Steve Moore is the Chief Executive Officer of Hywel Dda University Health Board. Steve has extensive experience in both the health and social care sectors and was previously Consulting Director for Health and Social Care Policy for a global multi-disciplinary consultancy firm ICF International. Prior to this, he was Chief Executive for NHS Cornwall and Isles of Scilly Primary Care Trust (PCT).
What is your current role?
I am the Chief Executive Officer of Hywel Dda University Health Board, the organisation responsible for the delivery and commissioning of health services to the populations of Ceredigion, Pembrokeshire and Carmarthenshire.
In order to provide services to our almost 400,000 residents we run 4 hospitals, 8 community hospitals, 14 health centres and a range of Mental Health and Learning Disabilities facilities. In addition to providing our own services we also take a lead role, in collaboration with Public Health Wales, for the health and wellbeing of our local population as well as commissioning (buying) services from GPs, Community Pharmacists, Optometrists, Dentists, the ambulance service and specialist health care centres (such as for major heart surgery) on behalf of our population. It is a big operation, involving almost 10,000 staff and spending more than £700 million a year.
I lead a team of Executives, both clinical and managerial to develop strategy, manage day to day operations and support our fantastic staff to provide services to our population.
I have been in this role for 18 months having worked in the Westcountry, around my hometown of Plymouth, for the previous 25 years or so. I am still getting to know Wales – it has a lot in common with my old patch in Devon and Cornwall but also has its own unique heritage and culture. I am (slowly!) learning the Welsh language along the way.
How did you get to your current position?
Looking back, it seems like my career has been characterised as a series of unfortunate (or at least unplanned!) events. I originally joined the NHS in 1989 as a trainee management accountant intending to get my professional qualification and then move into the much more exciting world (as I then saw it) of the private sector. Without realising it, however, the NHS got into my DNA. I think it is such a civilised idea – that we pool our resources to look after one another when we are ill and at our most vulnerable. At its heart, that is what the NHS is all about for me and whilst I am not sure exactly when I fell in love with the NHS, that is how I feel now.
Almost on the day I qualified as an accountant, I was given the opportunity to explore beyond the “safe haven” of the finance department and move into the fast developing field of health care commissioning. This involved the planning and buying of health services on behalf of the local population from hospitals which were, by this time, stand alone Trusts. As a result I undertook an MSc in Health Economics and Health Policy at the University of Birmingham in my late 20’s, graduating in 2002.
I was lucky enough to get involved in a lot of interesting work in the early 2000’s and was happy working at middle management level planning healthcare services . Somewhat unexpectedly, I was asked by the then Chief Executive of Plymouth Primary Care Trust to join her in Cornwall and Isles of Scilly Primary Care Trust where she had just been appointed as Chief Executive. After a few months “trouble-shooting” I applied for and was appointed to the position of Director of Commissioning and Strategic Development. This was my first board director role and was the most challenging and exciting time in my career up until that point. Having been a slightly shy analytical manager, I found myself suddenly chairing meetings full of clinicians and doing live interviews with little time to prepare. I learned a huge amount undertaking this role, about myself as much as the NHS, and emerged a different person at the other end. When the chief executive moved on I was asked to step into the role – being a chief executive had never entered my thinking just a few short years before.
Within your career to date, was there a specific period that you believe helped you to become the successful leader that you are today?
I am not sure I would agree with the premise that I am a successful leader –
leaders need to constantly strive and build relationships and this process never ends.
The moment you think you are successful you probably aren’t!
If I had to say what period most impacted on my approach to leadership, it would be my time as a director and then chief executive in Cornwall and Isles of Scilly. As mentioned above, I learnt a lot about myself in this period and the need to remove my own “ego” from the role.
I think my role is to make the people around me the very best they can be – and let them tell me what to do.
What was the first job you had that entailed managing people and what lessons did you learn?
My first management position was when I was promoted to be Head of Management Accounts in Plymouth Health Authority. I was 23 years old and was leading a team of about 10 people, many of whom were previously more senior than me when I started in the department. I think I made lots of mistakes but benefited hugely from having a colleague to mentor me. This was entirely informal and she wasn’t afraid to point out my errors, make me face them and help me learn from them. I have appreciated that ever since (and we are still firm friends now) and have found similar informal mentors at every stage of my career to challenge me and cause me to reflect on the way I work.
Throughout your career could you explain what leadership and management development you have undertaken?
I have to admit to not having done a huge amount of formal training and development. My career has been a little “sink or swim” and learning on the job which has been hugely instructive but also has its downsides. I have undertaken a few management and leadership courses, the most influential of which was a residential course in 2001 teaching facilitation skills.
Learning to be aware of the mood in a room, manage a constructive discussion and have “presence” has stood me in good stead and I have relied on that learning ever since.
It was probably the most constructive course I have ever attended.
Have you made any mistakes during your leadership career and importantly how did you recover from them?
I have made lots and lots of mistakes in my various leadership roles – as I said above, learning on the job has its downside. Whilst they have come in all shapes and sizes, a common factor in many of them has been
not having the difficult conversation with someone early enough.
I think it is human nature to try to avoid difficult situations which are likely to upset people – particularly those you work with closely but when I find myself struggling to make progress it is often because I am compensating to avoid facing up to the real issue. This may be related to a team member’s performance, capability or fit within the organisation or current role. I have learnt that having these difficult discussions, whilst uncomfortable, are fairer on the individual as well as the organisation in the longer run. My first priority is always to look after the human being involved – few people ever come to work to do a bad job but many people can find themselves in jobs they simply can’t succeed in. That difficult discussion can often lead to a better place for the individual as well as helping the organisation to reach its goals. I hope that someone will be brave enough to have the discussion with me if I ever find myself in that position.
And conversely what would you say is your greatest achievement in a leadership role?
That’s a more difficult question – success has always been a team effort for me. One of the biggest challenges I successfully negotiated was being the chief executive of 4 Primary Care Trusts in the last 6 months of their existence. Disestablishing these organisations and building an entirely new organisational structure whilst doing my best to look after the staff involved was at times very fraught. I remember we were holding interviews into the night in order to get everyone placed!
With regards to your current role, how would you describe your style of leadership?
I think my leadership style is fundamentally collegiate. I prefer to make progress by building consensus rather than through direction. I think that it gets the most out of people and recognises that I am often not the expert in the discussion. Facilitating the debate, creating the right environment and expecting people to do what they say they will do are the hallmarks of my approach. Having a strong team and supporting them to be the best they can has, for me, always been a more successful approach than more “heroic” forms of leadership. I don’t subscribe to the view that a single person can “save” an organisation – although a poor leader can do a lot of damage!
Did anyone in particular inspire your approach to leadership?
I have gained inspiration from almost everyone I have worked with but have had the opportunity to see some of the best leaders in action during my career. One stand out person for me has been Sir Ian Carruthers OBE – he was the chief executive of the Strategic Health Authority through most of my time in Devon and Cornwall. His deep understanding of organisations and constant focus on the patient were a real source of inspiration for me.
He taught me a lot about what a good leader looks like and the need to take responsibility and have courage in the face of difficult decisions.
When recruiting your team what do you look for in the managers and leaders that work for you?
I guess the most important thing I look for is a person’s value base.
What drives them to want to take on a role that can often mean sacrificing other parts of their life. If those values are clear and fit with the existing team and wider organisation that goes a long way to make me feel confident of offering them a role. Clearly they need sufficient experience behind them but some of the best appointments I have made have not, on paper, been the most experienced person applying. It’s all about the source of their passion and drive built on a foundation of experience and academic qualifications.
What would be your top tip to other managers?
Keep things simple, create clarity and engage with your staff often.
We have a tendency to overly complicate things particularly when considering strategic intent and tend to talk amongst ourselves rather than with the wider organisation. The NHS is a complex place but leaders should be able to describe to our front line staff and the public what we are trying to do in a simple way that people can understand and relate to. I hope I do that.
The LMW Team would sincerely like to thank Steve Moore for this interview.