Dame Jackie Daniel, equipping Newcastle Hospitals for success

Dame Jackie Daniel is Chief Executive of Newcastle upon Tyne Hospitals NHS Foundation Trust, Executive in Residence with Lancaster University Management School, and co-chair of the Shelford Group, being the ten largest teaching and research hospitals in the UK National Health Service.

She started her career in the early 1980s as a nurse. After 10 years of clinical practice she moved into general management, and has now been a Chief Executive for almost 20 years.

In addition to her Nursing degree and a Masters in Quality Assurance in Health and Social Care, Dame Jackie is a qualified business and personal coach: when she became a Trust board director she found that she was spending a lot of time in coaching conversations, and wanted to improve her skills in what she regards as a critical area. Studying coaching equipped her with a range of tools and techniques to support people to flourish in a tough environment.

Healthcare is a “people-centric business” and over the last decade or so, Dame Jackie has developed a programme for supporting staff to liberate their full potential. She says it is important in healthcare that people have a “discovery mindset.” She encourages her staff (and there are 17,000 of them) to be authentic and the best possible version of themselves.

In May 2019 the Care Quality Commission inspected the Royal Victoria Infirmary, the Freeman, and the Dental Hospital and returned an overall rating of ‘Outstanding.’ In reaching that verdict it cited the quality of the Trust’s leadership, an inclusive and supportive culture, and a commitment to innovation and learning. The Trust’s ‘Flourish’ programme provides a means of sustaining that success over the long term.

The programme has three domains: leadership and people (noting that people at any level in the organisation can lead), governance and risk management (including prioritisation and performance management), and the “relational fabric” of the Trust (communities of interest/networks of activity).

Dame Jackie and her team work in 12-weeks blocks, so are constantly looking ahead and back, reflecting and learning from what has gone well and what hasn’t. Communication is central to her approach. The 12-week system owes its origins to Agile project management, and enables the Trust to adapt rapidly to changing circumstances.

The challenges facing the NHS right now are well documented – an ageing population, budgetary constraints, increasing costs of pharmaceuticals and medical equipment. Dame Jackie believes that in addressing these it is essential to acknowledge the relationship between health, wealth, and wellbeing. The city is taking a systems perspective by including within ‘Collaborative Newcastle’ The Newcastle Upon Tyne Hospitals NHSFT, the City Council, the universities, the mental health trust, social care providers, and GPs.

On a wider scale the trust also plays an important role in a “provider collaborative” of eight NHS Foundation Trusts within the region. She says “we have stepped through every week of this pandemic together over the whole year.”

Dame Jackie’s proudest achievements include leading, as Nurse Director, a campaign called “Improving Working Lives” in the Trent Region. She is also pleased with the six years she spent at Morecambe Bay NHS Foundation Trust (where failings at Furness General Hospital led to the avoidable deaths of at least 11 babies and one mother), leading the trust out of special measures, rebuilding the management team, improving care, and restoring trust within the local community. In Newcastle she is proud of raising the Rainbow Flag to celebrate LGBTQ staff and patients, and also being the first healthcare organisation in the world to declare a Climate Emergency.

Jackie’s biggest mistake was to take on a Chief Executive role to turn around a financially challenged trust. Though she was successful in achieving her goal, the job did not resonate with her leadership style or values, and she reflects that it was “probably really bad for my health and wellbeing.” She says life is too short not to be true to yourself.

During her career she has found so many people inspirational, from the ward sisters when she was a student nurse to the families she worked with in Morecambe Bay. She remembers as a student nurse trying to get closer to people so that she could get a sense of what they were doing. Nowadays, she encourages people to ask for the help, support or advice that they need. “Most people are really pleased to help.”

Dame Jackie’s answer to Tracy Allen’s question “what is your leadership for” is “to enable staff to flourish.” If people feel they can give of their best and be who they truly are, it translates directly into quality of care for patients.

Exercise is important to her and she starts her day (at 5:30am) with a 40-minute spin on her exercise bike. In the early part of her career she used to “crash into Friday.” Now she is more cognisant of how she uses her energy during the day: as an introvert she builds short restorative niches into her rhythm of work. She also pays attention to sleep and what she eats, and she works with a coach to help her reflect.

The books that Dame Jackie has read that she has found memorable include: Becoming by Michelle Obama, Rituals for Every Day by Katia Phillips and Nadia Narain, Better than Before by Gretchen Rubin, The Salt Path by Raynor Wynn.

Dame Jackie doesn’t feel the NHS is doing enough right now to create compassionate leaders. The time when circumstances are most pressured and such leadership is needed tends to be when it is undervalued. “We need to do so much more to talk about this… and to make it clear that it is the root to all sorts of success.”

Dame Jackie is writing a book and most of what we have talked about today will be in there, along with the operational aspects of how you run a major organisation.

What advice would she give her 20-year old self? It’s a journey and not a destination. Slow down. Try to enjoy it. And be who you are – “I spent way too many hours early in my career trying to be who people wanted me to be, and it was uncomfortable… and it must have looked and sounded very odd.” Accept that you are good enough, and give yourself a break.