Senior leader reflections: Andy Green

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

I studied physiotherapy at the University of Birmingham and after graduating, I went to work as a physiotherapist at Russells Hall Hospital, where I stayed for around nine years. Towards the end of that time I was the clinical specialist physiotherapist in lower limb rehabilitation.

Currently I am a Clinical Specialist Physiotherapist (MSk and Trauma Rehab) at UHB, predominantly dealing with major trauma, but mainly from an outpatient point of view. In the last 18 months, I have taken on the opportunity to go on a secondment as the Allied Health Professions (AHP) Workforce Lead, in addition to my clinical role. The first 12 months of this role was very much looking at the agenda from Health Education England (HEE) and achieving the outcomes set by them, but since then it's been more about looking at what our objectives are internally at UHB, as well as working with the Birmingham and Solihull AHP Faculty.

I grew up in a town called Beverley, in East Yorkshire. I suppose when I was a little kid, I wanted to be a professional footballer. My mother used to work in nursing and my dad in chemistry, and I'm sure he would have loved me to follow in his footsteps. But that wasn't to be. I was quite sporty as a youngster and picked up a few injuries along the way. So I saw a couple of physiotherapists and had some treatment myself. I knew I wanted a job which didn't require me to be sat down all the time, and as I was quite an active individual, I don't think an office-based job would have been great for me. I am also dyslexic, so learning was quite difficult for me and different to the people around me. So actually, a job which was quite practical appealed to me. I also thought I would enjoy the caring nature of it. At the time, I thought I might end up a sports physio for a football team such as the mighty Tigers (Hull City), but I quickly realised that I enjoyed playing my own sports too much.

What can be very difficult with the patients I work with are those times where their aspiration or goal is probably, unfortunately, unachievable and you have to work with them to make them realise that. It can be quite demoralising for them to realise that they’re not going to get to where they want to be. With major trauma patients, where they have had life-changing injuries, their life after trauma is not the same as it was before. And it can completely devastate not just them, but their whole family. For example, divorce rates are much higher in people who've had significant injuries or they may lose their job and have to navigate through things like the benefits system, which is firstly very challenging, but secondly, probably doesn’t give the same level of income that they were once accustomed to. But they're now left in this situation, following significant trauma which can have a huge psychological impact, whether it’s from an unlucky accident, or something more sinister like knife crime, and they have to figure out how to rebuild their lives.

I would say if you want to be a leader, it’s about taking different opportunities at any stage of your career. So it might be just about offering your services for a particular focus group or attending a meeting, which allows you to see how different leaders within that room interact and operate and how they overcome challenges and keep the momentum of projects going. And year on year try and really reflect on what different experiences you're going to get in that next year, which will improve you as a potential leader. Don’t always look internally for leadership opportunities; they can come in the form of being on committees or working parties outside of your organisation. For example, I co-chair the West Midlands Association for Trauma and Orthopaedics Chartered Physiotherapist (ATOCP), which is a voluntary interest group.?This has provided a variety of leadership opportunities, such as helping to deliver a themed programme for a national physiotherapy conference, which I couldn’t have gained within my organisation.?But the opportunity may also be outside of your profession sphere such as school governor, guide leader or as a football coach.

A few years ago, I successfully applied for a position on the guidelines committee for the NICE Clinical Guidelines for the Rehabilitation after Traumatic Injuries (published Jan 2022).?When I applied, I remember thinking that this was a role that I felt I could make some great contributions to, but would probably be well out of reach.?Furthermore, this was NICE and as a shop floor clinician, like me, you feel that they probably want an eminent academic or clinician, which certainly wasn’t me!?They had also asked for experience working in national multi-professional groups/committees, which at the time I didn’t have. So I did wonder whether it would be a waste of time applying.?However, this was an area I am really passionate about and thought it would be a great opportunity to make a change for our patients.?So I threw my hat into the ring and was fortunate enough to be offered the role!?And I can truly say it’s one of the best experiences; it helped me from both a clinical and leadership perspective. To work alongside other passionate clinicians from other centres across England to understand the services that they offer but also to experience large committee working where we had to navigate the ‘healthy tension’ between the clinicians and the project team/managers has been invaluable.

Leadership style gets discussed a lot and I think it’s a bit of myth that we all have one particular style. I’d argue we move between styles depending on the situation and the task in hand.?I guess my preference is to listen and to actively canvas opinions before making a collective decision, so I guess a more democratic approach. Unfortunately this isn’t always possible. I certainly like organisation and structure and I’d say that comes through in my leadership style and I certainly struggle at times to be creative, as I’m consistently thinking of the practicalities and why it won’t work! This is something I know I need to work on.

This is going to sound cheesy, but I guess the thing that I really enjoy is seeing a noticeable improvement in a patient, and actually having that positive interaction with them, seeing that your contribution to a patient has made their life better. As you get more senior, or what I've found is, it's really nice to see the influence that you can have on improving other people's careers, whether that's giving them advice clinically about a particular patient or, more holistically, about where their career is going. It’s lovely to see how people I have worked with and who been part of our team go on to develop and thrive.

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