From Librarian to Leader, the Midwife who Made Things Happen.
Sue Holden was always a fearless leader, driven by a sense of right and wrong, but always mindful of the gifts that others have.
Sue Holden is Chief Executive of Aqua, an NHS improvement organisation. Starting her career as a librarian, she trained as a nurse, then as a midwife, and she has worked in the NHS for over 40 years. She became Executive Director in a Teaching Trust before becoming an Improvement Director for NHSI in 2015. She then worked 5 years with Trusts in Quality and Financial Special Measures, and from 2019 – 2022 as NHSE, National Director for Intensive Support. Sue believes in the importance of supporting individuals, organisations, and systems to improve.
“I remember the interview. One of the questions was, “Why should we train you to be a nurse if you’re just going to go off and have babies?” And, at the time, I thought, well, that’s nothing to do with you. And, I said it. “I don’t know why I’ve been asked the question. I don’t think that’s anything to do with being a nurse.” And, the guy that interviewed me,
Mr Dorgu who was the head of education, said, “Okay, we’ll put you on the training. If you’re prepared to speak up to me, you’ll speak up to others.”
Watch the video, listen to the podcast, or link to the transcript in BMJ Leader
Read the full conversation on BMJLeader. Here are some key quotations from the interview:
“…at the end of it, he said, “Well, you’ll never work in the main hospital again for the rest of your training” And I didn’t, I worked at peripheral hospitals. That was my first real experience of power being used inappropriately. And, it made me cross.”
“It’s what you do with your learning. It’s what you do in terms of reflection and how you test out your thinking and how you acquire new understanding. It’s not just going with what’s always happened. I didn’t appreciate the enormity of the job at the time. I just thought I could change things.”
“When I reflect back, and I’ve done quite a lot of reflection, working through what my triggers are, it’s a values clash. When I was younger, I tended to move away rather than work through them because I didn’t have the skills. I didn’t have an understanding of the politics. I didn’t have a recognition of the other person’s perspective.”
“And because of this, I also had the privilege of working with a lady called Kath Rounce from Middlesex University, and we set up the first professional doctorate (DProf) in health. At the time, doing higher qualifications through experience wasn’t really done, it was always programmatic. I’d always felt very strongly, and I talked about it quite a lot in my other role, that we need to be more willing to accept that experiential learning has equal value to academic learning, if not more.”
“We are, everybody, is a person first. And the humanity of the individual often gets veneered with the authority and the title. I’ve always felt, and always strive to be, authentic. And that means that if I’m having a bad day, you’ll know I’m having a bad day. And it’s not that I’m having a go at you. We all have them. I’m not perfect. Neither is everybody else. But I do expect certain standards, because I always believe that you shouldn’t ever ask people to do things you’re not prepared to do yourself. And I think there’s some fundamental ethics in how you lead that you need to own.”
“One of the misnomers, I think, is failure. When an organization reacts and responds to what’s happening externally, it changes and not everybody can change with it. That doesn’t mean they failed. I hate the word failure in the sense of an individual has failed. There isn’t any individual that fails. What happens is that that leadership style doesn’t fit any longer. And that might be because the organization needs a different style or set of skills to what the leader currently has, or the leader themselves can’t adapt to that. But it doesn’t mean the skills that they had before are suddenly useless.”
“The NHS fails leaders and it fails them because it believes that the same person is going to be the right person. When things start to be challenged, it’s an easy option to get rid of the leader and they go under a cloud. And it’s unhelpful, it’s disrespectful, and it’s not compassionate. Because with the size of the organization, we’ve got to be able to support people into the roles where their skills fit.”
