Published on: 4 October 2024
Over the last 20 years, Arun Chidambaram, Medical Director at Derbyshire Healthcare NHS Foundation Trust, has worked in six NHS Trusts, three ICBs and two regions. In each he has met inspirational colleagues, who have shaped his career. Arun shares a bit about his experience in a recent blog, which recognises his 20-year anniversary in the NHS.
I have sat down to pen these reflections with a chocolate, as I feel the need to give cues to my brain to revive some sweet memories. I open the wrapper and see a blob of chocolate. I let the chocolate melt in my mouth, instead of a bite.
I joined the NHS on 4 August 2004. I had taken a train to arrive into Liverpool the previous day from Norwich - it was a journey from the east coast to the west coast and had taken over five hours.
Liverpool was gearing up for being the European Capital of Culture in 2008. I still remember the warmth of the city, which fostered a sense of belonging. I arrived with one suitcase containing all my belongings and lots of hope and optimism.
On the day of my induction, I met my peers and did the mock exercises for the Management of Violence and Aggression training. Some of the colleagues who joined me still work in different parts of NHS, in various senior roles.
Over the last 20 years, I have worked in six NHS trusts, three ICBs and two regions. In each I have met inspirational colleagues, who have shaped my career. I have had the privilege of working in the most resourced parts of the NHS and also the least. What was consistent is that I saw staff delivering their best, wherever they worked and whatever the challenge.
One of my most fulfilling jobs was to work with families in one of the most deprived councils in the country. This team worked on a model called multi-systemic therapy, where the aim was to prevent children being taken into care. We visited the families in their homes and would help them engage with services – social care, law enforcement, school and other agencies. I still remember one of our service users, who had a challenging time due to her neighbours and also experienced mental health symptoms. We worked with a housing agency to find her a more friendly neighbourhood and addressed troublesome symptoms through medication in a phased manner. This was a great example of partnership working and person-centred care. As a clinician my practice was mostly in super-specialities and this was a career milestone in moving to a generalist role.
One of my learnings as a clinician was the value of working in the heart of a community, in a team with flat hierarchy. As a leader, I gained practical experience of working for a council, which had a very different culture to the NHS. Within the NHS we have traditionally focused on specialist teams who work with people who have complex and enduring conditions (like developmental disorders) and an offending history linked to that disorder. If we had more generalist teams like the multi-systemic therapy team, we could prevent illness burden at an earlier stage of life, that will eventually reduce the need of specialist teams like complex offender health teams.
In my corporate role, I was keen to get inputs from colleagues that strengthened my assurance. We were based within a huge building that brought together a number of different teams. When I finished walking the length of the floor, I would have spoken to colleagues from reception, finance, HR, communications and temporary staffing. It was by piecing all these bits of information together that I would get a deeper insight into organisational health.
Over my 20 years in the NHS I have always had an affinity towards admin colleagues, who have always been equally supportive to me. I remember one reception colleague breaking down in tears, when I didn’t get a job that I wanted. On another occasion, an admin colleague brought a box of chocolates to console me from a different career setback.
When I look back I see two transformations for me as a person over the last 20 years:
- I started as a super-specialist, but chose to move to become a generalist as a clinician, to role model the change that was required for our patients
- I used to really wonder how some senior colleagues had the gift of reflection. Despite being a psychiatrist, where reflection is part of the development, I couldn’t have the depth of reflection of senior leaders. Over the years, I realise that I have imbibed some of this ability. I didn’t think I would be able to do this.
I constantly challenge myself to move out of my comfort zone to stretch myself. I still have the fire in my belly as my first day in 2004 and I tell myself when I don’t have that I should stop working.
However, no matter how hard I have tried over the last 20 years, I can’t move away from the comfort zone of chocolate.
