Leading by example

January 3, 2020

John Lawlor is chief executive of one of the largest NHS trusts for mental health and disability services in the UK. Richard Dawson sits down with him to discuss his business journey, the challenges facing mental health provision and how business leaders can play their part

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) is one of the largest mental health and disability services providers in the UK. It covers a population of 1.7 million people with 7000 dedicated staff and £380 million in revenue.

Leading the organisation from the front is John Lawlor, chief executive of CNTW. Regarded by many as an inspirational boss, John’s business journey has seen him take on a number of different roles in the public sector.

From working as a schoolteacher in Doncaster during the 1984-85 Miner’s Strike to becoming a statistician in the Government Statistical Service, John entered the NHS in the mid 90s, working his way up to chief executive level thereafter. He’s been chief executive of CNTW since 2014, a job he describes as “the best I’ve ever had.”

For John, being in charge of mental health provision for the North East is also deeply personal. He talks openly and honestly about his own struggles with depression, a condition that has affected him for 20 years.

Asked what it means to be at the top of an organisation that has helped him deal with some of his own issues, John says: “I didn’t come to do the job because of that, but I’d like to think I can sort of wear two hats. I can be the chief executive and I can be a punter.”

Having been a service user himself, John is uniquely placed to be able to see both sides of the organisation, identifying areas for improvement and working to deliver a patient-centred approach. He is also the clearest example of a mental health champion that you will find in any business, showing others that mental illness does not have to be a barrier to achieving your ambition.

Since John took over CNTW, the Care Quality Commission has given the trust successive Outstanding ratings in 2016 and 2018. He has also implemented numerous cultural changes to the organisation, moving from a top down model to what John describes as collective leadership. Walking around the central office at St Nicholas Hospital, you can see the positive impact this style of leadership has had on the smiling faces of staff.

John explains: “We spent a long time developing what we call ‘collective leadership’ – how do we make staff at all levels feel more in control of decisions and how we do things?

“All the evidence says, if you show that you value your staff, you show that you listen to them, you support them to try things out; you improve morale and you often get better results.” CNTW, like any other frontline NHS service, does have its challenges. John highlights a number of areas that he and the team are working to address. One such area is the ever-growing numbers of people presenting to their GP with mental health issues.

Increased demand is clearly a welcome indication that some of the stigma around mental health is abating. After all, it is estimated that in any given year, one quarter of the population is likely to be suffering with some mental illness, so it’s good to see more people coming forward.

“But there’s a double-edged sword with that,” says John. “The more that people talk about mental health issues, the more they present to their GPs or somewhere else and want help and the capacity isn’t able to grow fast enough to support all of those people.”

John clarifies that this is a nice problem to have and discusses various steps being taken to alleviate some of the pressures on the service.

He says: “We’ve introduced single points of access where GPs can get in touch and get advice to try and avoid them referring someone in and sitting on the waiting list when they didn’t need to.”

CNTW is also one of the first trusts to fully implement electronic patient records, meaning that staff can go anywhere in the country and access any of their patient’s information.

CNTW has also launched a prevention agenda to help keep people well, support them before they need to access services, and is encouraging other public services and the business community to do more to employ people suffering from mental health issues and support wellbeing in their workplaces.

John explains that only eight per cent of people with very serious mental health issues are in work. “Over 90 per cent are not in work and we know from the work that we do that many of them can be in work. They clearly still need to go through the recruitment processes but all we’re asking is for employers to be objective,” he says.

John is also challenging business leaders to open up about their own mental health issues and adopt his collective approach to leadership.

“Another big thing is about role models,” he says. “If you have mental health issues and you say that you have or have had them, that will free up people [in the organisation] to talk about things much more openly.”

John believes passionately in what the service is trying to achieve. He has enormous respect for the support workers and carers who make a real difference on the frontline day in, day out. As both a service user and a chief executive, it’s safe to say that CNTW is in the hands of someone who really gets it.

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

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