CEO Series: Tim Guyler, Assistant CEO, Nottingham University Hospitals NHS Trust

In our most recent leadership series interview, we speak with Tim Guyler, newly appointed Assistant CEO at Nottingham University Hospitals NHS Trust.

In focus, Tim discusses the technology that has been most useful to his trust and shares his leadership learnings from the pandemic.

Tim also shares his advice for those aspiring to become senior leaders within the health service.

Can you tell me about your path to becoming Assistant CEO?

My path started through the NHS management training scheme which I applied for and successfully joined after university. At university I studied Business Studies and French in which I probably had some grandiose idea of becoming an international business person and retiring by the time I was 30 (which clearly hasn’t come to pass!) but as part of the course I studied Health Economics which opened up a broader interest of the impacts on society that well-organised health and care services have.

Since then, I’ve undertaken a number of roles in the health service which have predominantly been around operational management and service improvement in several places around the country. But I then came full-circle back to Nottingham where I was born and bred and I’ve undertaken a number of different roles in Nottingham University Hospitals including Deputy Director of Operations, Programme Director for the Whole Hospital Change Programme and Chief Operating Officer, subsequently ending up now as Assistant Chief Executive.

Has your leadership had to change since the start of the pandemic? 

It has required a different kind of leadership from all of us; leading at greater pace and leading within greater ambiguity have been the two key aspects of leadership change for me.

In the NHS up until recently, there was incredibly strong focus on seeking to get as much assurance as possible before making changes. This comes down to risk balances and understanding the likelihood of risk, and quite often we would look to get as best an understanding of risk before progressing change.

The Covid-19 situation ‘do nothing risk threshold’ has changed markedly and so the necessity to change was much greater even though what you were changing showed a great deal of uncertainty in terms of how much assurance could be afforded to that change.

So, from a leadership point of view we needed to involve the best people and enable the right people to come to the fore. That’s nothing new – it’s what we’ve always sought to do and is an important aspect of good leadership – but we needed to be better at it than we’d ever done before. We needed to give the right people the head room and support to get on whilst there are unknowns and unmitigated risks.

Pace and leading through uncertainty have been significantly different within the context we are in now compared to what was previous. Leadership should create clarity and support to allow people to make decisions when the situation is unclear and difficult so that we move forwards.

What are the key challenges in your role as Assistant CEO?

A large part of my role is working across the health and care system with partners; I can’t remember who made the comment of ‘if you think competition is hard, you should try collaboration’ but this does often feel very true.

I think there is something in terms of how we drive forward collaborative work to yield greater benefits and I think this is one area where Covid-19 has helped us all – it has allowed us to collectively respond to what we can do as organisations; we have broken down barriers that have previously prevented us doing things, and we have recognised that what we would have previously perceived in terms of risk, pale in significance compared to population outcomes.

We have to try harder and be more willing to take risks, make things happen, and own the implications together; during Covid-19, we have seen some brilliant examples of this happening which wouldn’t have happened otherwise and we need to make sure we continue down this path.

What technology has been most useful to your trust?

Within our hospital, one of our primary systems is Nervecentre and over the years there has been a rollout of handheld devices to do a manner of things digitally. That as a core centre of an information system has been critical as well as the flexibility of that system, where the adaptation of that system around designing IT systems in supporting clinical teams has been absolutely essential.

Having an adaptable system that supports clinical colleagues in capturing and accessing information quickly, to be supported in decision making by clinical information at the point they need it has been absolutely critical.

More broadly speaking, it has been amazing to see the type of work that has been done through the digital and informatics space to get a deep understanding across the populations of what is going on to inform decision making.

Data has been absolutely critical in making good decisions; the IT systems, the modelling systems, the population systems underpinning decision making are important, and as we move into the Covid vaccination program, the IT systems that have enabled population understanding has again helped us massively in planning what the best model is to role the vaccination out.

Can you share any learnings you’ve acquired?

Two main things come to mind; the first is if you ask people to do something with a clear intent, they will do it. I’ve been so humbled by the stories of what people have done – exceptional personal sacrifice in caring for the population across health and social care. The response has been so strong even in dark times.

The second thing is the depth of ability and experience which exists across organisations; we’ve worked very closely with the University of Nottingham and we are very fortunate to be located next to one another in the centre of Nottingham. The university wrote to the CEO and said “we will help in any way we can”, and since then I’ve been the mutual aid link to the university. We are now part of a civic agreement between the universities to do the best we can across the community.

What advice would you give to those aspiring to become senior leaders?

The first and foremost for me is make sure you surround yourself with good people; a previous boss once told me “always employ people who are more capable than you” which I think is sound advice, but to add to that is ‘always look up and out towards people who you can learn from and ask them for their help and advice’. I have always found that when you ask, people are incredibly generous with their time and will help you learn and develop.

Those people can be a huge source of support as you develop. I have been blessed during my career in having really fantastic people around me, supporting me, guiding me, sometime through luck and other times through actively seeking those people out – these people become career defining.