge and better team working skills, with the private health sector’s pace
If anyone wants further help in making this transition:
Contact me on cathe@theresultsco.com    
Cathe Gaskell is Managing Director of The Result’s Company – “extracting the best from your business” is what The Results Company does for businesses involved in Health.  She works to improve the quality of service within healthcare through operational management, lean thinking and essentially making things work smarter not harder.  She believes profit line improvements will be guaranteed if your customer care and the way you treat your staff within health care is outstanding.

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