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Adrian Burns, shares his experiences of the NHS whilst on the Graduate Management Training Scheme

This is a follow up to my last blog which can also be found on this site. I am on the graduate management training scheme – general management stream – and am now in my third and final placement, at a Clinical Commissioning Group as a project manager. I am currently leading on setting up a pioneering community based service to support primary care and avoid inappropriate referrals to secondary care.

I found this follow-up more difficult to write than the first, mainly because the start of the scheme – and when I wrote the first blog – now seems a very long time ago. The learning curve has been steep so it’s difficult to neatly summarise what I have learned.  I am also writing this at a time when A&Es are struggling and the NHS is in the press – more than ever - highlighting the issues we are facing, issues that I and my cohort have become aware of during our time working in the system. Issues like: recruitment and retention, tighter finances, emergency care being overloaded, rising demand, structural changes (there is much to get your teeth into). The issues that the NHS faces are complex and it seems that everyone thinks they know what the answer is: charge drunken people for A&E visits, pooled budgets, prevent avoidable admissions, some have even suggested rationing care. People with longer memories know that the NHS has been under pressure before, but still forces internal and external make solutions difficult to find.

I think that is what makes writing this difficult, solving problems isn’t neat and it isn’t simple; but what I can say is that when you are working in this kind of environment you cannot fail to develop the interpersonal, planning and analytical skills needed.

This is the landscape into which trainees are lowered, and need to learn to swim. I will be brutally honest and say when the management buzzword of ‘resilience’ is used I can see why – it is not the easiest job. But then when you get over the initial shock you realise that it is not insurmountable, it is gloriously complex, never boring and when you stop trying to be perfect (a totally unachievable goal) it is fascinating.

So yes there are challenges working in management in the NHS. There is not one answer to its problems and instead there are currently lots of local responses chugging away. In my experience so far the best people are those that don’t take themselves seriously, use their sense of humour and harness the experience and expertise of those around them – if you properly listen and engage people they will trust you and you will be able to make improvements for patients. I would advise against ‘behaving like a manager’ and instead for being yourself and starting from the shared understanding that what is driving you is patients, their needs and how to make the best use of the resources available for them.

So in short, yes steep learning curve, yes challenging, yes satisfying, yes interesting. If you are reading this and you want to improve the health of the population around you, and you have bounds of enthusiasm, you enjoy complexity and want to get to the bottom of things – apply! Your health service needs you.

If you have any questions about my experience on the scheme please get in touch and I will be more than happy to talk to you: adrian.burns@nhs.net