Senior leader reflections: Kiran Patel

University Hospitals Birmingham NHS Foundation Trust runs Good Hope, Heartlands, Queen Elizabeth and Solihull hospitals, the Birmingham Chest Clinic, and Solihull community services.

Medicine was probably my third-choice career...like all children, I wanted to be an astronaut, and then as I grew up, I wanted to be a professional cricketer. I ended up being a medic. I never planned to go into management; it sort of just happened. I guess it started because I set up a charity when I was a registrar, called South Asian Health Foundation, which looks at health inequalities in the UK and helps the National Institute for Health and Care Excellence (NICE) with equality impact assessments.

I was born and bred in West Bromwich. Growing up in the Black Country, I thought it was normal to see people dying at the age of 30 or 40 from heart attacks, drug abuse, and strokes. I was lucky enough to go to Cambridge University, which as you can imagine was a completely different world to what I had experienced back at home. It was like going into Harry Potter land! I would study in Cambridge and then go home to West Bromwich in the holidays. It was then that I realised what I had seen growing up wasn’t normal. At the time I didn’t call them inequalities, but I did eventually see that there are genuine inequalities in this country, and they are stark. As my life was getting better, and I was becoming more educated in a surreal and privileged environment, I wondered why everyone didn’t have access to this. I saw myself as lucky for getting the right breaks in life, while also being very driven myself, but I was studying with children for whom this was normal, and they were sometimes from a long line of generations getting this experience.

I want society to be meritocratic and everybody to have the same opportunity in life. If you have the same opportunities, you get closer to having the same outcomes. When I was a registrar, I remember seeing a patient when I was training in cardiology who had had a heart attack. He was a Punjabi man and the dietitian’s advice was for him to eat less mashed potato and more peas and broccoli. I remember how this shocked his family, and they asked me if I thought, as a fellow south Asian, if this was appropriate advice – which of course it wasn’t. I realised the NHS wasn’t really doing anything about health inequalities, or at least that’s how I felt; it was treating everybody the same and therefore widening inequalities.

So, I went off and developed a charity, which is now 25 years old. Health inequalities have always driven my passion and I want to make life better for every single patient that I see. It isn't about depriving some, but levelling up, and making it better for everyone else. My dad died too early. My sister died too early. I have friends who died too early. And I am sure many other people living around the West Midlands will say the same thing. These are avoidable deaths – so let’s do something about them.

With the charity, I worked at a national level for a while before I became a consultant. Within a year of starting as a consultant, I became a clinical director at the Strategic Health Authority regionally. I went on to become a medical director across the West Mercia Primary Care Trust cluster. I then returned to Good Hope Hospital, where I had done some of my training, where I was a medical director before joining NHS England as a regional medical director for six years. Prior to returning to University Hospitals Birmingham (UHB), I was the Chief Medical Officer and Deputy Chief Executive at University Hospitals of Coventry and Warwickshire. Now, I am UHB’s Chief Medical Officer, having joined the Trust four months ago.

I think there are three purposes to my role as Chief Medical Officer. First is to be reactive to issues that need a reaction here and now. The second is to identify what needs a response and then to make sure there is a structured and measured response to that. The third is to be predictive and seize the initiative and identify areas where you can make a genuine difference. I find it really exciting to look at where the gaps are and the opportunities to really innovate.

As a leader, I think people describe me as fair, transparent, and consistent, as well as calm, wise and compassionate. The best bit of advice I’ve received is just to be myself, do not try and pretend to be somebody else. The second is to do the right thing. Whenever I am making decisions, I remind myself of those two things. I always challenge myself to avoid being impulsive, and I try to think about what the right thing is to do. If you don't do that, you just end up with ‘group think’. I enjoy working in teams that challenge themselves to say what is the right thing to do. This, at UHB, is a great team to be in right now. We are trying to do the right thing.

As clinicians, we are always kind. I learned to be kind during my practice throughout my clinical career, and that is because we are driven by making a difference to patients; that is why I still practice clinically. I extrapolate that to the colleagues I work with managerially too. Sometimes being kind can feel unkind – such as when you have to give clear and constructive feedback. It’s not always easy, but it is the right thing to do.

I think I'm kind to our patients, our staff and the populations we serve. But people are kind to me too. Sometimes we forget the difference it can make to ask someone if they are OK. A few weeks ago, Margaret Garbett, Chief Nurse, gave me a Kit Kat. I had been having a really long day with back-to-back meetings, so when she gave me that Kit Kat, I thought it was a really kind thought and gesture – it was just what I needed. My team within the medical directorate have also been amazing in coping with so much in the past four months. They’ve given me the space to get settled in and helped me adjust to UHB.

My best advice to other leaders or aspiring leaders is to be ‘the calm’. You are a role model, and it is important to be calm, particularly when the going gets tough, and situations are complex and volatile. You've got to be a leader and be that calm individual who people can turn to. Lastly, being a leader means doing the right thing. Sometimes it's hard to know what the right thing is. So, when it's not obvious, take your time to work it out. You're better off taking your time and doing the right thing, then acting quickly and doing the wrong thing.

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