I’m an operational manager without clinical registration. My perspective is as valid as anyone else’s. Professional registration carries expertise and responsibility, but it doesn’t make one voice more legitimate than another. Every day I work alongside clinical teams, and together we’re responsible for making services safe, effective and sustainable. My role is about creating the environment for those teams to thrive, making sure the right systems, people, processes, information and delivery are in place.

I haven’t been handed trust and credibility. I’ve worked to earn them, and I know I’ve done that with some clinicians, made real progress with others, and there are still some I need to convince. Without a clinical background, I’m sometimes asked if I can truly understand the pressures of frontline care. I understand why those questions are asked. But I also know credibility comes from being visible, listening, understanding the context and staying relentlessly focused on outcomes, quality, safety and accountability.

I won’t compromise on separating quality and safety from operational performance. For me, they are the same conversation. If services aren’t accessible or responsive enough, safety and quality are already at risk. That’s why I look closely at themes from incidents and complaints, and I’m always keen to implement learning. This, alongside performance measures, patient experience and staff feedback, helps identify where improvements are needed so that I can work in partnership with teams and patients to strengthen services from end to end.

In the current NHS context, I know there’s a perception that non-clinical leaders are focused only on targets, KPIs and saving money. I’ve even heard that I care more about budget than patients. It’s not true, and it hurts to hear. Operational leadership isn’t about numbers for their own sake; it’s about protecting patients and supporting staff, and improving care in a sustainable way. Looking at metrics, targets and performance standards is one of the tools I use to understand what’s happening, but it’s the broader leadership – bringing people together, making decisions, and improving how services work – that creates real change.

This work sometimes brings conflict, and that’s not a bad thing. Healthy challenge between clinical and operational leaders is essential, as long as it’s done respectfully and with the same end goal in mind. I’ve challenged clinical colleagues and they’ve challenged me. We don’t always agree, but shared goals and honest conversations often lead to better solutions.

We often talk about inclusive, compassionate leadership and creating psychological safety in the NHS. If we mean that seriously, then we must also value the contribution of non-clinical colleagues, and not just in support roles, but in leading clinical services and shaping the future of care.

Robert Szymanski, IHSCM Member.