Crossing the road in Delhi (or how to navigate the NHS)

By Rahul Singal

I was honoured to be appointed as the first Clinical Fellow to the Chief Pharmaceutical Officer, Dr Keith Ridge at NHS England. When reading the job description, I recognised this was an opportunity that encompassed everything I wanted in my ideal role within the NHS. However, I didn’t think this opportunity would come for another 10 to 20 years in my career.

Clinical fellowships in the pharmacy profession

At the beginning of the fellowship although I felt a great deal of excitement and motivation, I was also very anxious. Fellowships are not well understood within the pharmacy profession, perhaps because of the few opportunities to get involved in them currently. This made it difficult for me to seek advice from senior leaders and peers on what to expect and indeed to explain what I was leaving my job to do for the upcoming year.

By chance, my first day fell on one of the ‘away days’ that are arranged by the National Medical Director’s Clinical Fellow Scheme to meet senior leaders and learn more about a particular national organisation, which happened to be at NHS England this time. I had little knowledge of this scheme prior to starting my role and remember feeling slightly intimidated by this cohort of clinical fellows. As a whole, they came across very confident, well-informed, politically astute, and inquisitive. Although this didn’t help the first day anxiety, as the year went on I was somewhat kindly ‘adopted’ onto this scheme and had the opportunity to build stronger relationships with the group as well as individuals in it.

This was a very important aspect of the fellowship for me as there is a lot that is said about professional tribalism and hierarchy that exists in NHS organisations. But I found – despite a few differences – we had a lot in common. We bonded over desires to improve patient safety, our pursuit of opportunities and a strong belief that we can genuinely do something better for our patients.

A career-defining moment

I have always heard that ‘good’ employees and colleagues are those who ‘get it’, but I was never clear on what the ‘it’ was. This fellowship clarified that for me. The ‘it’ was just a sense of perspective, drive and common value that aligns people to impact positively.

Throughout this fellowship year I have had the opportunity to be involved in a number of high profile projects focussing on improving the value and outcomes patients get from NHS-prescribed medicines. My time was mostly devoted to leading a programme of work and authoring a national report on seven-day clinical pharmacy services in acute hospitals.

In delivering this, I had the opportunity to extend my network and meet with a range of professionals and senior leaders across the country to share best practice and strengthen my understanding. Having a scientific background, my steepest learning curve was refining my plain English writing skills in order to publish the national report. I benefited from working across departments within NHS England, including publishing, communications, media, finance and strategy. This really developed my communication skills, as I learnt you need 10 different pitches for 10 different people and was fascinated by the effectiveness of this – when you get it right.

These are some of the many examples of the opportunities available to a Chief Pharmaceutical Officer’s fellow. For me, this fellowship has been the defining moment of my career so far. It has allowed me to work with the most senior leaders of the NHS and learn first-hand under their guidance. It has provided me with the opportunity to enhance my professional network and profile. It has allowed me to lead and deliver a national report and present on various platforms. I feel privileged to have been able to participate at this level. As the first to have this opportunity in pharmacy, I felt a sense of responsibility to help grow the fellowship within the profession during my time. Therefore, through the collective efforts of all the clinical fellows, I am thrilled to see the fellowship go from one place to the nine offered last year.

I have struggled to find the words which fully encapsulate this experience and my new found understanding of the NHS. However, in a recent discussion with the Chair of an acute trust, I found them – she used the analogy of the culture and opportunities within the NHS as ‘crossing a road in Delhi’. It is a busy, chaotic and complex system, which is further under pressure by a constant demand. However, we can’t wait for the ‘traffic’ to stop in order to be effective in ‘crossing the road’. As future leaders in the NHS, we need to be comfortable with the uncertainty and complexity that exists and continue moving in the direction we need to go.

Applications for this year's Chief Pharmaceutical Officer's Clinical Fellow Scheme are now open: Apply now