Breathtaking: leadership insights for founders from the NHS

The recent television adaptation of?Breathtaking was a deeply sad, highly authentic drama, based on the Covid memoir of Dr. Rachel Clarke, who worked on acute wards during the pandemic. Joanne Froggatt played A&E consultant Abbey Henderson, who we see transform from cheerful, compassionate leader of a hard-pressed, dedicated team into an overloaded professional barely able to comprehend what is happening around her, let alone prevent it.

It offered in insightful allegory of inspired leadership – humanitarian, decisive, with understated heroic moments, around a shockingly vivid picture of life as a doctor during Covid. It captured the chaos, the impossible decisions, and the utterly shameful government failings. A potent drama with a retro sensibility frayed my sensibilities.

Beginning a few weeks before the first lockdown, the drama took us through the successive unpredictable, bewildering phases of the pandemic, the terrible sense of fear and then the reality of being completely overwhelmed by this mysterious new virus. We see Dr. Abbey losing patients and colleagues, spending whole weekends on shift, and denied PPE that would have saved the lives of carers and staff alike. What price for a piece of dignity?

The ‘low oxygen’ alert goes off, meaning the hospital, as well as its patients, are running out of breath. No suitable masks, no aprons, no ventilators, now no oxygen, and Dr. Abbey soon has to start making life or death decisions in the back of an ambulance. I felt immersed in the chaos and nervous sweat of trepidation, a dark and claustrophobic feel. You sensed its debilitating impact on Dr. Abbey as a leader, where despite the personal impact of the situation, she has to give hope to her team, her patients, and their close relatives. From despair to where?

Without lapsing into heavy-handed political propagandising, the drama had soundbites of Johnson floating above the traumatic scenes, peddling his emollient narrative. The juxtaposition of his vacuous rhetoric and lazy spin - sending the coronavirus packing - ?and the reality of people dying, victims with the saddest hearts, was stark. Johnson’s subsequent empty defence of his leadership and decision-making at the Covid enquiry were made more harrowing and negligent sat alongside Dr. Abbey’s empathetic leadership. La tristesse durera.

At the closing credits of the final episode, I was frozen for a moment in silence. Then I just started to clap spontaneously. I realised that I was also crying. The NHS workers being forced to pitifully clad themselves in their homemade PPE made from bin bags, whilst beginning to fall sick themselves, or buying their own respirator for ￡300 on Amazon because there’s nothing in the hospital stores that fits the faces of women was beyond belief.

The story of what unfolded behind closed hospital doors was honest and unflinching. I was in and out of hospital myself throughout this period and saw the chaos creating the frustration of medics like Dr. Abbey, but also first-hand exemplar leadership which was truly inspiring and humbling.

As Dr. Rachel Clarke has commented, she was thrust into a leadership spotlight where the unknown unknowns were tumultuous, and the daily challenges became increasingly complex. The existing system was overwhelmed before Covid arrived, and it became rapidly dysfunctional. She has no reference points, relying on her instinct. She also had to reflect upon her own wellbeing as the maelstrom spiralled around her.

With less dramatic and serious consequences, the turbulent and volatile situation of leading people, shuffling scarce resources, and trying to prioritise as a medical leader reflects the scenario facing many startup founders. Being a founder driven by entrepreneurial flair a thirst for innovation and ambition to make your mark are the self-sustaining aspects of startup life, but nothing is more important that building a team and leading people.

But having leadership responsibilities thrust upon you, maybe for the first time, can be intimidating and even overwhelming. Some trial and error needs to happen before you find your groove, but in a constant vortex of competing demands, Breathtaking offers some useful insights for founders to consider. Here are my thoughts.

1. Leaders are there to help people grow

Dr Abbey shows the role of a leader is about building strong, personal relationships based on trust with individuals. Being engaged in both their emotional and professional skills development to help them grow. Is vital. Managing through a crisis where they have little experience exposes this responsibility. Empathy, active listening, and clear language can transform a frenzied interaction into a therapeutic one. In high-pressure scenarios, these skills are even more critical.

2. Leaders need to be flexible and adapt

Leaders need to flex and adapt to any given situation. Leadership is not a one-size-fits-all role, great leaders are those who understand what is needed and can then pivot to provide what will make a difference. If you to accurately diagnose a situation and then adapt to meet the needs at that time, you will be successful.

3. Self-awareness is a trait of effective leaders

Effective leadership starts with you, cultivating your self-awareness and presence - how you show up and what you convey both emotionally and energetically. Leadership is not about you, it’s about those you lead. It’s knowing when to step into a situation, and when to step aside. Learn to lead yourself, and always position yourself in a place and headspace where you can help.

4. Do the right thing: it’s not a popularity contest

Trying to improve bad situations whilst trying to look perfect isn’t authentic, it creates an unhealthy focus on perfectionism. Be open and transparent, recognising the reality and avoiding any deflection will ensure that you build the right culture creating trust and an environment where a commitment to doing the right thing is pervasive.

5. Listen and respect front-line employees’ opinions

Dr. Abbey was in the front line, side by side with her team. This enabled her to see and listen to their direct experience and feedback. The reality is that often, front-line employees have the solutions to organisational problems, and we need to give them a stronger voice.

6. You evolve as a leader

To become a great leader, you need to challenge yourself and embrace the responsibility every day. Being a leader is not a sprint, it’s an event that helps you become better with every challenge you overcome and every opportunity you take advantage of. Experience and resilience shape you, as Dr. Abbey showed.

7. There is no downtime as a leader

Dr. Abbey’s situation was constantly frantic and fraught, each day she walked into a traumatic environment where she was ‘always present’ and ‘always a leader’ with people dependent upon her. ?There is no downtime. It’s imperative that you are mentally two steps ahead because when pivoting is necessary, everyone will be looking to you for a quick response , with decisive decision making creating a clear sense of direction.

8. Leadership is about showing trust

Leadership is about having the right people and teams in place so that you can point them in a direction and let them manage what needs to be done. Show them the way, then let go. Delegation creates trust, give folks the opportunity to show what they can do and give them responsibility.

9. A leader’s morality matters as much as their competency

Dr. Abbey shows us that the moral aspect of leadership is as important as any aspect of competency. You must lead by example and do your work with high integrity. It’s not just about getting the job done but embracing the moral imperative of doing the right thing even when it may mean an unpopular decision.

10. Leaders are dealers in hope

Leading by example oversimplifies the underlying reality. Yes, you have to stand at the front but its about ensuring you create followers by reaching into the hearts and minds of your people. Positive mindsets can be built in adversity, a leader is a dealer in hope.

Breathtaking was harrowing, provocative and audacious,? I liked the uncompromising way it looked at Dr. Abbey’s leadership role with an intensity of focus. It asked the big questions of what makes an effective leader, and offered a litmus test in communication, all of which gave a fine sense of the utter bewilderment and chaos at the time and how staff were left scrambling to deliver any kind of care.

My key takeaway for startups was that founders should aspire to be empathetic leaders, a more subtle, personal approach to leadership as evidenced in Breathtaking, not the populist hustling style. ?Set empathy as a cultural value. The behaviours that create psychological safety are part of the human bonds that matter as much at work as anywhere else. The best leaders listen show sensitivity to feelings and needs.

As leaders, we have a duty of care for the people we lead. Founders willing to set their ego aside, show their own vulnerability and be authentic, humble, and sincere grow as leaders and become better versions of themselves at work and in life. Empathy and kindness create a healthy foundation for startup growth. You have an opportunity to create a meaningful, positive, and thriving environment which will create increased social connection and inclusion.

Work is a big part of our lives, being happy and whole at work means I am truly living. If you can spread kindness and joy at work, then do it. The evidence tells us that performance improves too. Being an empathetic leader starts with the simple truth that leadership is about people. When you demonstrate these behaviours, your people will be engaged. They’ll give their best effort. They’ll be more innovative.

Create a balanced, egalitarian startup environment helmed by being a caring, thoughtful leader, one who considers more than just the bottom line. Measure your impact on the lives you touch, creating human experiences to achieve something extraordinary together, not an unending drive for financial success. Don’t leave people behind, mentally and physically worn out by the lack of emotional engagement from the founder and a binary focus on what success looks like.

Breathtaking showed the reality that true leaders affect people’s lives, both in day-to-day relationships but also in the memories of together in-the-moment experience. In your startup, draw a narrative arc from impossible to possible, and show people the way. That's what made Dr. Rachel Clarke a great leader in Covid. She put her heart and soul into getting there, and beyond.