Leadership is complex and messy, just like people

Tim Taylor reflects on his experience as a Sciana Fellow, lessons on leadership, and thinking about purpose

Tim Taylor is currently a deputy medical director at NHS England Midlands and a neuroradiologist at Nottingham University Hospitals NHS Trust. He qualified as a doctor in 2000 and has been working as a consultant radiologist since 2010. He has held numerous leadership roles in the intervening years in several different healthcare settings and at a variety of scales. He is a member of Sciana's fourth cohort.

Sciana spoke with Tim during Cohort 4's fourth in-person residential meeting in November 2023. This interview has been edited for clarity and brevity.

Sciana Network: What comes to mind when you think about your experience in this programme throughout the two years?

Tim Taylor: The calibre and depths of conversations that we have as Sciana Fellows and the insights we give to and receive from each other are unlike anything else I get anywhere in the work that I do. The discussions are challenging, stimulating, robust but sensitive, and they stay with me for months after each in-person meeting. I like the concept of "liminal spaces"; these are the transient spaces you find between running from one meeting to another and where useful and interesting conversations often happen. Salzburg is full of these little spaces for those sorts of conversations, and they happen all the time.

SN: Part of the Network's mission is to help equip leaders for future challenges in health. So, could you provide examples of what you've learned about leadership while participating in this programme?

TT: Being a leader is complex and it is often messy, but then, people are messy, so we should expect messiness as leaders. Often, we are encouraged to use tools for models of leadership. However, always using the same few tools blunts them and can make them useless. The Sciana programme is different. It does not describe two or three tools; rather, it shows us the whole toolbox, and several different toolboxes at that, for people then to choose what to use in order to best work together.

Has my approach to leadership changed during the programme? Yes. Would I have changed anyway? Most likely, but not nearly in the same way. Does the programme help me to understand why that change is a good thing? Yes, absolutely.

SN: With your experience working at the NHS, what sort of change would you like to see in leadership and in the lived experiences of people working there?

TT: The NHS in the UK has the same status as a religion. It is something that is simultaneously too big to fail and beloved by almost everyone in the country. One of the problems of something with that status is that elements of the NHS are almost a ritual. Over time, it is easy to forget the meaning behind a ritual. When we forget the meaning behind what we do, we start to deliver things without purpose. The Sciana programme encourages a degree of looking at why we do things rather than how we do things. As someone who is a leader, the ability to take time to think about the why rather than the how is very helpful. For my work in the NHS, where the emphasis is often on delivery, the opportunity to take a step back and think about purpose is invaluable.

SN: As a Sciana Fellow, you have a challenge to work on building a new social contract for health and wellbeing. What does this challenge mean to you?

TT: The Sciana Challenge is a way of bringing sustained continuity through multiple physical, in-person meetings. It is carefully constructed to ground us and give us a narrative and a goal. In our little group of leaders, we took the principle of the social contract and applied that to dignity in ageing. Since ageing is a tricky topic, we chose the topic to ask the tricky question: what is most important to people as they get older? What is most important to stakeholders and policymakers? The challenge has allowed us to have conversations that we wouldn't otherwise have had between different leaders in different countries. It gives us a construct to unpack tricky conversations carefully and to learn from each other.

SN: During the COVID-19 pandemic, there were a lot of conversations around like "building back better". Do you think COVID-19 influenced changes in healthcare?

TT: I am a pessimist. I don't think that the COVID experience has led to a meaningful step-change in healthcare or an improvement in equitable access to care or resources in the way that many hoped it might. We haven't had the impetus to change because the COVID response basically reinforced capitalism and globalism as a model that works for those who are inside those models already. What the COVID period demonstrated is that it is entirely possible to run a society – for a short period, at least - on rushed contracts and massive capital injections. What the COVID period has done is accelerate the rationale for inequality at scale; the rich get richer using the excuses of "resilience" and "preparedness," and the poor continue not to have the luxury of either of those.