Redefining the relationship between patients and medical leadership

Navina Evans profile picture

06 January 2020

Navina Evans
Chief executive
East London NHS Foundation Trust


My recent experiences as a patient has made me think about the role of the consultant in our care. I have been looked after by a physician for my stable, long-term condition and a surgeon for the treatment of cataracts.

Both are highly skilled in their specialty, knowledgeable, expert and competent. They both achieved good outcomes determined by symptom relief and other quantifiable measures. My treatment was without adverse effects or complications.

So ‘our NHS’ delivered for me once again. My general experience of services did however highlight room for improvement in organisational processes, systems, management of flow etc. To address these, I hope to get the opportunity to contribute to the patient engagement systems beyond surveys, to give something back.

My general experience of services did however highlight room for improvement in organisational processes, systems, management of flow etc.

Navina Evans    Chief executive

I am writing this because I was struck by what these two clinical leaders brought to the role of the medical consultant by way of their personal qualities; their behaviour, values and people skills. I observed them as individuals, how they interacted with their teams, colleagues and fellow patients. I participated in conversations with other patients and their relatives whilst waiting (there was plenty of time for this, a lot of hanging around was had!). This led me to reflect on how medical leadership behaviour affects outcomes of care.

Both clinical leaders treated me and other patients with respect and dignity. They were kind and patient, not in any way patronising. They used language that we could understand. When some patients were obviously upset, they were understanding and calming. They answered some of my foolish questions without making me feel inadequate. Both enquired about my feelings.

I was struck by them as individuals. Both were softly spoken, casually dressed. Both had kind smiles and there was warmth in their eye contact. Both were authentic and gentle. Both were able to put us patients at ease. Both apologised when an apology was due. Both listened to what I wanted and tried to accommodate my needs. Not always possible, but I felt heard. I felt safe and I felt some degree of control at a time when I was most vulnerable. Their behaviour had a direct impact on:

  • my acceptance of my condition and thereafter on my ability to function.
  • my cooperation with the treatment plan (hence the good outcomes which in turn meant minimal use of services).

I also noticed that their colleagues visibly enjoyed being around them.

I felt safe and I felt some degree of control at a time when I was most vulnerable.

Navina Evans    Chief executive

If we were to examine metrics associated with such human characteristics, would we find an association with: improving patient outcomes, successful team working with better staff satisfaction, higher service productivity and improved value with more effective use of resources? I believe that we would.

We would be able to redefine the relationship between those in need of care with those who hold the power as providers of care. Ultimately working towards true co-production in decision making about the deployment of precious NHS resources. I want to start by exploring further with medical and other colleagues as part of our work to embed continuous improvement in my own organisation. I am looking for leaders from other organisations to join me. Any takers?

About the author

Navina Evans profile picture

Navina Evans
Chief executive

Navina has over twenty years’ clinical experience in psychiatry, medicine and paediatrics, and came to East London in 1997 as a consultant psychiatrist. In 2011 Navina took on the role of deputy chief executive and director of operations at the East London NHS Foundation Trust (ELFT), and was appointed as chief executive in August 2016.

Prior to 2011, Navina worked as the clinical director for Child and Adolescent Mental Health Services (CAMHS) at ELFT, where she led on ensuring effective delivery in terms of quality, performance and effectiveness and had lead responsibility for partnerships and integrated care.

Follow Navina on Twitter @NavinaEvans

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