Sir Jim Mackey: "We need to be honest about our problems"

Matthew Taylor 

Hello and welcome to a rather special episode of Health on the Line, which you're hopefully now listening to as you pack your toothbrush ready to join us in Manchester for the annual NHS England and NHS Confederation joint conference, NHS ConfedExpo.  

There will be so much to get your teeth into. Did you see what I did there? Sessions on integration, collaboration, transformation, improvement, all being debated on the eve of the government's ten-year plan for the NHS and with the small distraction of the comprehensive spending review taking place in the background.  

Well, I can't wait to experience it with all 8,000 plus of you who will be there. I really hope you get lots out of it. And if you're not able to come, there will be online content to follow.  

So ahead of ConfedExpo, I was delighted at the end of last week to be joined by Sir Jim Mackey, chief executive of the NHS. I talked to him about the state of the NHS, where we go next, and his views on leadership. 

Welcome to Health on the Line, Jim. 

Jim Mackey 

Hello Matthew, good to see you. 

Matthew Taylor 

I'm just going to say a little bit about your background for anyone who doesn't know you. You were until very recently chief executive of Newcastle upon Tyne Hospitals NHS Foundation Trust. You're technically on secondment from that role. You're also previously chief executive of Northumbria Healthcare. And during that time, you've been national advisor to NHS England on elective care. And before that, you had a two- year secondment as chief executive of NHS Improvement. And now you've got this critical role at a critical time as chief executive of NHS England.  

This will be your first Confed Expo as chief executive of NHS England, Jim, we'll be looking forward to your speech, but what's the core message you want to get across to us in Manchester? 

Jim Mackey 

We're grappling with the minutes, so you understand what it's like Matthews. We've got trying to work out what I'm going to say, how we're balancing the spending review and ten-year plan, all sorts of things. But I think the key things I want to just try and get across and then also pick up in the interactions in the informal stuff is we are trying really hard. Everybody recognises it's really tough, difficult at the minute, but we're trying really hard to work together and alongside each other to do what we need to do in tricky circumstances and hopefully people can see and feel all of that.  

Working also really hard at the centre to create the conditions for success to enable people to do what they need to do. And as part of that, get out of some of the space that we've ended up being in in the centre and also link to that, and hopefully the ten-ear plan will really stimulate this, just generate and help and generate that sense of ambition for the service and for the future and the hope and optimism that things might be tough now, but in the foreseeable future, that can be a hell of a lot better. But that's all of our jobs. It's not, that's not a single person's job. It's, what, how we all respond. 

Matthew Taylor 

That's great, Jim, and very powerful messages. Now you've been in this role for a few months now, a couple of months now. What's been the kind of biggest learning that you've had since you've taken on the role? 

Jim Mackey 

That's a really good question, Matthew. You're learning all the time of these things. And I found when I did the NHSI job and a bit with the elective job, when you're in the national world, it is different. You're using different skills and you can see things that get very well analysed and magnified and misinterpreted sometimes. So, there's a bit of that major sort of relearning that have to be aware of that. 

So I can say some things and they can become a really big thing really quite quickly when you didn't intend it or in other times it can kind of get lost in the noise. I think just trying to understand how it actually all works. I've been attached to the national system for quite a while, you know, in the elective role, but it's not until you're actually in it, can you really see how NHS England works, the relationship with the Department, relationship with government. And I've learned a huge amount from that just in a very short space of time. 

And the complexity is really weird as well. You know, we all live, chief execs everywhere live with complexity and ambiguity. But this is, again, really quite different. It's in a different order that I've ever experienced. Partly about government, where they are and their sight or coming up with an anniversary; where we are in terms of international security, defense, what that means for the economy; the position we're, in public response, public attitudes to sort - it just feels really complicated.  

So I feel like I've had a bit of a need to adjust and re-acclimatise to that, but also not really the time to think about it too much because it's been so fast paced and there's been so much to do in such a short space of time. 

Matthew Taylor 

Jim, we're speaking just before the publication of the UEC delivery plan. I think you've just done a briefing on it, but the broadcast will be going out after that. Tell me how the UEC delivery plan reflects some of those kinds of shifts that you're trying to make in terms of the way in which the centre acts and the centre is perceived. 

Jim Mackey 

So that's a really good point. This is a plan that was theoretically ready to go before I got involved. So it's been there and there are thereabouts for several months but been going through the machine. That's given Sarah Jane and Julian and other colleagues a chance to really work with people on the ground to make sure that it's realistic. It's stretching, but realistic. It's helpful. It's not, it doesn't jar with people. 

So that's one thing where we're really trying incredibly hard to make sure that we do this as much together as we can, rather than it's just a view. It’s gets sent out. It is what it is. People make whatever they want of it. We want much more interactive, collaborative alongside each other has been the key point.  

There's some subtle things in that, it immediately doesn't ask for loads of returns and reports. It's not something that is pointing upwards immediately. It's deliberately trying to help people point locally and work locally.  

We'll support, you know, being accountability as always, but hopefully people will be able to see and feel that as well. It doesn't immediately provide a load of templates. The other bit we're trying to do in everything is just get the balance right between we are where we are and it hasn't been great. It's been tough for everybody. We need to improve. We've got to improve with some pace and stretch ourselves, but I can't ever look or feel beyond reach or unreasonable or just Pollyannaish as well.  

So I think trying to get the balance right on that. And you know what that's like. Sometimes it can feel out of balance. Sometimes you go too in hard, sometimes too soft to sort it all. But the team are working really hard with colleagues to just try and get that balance right. 

Matthew Taylor 

Yeah. And reading through the document, Jim, I noticed that subtle, but really important shifts in the kind of tone of that. I mean, I used to think when I listened to NHSE senior folk in the past, that there was this kind of disjunction because there were used to be kind of two messages. One was, you know, we're doing really well. And the other was we really need help. And you kind of thought, well, how did these things add up? Whereas what I got from the UEC delivery plan was more actually, we're not doing very well and we need to admit that we're not doing very well and admit that we're letting down patience and that the performance is too variable, but actually is largely within our hands to make a difference to that.  

That's what it sounds to be like. That's the kind of the shift I'm hearing in your tone. 

Jim Mackey 

Yeah, I think that's absolutely spot on Matthew and you reminded me when you were talking, I was in Bolton on Tuesday. I went to see colleagues in the northwest. I had a really great visit to Bolton and it was a really good reminder that at times in the national world, you can feel like you need to tell people to do stuff without realising they're actually already doing it or hope that something gets fixed and it's already been fixed. What the issues are, know, things that you're not seeing in the forms returns, there's a different set of issues to the ones you can recognise and describe.  

So we are trying to be realistic about that. It's messy. It's difficult. I don't think we can actually fully solve our problems unless we're honest and we can say that they are, you know, they are what they are. The public can see it now, our staff and see it every day, but use that as the platform to push on. And it's that releasing the local ambition thing. I saw a load of in Bolton. It was a really fantastic few hours. It was really lovely and team were great and the staff on the ground were absolutely brilliant. Really bursting with ambition. That's what it's all about. And that's what we really want to try and generate more of in this next period. 

Matthew Taylor  

I think this point about ambition and also about your style, let's take it into the kind of relationship that you have to have with the politicians. Obviously, NHSE is moving into the Department. It was clear from the outside, and I've been in this role now for more than four years, that there have been times when there hasn't been an enormous amount of trust or even necessarily mutual respect between, you know, politicians and ministers and people high up in NHSE. 

Your focus on delivery, your focus on sorting out the finances, your focus on hitting the key targets will be music to the ears of ministers. But part of the reason that's important is so that when you say to them, you need to be realistic about what's possible in the context of the spending review or the ten-ear plan that they listen to you, that they know that you wouldn't be saying to them certain things aren't possible if it really wasn't the case. 

That's an important part of your role, isn't it, Jim, is to help the politicians to be realistic about what we can achieve? 

Jim Mackey 

Yeah, absolutely. And that's, know, with the NHS England change, I've been asked a few times about, this make it harder? And, you know, am I going to find it hard to stand up to the politicians and those sorts of things. And it's just really not, not like that. Everybody understands we're in a difficult position, not just the NHS, but the broader stuff that we're taught about the economy and stuff.  

And there are always choices. We always have choices. They're always in, they're always ways through situations. And I think working at a trust level, people are actually really good at that. They're confronting choices all the time. They're having difficult conversations all the time, but they're having them out in a professional way, agreeing what they need to do. Sometimes no one full well in their work and then have to course correct. And that's terrible. You know that's just life.  

My time working with the political team, previously with any elective role and now in this role, they're actually really good at that. You know, they're sensible, mature, intelligent, challenging and can see that sometimes it's not completely binary. It's not choice A or choice B or it's not simple. If it was simple, it would all just be sorting itself out. We've got a lot of complex interactions going on here, but it is absolutely my job to make sure that we don't just drift into assuming something is going to happen when it can't. Or we'll start being unreasonable and expectations, we also start doing, we're not defeated before we start.  

It's just hard to get the balance right. And we've been doing quite a lot of that all week. As you can imagine with the ten-year plan and the spending review and where we are and just trying to get that balance right. 

Matthew Taylor 

That's very tough. But my sense is that the trust that you've got with the politicians makes it easier to be credible when you when you say those difficult things, talk about those hard choices.  

Let's go to the ten-year plan now. So the kind of two contrasting perspectives people can have in the ten-year plan and what it can achieve. And one is, well, let's be realistic. The next three, four years or about three years or about recovery. And we can only really just kind of pick up the edges of reform. It's just not realistic to sort out the finances, hit our targets and expect to do radical change at the same time.  

And then there's another view. And the other view is, look, if we don't start moving on reform, you know, the day after the ten-year plan is published, then people will say, yeah, but the things we, the plan are supposed to achieve, particularly the left shift, we've been hearing about this for decades and it never actually happened. So unless the plan shows real change over the next few years, it will lose credibility. Where do you kind of stand in that conversation? 

Jim Mackey 

So I'm fighting with myself about that every minute of every day. It's been complicated honestly, ten-years is a long time. It's ten years this year that I started at NHSI and you know, it feels like hundreds of years ago. you think at that time we didn't have the ability to do Teams calls even, you know, so there's a lot can happen in ten years and it does feel in NHS terms a really long way out.  

And also if we're really serious about generating our own ambition and really trying to step up to what the public expect, a lot of it can't wait and we don't want to hold people back. And in my former trust, like I'd expect to read the plan and want to do all of it the next week. And again, it's about balance, isn’t it, just about being, you know, we've got the money that we've got now. We've got the workforce that we've got, you know, we've got the physical buildings, you know, all those sorts of things. We've got a spending review that covers the first part of that plan, I think it is actually a bit of a hard sell to say you've got to wait three years while we dig out of this before you can see any results. We're going to have to go much harder than that in reality.  

But also some of the things that we're going to set out in the plan will have a natural quite long gestation. It will take time to create and build and all going to necessarily have to follow a few sequences of events where we build confidence, momentum, infrastructure, technology, you know, sorts of things.  

But what we'll not be doing is saying it has to be absolutely the same everywhere; it has to be the same piece everywhere, which is one of the things that I think is one of the good changes and I think really quite liberating, just trying to let people get out of the box and find their own way.  

And again, just going back to the Bolton thing, you know, spent a lot of the last few weeks talking about neighbourhood care. I went and I saw a bit of it in Bolton and it's not exactly the same as we've been talking about it nationally, but it's not exactly the same in my old patch either. But you shouldn't believe these things aren't happening. They're actually all happening in some way. We just want to take them on with different level. In an ideal world we’d like the have an SR that completely supports the plan, has all the money in place, the plan gets published, everyone go hell for leather straight away and deliver it all.  

Life's just not that straightforward. But the NHS will do its best and we'll smash it. And I'm really confident in a few years' time we'll be looking at this tricky period as actually probably quite a helpful part of a process that give us a bit of a jolt and we'll get out of it. 

Matthew Taylor 

If we think about financial sustainability, Jim, obviously the ten-ear plan is going to have lots of excitement around technology and AI and genetics. And that does offer transformative possibilities. But also we know the history of the NHS is that generally technology and innovation environment is actually, in some ways, increased demand. They expand the range of things that we can treat what people expect of us. 

You know, I believe, I think we at the Confed believe that in the end, the really big shift has got to be that left shift. We've got to get better at working with people to prevent and to manage illness and to reduce unnecessary demand, particularly unnecessary demand on acute hospitals. And I'm interested in your message there. So again, if you look at the UEC plan, one of the things that I thought was great about it was it recognised that UEC is a systemic issue. It's not just about flow in hospitals, of course that matters, but the planning even gets into issues like out-of-hospital placement, out-of-area placements for people with severe mental illness, recognising the way in which things going wrong in one part of the system, then impact in others.  

But yet, Jim, when I talk to leaders at the moment under financial pressure, under operational pressure, I do hear them say, look, in this environment, I've just got to focus on my organisation. I've just got to focus on that which I control that which I'll be held to account for. I just don't have the energy to be leaning out to other parts of the service, other part of the system. Some people have interpreted the shifts in ICBs as a moving back away from the kind of ambitions around system working. So Jim, what's your message to leaders about how they balance their responsibility to run their organisations efficiently, but also the responsibility to work with their partners to change a system of care that's just not working at the moment? 

Jim Mackey 

Yeah, well, it's a really good point. When I was coming through as a young director hundreds of years ago, working for Sue Paige, who was my chief executive at the time, and Brian Flood was my chairman. Brian would have been a council leader. Sue was really system orientated, very used to talk about whole systems all the time. We were as a trust that had its boundaries. 

But it was our job to work with a council. I knew, it was trained into me, it built into me, it was our job to work with a council. We ran most of the community services, but when we didn't work with the community providers, work with all the other agencies in that place, it's just always been part of the job. It’s been, and it is in certain parts of the country you can see that's really hardwired. You'll run out of road just trying to deliver everything internally.  

But in the last few years, partly because it's been so hard and partly because covid things, people have at the same time become, I think at times a bit harder about the boundaries. But also a lot of people were telling me there was an awful lot of wasted meetings, pointless meetings, lots of meetings that didn't have a purpose. And there's nothing worse for busy people as to feel like you're wasting your time. So what we're trying to do is to have a bit of a rebalance and say this isn't all about just delivering within your boundaries or being in external meetings four days a week. Get the balance rate, but there's got to be a point. There's got to be a purpose. Challenge it. If it's delivering, or you’re not sure what it's supposed to be delivering, challenge it and don't do it. You know, have a think about what's the point of this interaction with the council or with the ICB or with another partner. We've all got to be more ruthless with our time and the potential for an impact and what it's doing for the population or patients and our staff.  

So that's really what we're trying to do in all of this. It's not, you've reminded me last time I did a Confed speech, I think it was about 2017, I think it was. And the point of it was about false binaries where the NHS often portrays things as I can do that, but I can't, that means I can't do the other. It's not like that. It's not, you know, it's just not how the NHS works or any senior leadership role works in reality. 

Matthew Taylor 

Is this therefore a kind of cultural change? Is it to do with the incentives? Is it to do with the financial flows? I think I've quoted this before and I do it with due deference to the leaders that I represent. I mean, I think the leaders I speak to in the NHS are amazing people doing fantastic work, often in incredibly tough circumstances. But someone I spoke to work with the NHS leaders said similarly very, very positive things, but then said that the one thing they thought was less positive was how quick NHS leaders could be to blame other people in the service for the problems that they have. That does feel like it's a cultural problem and sometimes something that's been reinforced by the way our incentives and accountability and financial structures work. 

Jim Mackey 

Yeah, think that's right. And I think we've got, we've all got a bit blamey over recent years. It's hard to tell how long that's been going on for, but whether it's like in the DNA, we can be very tribal. There's often a council NHS thing goes on or acute community or, whatever other things going on in the local dynamic. It's an excuse, isn't it? It's a distraction activity. And we were just talking about this morning, you know I don’t like going back over the covid thing too much, but we need to create another moment that's a bit like that where people actually did just muck in. They just... you know... clinical staff, operational staff, the regulatory system, local partners.  

A really good council chief exec friend at the time told me, you make all your friends in peacetime. This is when you find out how good a friend they are. I think there's really something in that. There's really something powerful in that.  

We're looking after the same people - population is the same, whether they need the housing repair done or they need us to fix their knee or their eye. Just got to remember that at all costs. And at the minute, people are worried, they're skint, they're concerned about international security, they're worried about waiting too long. Just all like important but fundamental human needs aren't there? None of us have been fixed by ourselves. There are some specific things that only we can fix cause they're within our complete control. And I think that's, I think you just have to be a bit grown up about that. 

Matthew Taylor 

Back to leadership, you've put a lot of emphasis on variation and I get that completely. And Wes Streeting talks about kind of league tables and cracking down on leaders who fail. I understand all of that. We have to be accountable. We spend public money, but also sometimes those variations have to do with historical factors to do with local resources. I spoke to a leader the other day who still hasn't got a trust that still hasn't got an electronic patient record and I was talking to them about all sorts of exciting things and they said look I haven't got time for any of that I'm just dealing with the most basic challenges.  

So, Jim how do you get it right? How do you kind of reward success and incentivise success but also recognise that we don't all start from the same position? 

Jim Mackey 

Yeah. So, I think there's a few really good points in there and I think the transparency is one thing. We are trying really hard to gradually keep making more things available, more data available so people can understand how they look and compare with others. 

On the conditions point, you made a point earlier on as well, try and give everybody good conditions, a reasonable set of conditions for success, whether they are payment reform or in the oversight system or decision-making processes, capital investment to help address some infrastructure problems. And when we're looking at variation, you can very quickly get the point of saying that's understandable because it's a rack hospital and everybody's walking around all the time having the CEO in front of them or something like that. 

But also then the other kind of variation that we need to tackle where you can look at two places that look almost identical, often very close to each other, getting very, very different results on a specific issue. We've got to get better at understanding and differentiating on those things, get everybody on the pitch with a reasonable chance. So over time, help and fix the infrastructure problems and the financial flow mechanisms and all the other workforce supply problems in some parts of our system, et cetera. Give everybody a reasonable chance. Make sure the data is available. Make sure everybody understands that locally. And then they're asking their own questions in the board and in the clinical teams. And how is that possible over there when we can't actually manage to do that?  

And over time, that feel less like it's a local centre argument or discussion, the oversight system, it's more self-generating on the ground. I know you're really keen, helpfully to get into improvement. I think helping people deal with that with each other voluntarily because the energy's there to do it rather than the being forced or pointed to, or it's part of an arm wrestling about, need some money to fix part of the building, you know, that sort of thing. That'll take time from where we're at now, but it was a start. 

Matthew Taylor 

Last two questions, Jim, I'm very aware of taking up your valuable time.  

One's about primaries. So I would say as I go around the country, Jim, that the biggest variable when it comes to integration, when it comes to innovation in terms of, for example, trying to stop unnecessary visits to A&E or whatever, is primary engagement. Where primary is organised, where it operates at scale really amazing things can happen. Like you can see, for example, in East Birmingham, but in too many places, it feels like primary doesn't operate at scale, that it's hard to engage any more than a relatively small sliver of the local GPs in talking about change. And we know the kind of incredible pressures primary is under. How important do you think it is in the context of the ten-year plan that we, the primary is able to operate at scale? And how do we go about making that happen? 

Jim Mackey 

It's a really big part of the part of it. It's a very central part of the neighbourhood care part of the ten-year plan, which I think is still pretty much the best part of the plan. It'll be the thing that generates most energy, you know, maybe alongside the quality stuff. It's stuff we're all interested in. But you're right, scale is a factor, but also, you know, thinking back to my early life in the NHS, there's a huge amount of work went in to develop and primary care leadership developing relationships between primary and secondary care so people work together as equals rather than having this feeling that one was looking down the nose at the other or it was some kind of competitive thing over money. These things aren't always perfect and they're not perfect now, but at least there was an effort that went in there keeping people together, having the right mechanics, having the right conversations, making sure the dynamics were working properly. The relationships were probably people were being developed together.  

None of this works with one part of system being really strong and another part of the system being very weak. It is easier in parts where primary care is at scale because it's more organised, it's more coordinated, it's more consistent and the big trusts are really big entities. When they interact with individual practices, they're dealing with SMEs. There's quite a really big structural and psychological difference there and you know how to work. So it's naturally easier as you've got sort of big corporates talking to big corporates. There is a bit of that. We need all parts of the system to be as strong as every other part. That's another thing that we'll hopefully try to see moved on in this next period is dealt with developing every part of the system rather than one part at the expense of another. 

Matthew Taylor 

And then finally, Jim, in various points in this conversation, we've touched on two issues of leadership, but I just want to end by going to the heart of it. It feels to me that often we ask leaders in the health service to do things, but we don't invest in leadership development. And this is partly, we ask people to take on new roles. I think this is one of the challenges of PCNs. We suddenly ask GPs to run quite significant workforces to do things in different ways, but we expect them to just kind of magically find out how to do that rather than investing in giving them the kind of skills and the support of organisation development. And equally, I go to places and we're asking people to collaborate. It's really hard to collaborate. It's hard to put the needs of patients in the place ahead of the needs of your own organisation, your own staff sometimes. But again, we just push people into a room together and say, go on, you get on with it. You start behaving heroically. 

How important is it for us to invest more in leadership and organisational development if we really want to do things differently and better in the NHS? 

Jim Mackey 

It's absolutely essential. It can't be a negotiable and I you've described a really accurate picture of the way you see it. I mean, all these things, collaboration is hard anyway, but in extreme circumstances when everybody's skint and really under pressure, then you put young and experienced people in without the training and development and expect them to get fantastic results out of that. How is that going to work? Who would think that's a good idea? We have to be trying wherever we can to develop talent, get people in the right places, give them the right skills, give them the right opportunities, support, challenge in the right way. And I really benefited from that throughout my career. I've had a lot of personal development. I've had a lot of coaching and mentorship. I've had a good, experienced colleagues around me to look after me and stretch me and put me into uncomfortable positions, but know that they're there when, when it becomes too much. And we first want me to talk about it more. 

But secondly, we need to get organised about it. It's not something that can happen by accident. You know, talk a bit about different points in my career. I was a young finance director when we created the Northumbria Leadership Programme. We had absolutely no money and we could absolutely not afford to do it at the time. It's still going now. It's 25, 26 years old with hundreds of people who've been through that system to great benefit.  

A few weeks ago I met with the aspiring chief execs groups and there was honestly, it was absolutely fantastic ‘cause again, at a national level, you convince yourself people aren't up for these jobs. There was a lot of people in that room really up for these jobs. One of them told me the other day was the best thing they'd ever been through. They thought they were ready before the start of the programme, realised they weren't and now think they are because of what the program's done for them. The problem is it's sporadic. It's not systematised. It's not as universal as it needs to be. It's not as consistent as it needs to be. 

But we're going to get out and through this through great leadership and we've got great leadership, but it's too often accidental and instinctive. And we need to add to the accidental and instinctive with coaching, development, education, intelligence, you know, all those things as well. And that's what that's again, part of what we'll be trying to do. So it’s our job to create the circumstances and conditions. It's everybody else's to put together and deliver what we need to do. 

Matthew Taylor 

What a great way of ending our conversation, Jim. I'm so grateful to you for joining my Health on the Line. I look forward to seeing you next week in Manchester. 

Jim Mackey 

Excellent. Thanks, Matthew. See you then. 

Matthew Taylor

And that just leaves me to introduce our latest Leader in Six interview, which is with Lorraine Mattis, chief executive of the University of Suffolk Dental CIC, which I've been lucky enough to visit. And indeed, Lorraine and I appeared on the Today programme last week. My colleague Sarah Miller caught up with Lorraine a few weeks ago. 

Sarah Miller

So, what would you say is the most pressing issue for you right now? What's your biggest challenge? 

Lorraine Mattis 

Undoubtedly workforce is the biggest challenge in the dental sector. Though there's a lot for us to do in terms of improving access for local people and residents, as well as supporting the grossed retention of a dental workforce. And by a dental workforce I mean dentists, dental therapists and dental nurses and beyond, because there are more than just dentists that support the profession of the dental profession. 

Sarah Miller 

Fantastic. And what's the air of improvement or innovation that you are most excited by in a moment? 

Lorraine Mattis 

The ability to set up an innovative new organisation that focuses on both delivery and also workforce, so it's addressing very access and workforce issues across NHS dental care. But also it's the ability to challenge the status quo. We are innovatively commissioned through the ICB and it's with a focus on outcomes as opposed to historical activity metrics. 

Sarah Miller 

Great. Now, if you were NHS Queen for the day, what's the one reform that you would introduce? 

Lorraine Mattis 

Ooh, that's an interesting one. I suppose there are probably a number of reforms, but one I think is probably important for all of us is, but it's not necessarily particularly innovative, is just breaking down barriers and silos. When I think about primary care more broadly, we work in a very siloed way. So how do we completely eradicate those silos? And we're working as one team, one function, delivering the care to local people and residents. 

Sarah Miller 

Lovely. And who do you say is the leader that you admire the most, whether that's a health leader or a world leader or someone that you admire and why do you admire them? 

Lorraine Mattis 

I think the one that I sort of immediately sort of comes to mind is Michelle Obama actually. I just find her inspirational, she's willing to challenge the status quo and let's just be frank she doesn't take crap. 

Sarah Miller 

Very good, very good. And tell us something about yourself that is interesting and nothing to do with your day job. 

Lorraine Mattis 

So I suppose what I would say is I love, you know, I've come from a family where we're avid athletic and sports fans. So I suppose if I wasn't in the health space, albeit sort of health related, I probably would have been an athlete in a formal world or life. 

Sarah Miller 

Fantastic. And then lastly, just a book or film or TV series or podcast guessing to that you would recommend. 

Lorraine Mattis 

Yeah, so there's one that was recommended to me, which is very cathartic actually, it's called Let Them Be. It's associated with Mel Robbins, so it's that ability to let go of control, be calm and actually control the things that you can control, which is ourselves. 

Sarah Miller 

Lovely. Thank you, Lorraine, for doing a Leader in. 

Lorraine Mattis 

Brilliant, thank you very much. Thank you.