Leadership in a time of crisis

Published: 10 Nov 2020
Last reviewed: 28 Nov 2020

We meet Dr Sandy Mather, CEO of the Intensive Care Society and winner of the memcom Award for Outstanding Leadership in a time of Crisis for a deep dive into her career and role over the past few months.

I am fortunate to be in the privileged position of being Chief Executive of the Intensive Care Society.  I began my career in 1986 qualifying as a radiographer in Liverpool and immediately moving to London.  I decided to specialise in diagnostic ultrasound in 1988 by studying part time while continuing to work in the NHS, putting theory into practise and learning to scan.  Two years later I moved hospital and studied for a teaching certificate and then a few years later I moved hospital again and studied for a Masters Degree in Clinical Imaging and in 2000 I completed my PhD in Ultrasound.  

 

I realised I needed to leave the NHS because at that time there were no career pathways for radiographers like me wishing to remain practising clinically while also progressing as a leader.  So, in 2000 I made the decision to move away from a clinical setting and gained a wealth of experience operating at senior management level, leading strategy, policy and change programmes for regulatory bodies and then not for profit health organisations and membership societies particularly those involved in professional education, training, standards, research and international development.  While leading the international division at the Royal College of GPs I once again studied part time – on this occasion it was for a Masters Degree in Charity Management which I completed in 2017.  In November of that year I joined the Intensive Care Society where I’m now Chief Executive.

 

What does  a typical day in your life as CEO comprise?

It’s difficult to describe a typical day as CEO of the Intensive Care Society.  Every day is different and every day brings new challenges and new surprises.  If I had to summarise it, I’d say that my role as CEO can be classified into three broad areas of leadership:

  • people,
  • governance; and
  • financial sustainability.

 

People

Everything comes down to people and organisational culture.  Our values define our culture and are at the very heart of the Intensive Care Society– who we are, what we do and how we do it.

  • Collaboration – we work with others to maximise our impact.
  • Freedom of Expression – we are bold in our actions and words and encourage diversity of views
  • Accept and Respect – we treat everyone with dignity and respect and accept differences delivering our mission more effectively.

 

Our two critical enablers are the train-tracks which hold our values together and direct us through our five year strategy.

  • Our multi-professional membership
  • Sustainability and Governance 

 

We all know that we will each be held to account if we do not behave in a way that demonstrates these values.  One way this is measured is by incorporating our values into annual personal objectives and our performance is reviewed against them at the end of the year when we reflect on what we have achieved and how we have behaved during the year and how we have upheld our three values.  

 

In January my average day was spent leading the implementation of our business plan for the year. A focus on ensuring our members and other beneficiaries received the maximum support we could provide them. 2020 was planned to be a celebratory year for the Society as we reached 50 years.  I was also having regular meetings with our partners – Docsville – award winning documentary film makers who we are collaborating with to film a documentary series about intensive care to raise the profile of the multi-professional team who look after patients when they are at their sickest and lowest ebb.  In January, very few people knew what was behind the doors of an intensive care unit and even fewer knew the wide variety of clinical professions involved in the care of these patients. Our aim was to shine a light on them all – the intensive care consultants, trainee consultants, nurses, physiotherapists, pharmacists, advanced practitioners in critical care, occupational therapists, dietitians, speech and language therapists, psychologists and more. 

 

During the first wave of the COVID19 pandemic I led a small team of seven amazing people.  Three of them were working less than full time at the start of the pandemic and one of them converted to full time during the peak months when our members and other beneficiaries needed us the most.  All staff worked many additional hours and weekends without being asked and without financial remuneration for doing so.  These people joined the Society because they believe in what the Society, as a charity is set up to deliver.  They were recruited as people who would fit into our culture and would be comfortable working to our values.  I believe that cultural fit and team fit and alignment with organisational values is as important as skill set and competency to perform in a particular role.  So, in retrospect, I am not surprised that these amazing people voluntarily worked so many extra hours to deliver the extensive support to our beneficiaries. 

 

In March the team set up the first of three major fundraising campaigns to generate sufficient charitable funds to enable us to pay for staff to run webinars and manage new committee meetings, new software, daily revisions to our website and communication with our members and the broader intensive care community via newsletters every few days.  This funding also helped to pay for the design, development and publication of new guidance to support our members and wider intensive care community and patients during COVID19.

 

I also spend a significant amount of time involved in communication with volunteers with expertise in marketing, public relations and fundraising who have given their time freely to help us to generate charitable funds to deliver more support to our members.  Also the public and policy makers either directly or via the media and donors who have supported us generously.

 

Governance

Interestingly, governance-wise I have to spend more time than may be expected of CEO to “keep the show on the road” and ensure we meet our legal requirements as a charity and membership association.  

 

We have 3000 members and are a relatively small membership body and charity with just 8 staff including me. Although we are very different and significantly smaller than the large charities most people are familiar with we have to meet the same governance requirements.  So the amount of time I need to personally spend on governance on a daily basis is disproportionately larger than that of a CEO in an organisation with 100 or more staff where more work can be delegated to specialised teams.  We have a valuable role to play for public benefit which is set out in our charitable object: “To advance and promote the care and safety of critically ill patients.” We have to demonstrate who we achieve this public benefit and we use our Trustees’ Annual Report to demonstrate our impact.

 

Part of our five year strategy is to increase the multi-professional membership of the Society and Council decided to ensure there was also appropriate democratic representation of the wider multi-professional membership on our Council. So, this week I have been liaising with our lawyers to amend our Articles and Regulations prior to a vote by our company members.  We are also mid way through an election for our Trainees Advisory Group and are delighted that we received 21 nominations for seven available places.  The younger generation of consultants, nurses, physiotherapists – all intensive care professionals are our future as a membership society and we depend on the skills and contributions they bring to us.

 

Financial sustainability

At the beginning of COVID19 I had many sleepless nights worrying about our challenging financial situation and the long term viability and sustainability of the charity.  At the same time I was also worrying about the clinicians I work with: wondering whether the Council members would be safe while treating patients for this unknown disease.  I knew that the only contribution I could make was to keep the show on the road and look at ways to ensure our financial sustainability long term and enable us to deliver maximum support to our members and beneficiaries of the charity.  Fortunately, I was introduced to many people who were experts in their own fields who volunteered their time and expertise pro bono to fundraise with us and others who were able to provide me with the expert legal advice I needed.  As a result we have run three successful fundraising campaigns since March.   This led to many members of the public and some institutions generously donating to our charitable funds.  This means we are now able to plan for 2021 and 2022 safe in the knowledge that we can support our members and the intensive care community.

 

During COVID19 we had challenges...

I realise I am fortunate in not having to make difficult decisions to furlough staff or make any roles redundant.  On the contrary due to the fundraising I have been able to work with our Council and trustees to invest in the future of the society and provide much needed support in the here and now by appointing a National Project Director for Wellbeing and a new Assistant Manager to support her to lead our Wellbeing and Resilience through Education project to provide much needed psychological support to intensive care staff.

 

We published some research in December, 2019 which demonstrated that before COVID19 approximately 30% of the multi-professional intensive care team were susceptible to burn out.  We know that increased during the first wave and in October we held a webinar on PTSD arising during COVID19.  One of our speakers (Prof Neil Greensburg) reported his research showing that of those working in intensive care 53% of nurses; 41% of allied health professionals and 33% of doctors had probable PTSD. 

 

We are supporting the wellbeing of our intensive care community in a range of ways including education.  We are running wellbeing webinars providing ad hoc psychological support, providing generic business case for units to apply to their trust to create posts for clinical psychologists to support staff and patients.  We are also training up staff in five pilot sites to be peer supporters to run group sessions with intensive care staff at a local level.  We are also developing psycho-education and leadership courses.  All of this has been made possible by the incredibly generous donations we have received in response to our fundraising campaigns. 

 

We have been supporting our members and the wider intensive care community during COVID19 in a variety of ways.  In March we established a new member-led group: the National Emergency Critical Care Committee which met weekly during the first wave of COVID19 and is now meeting fortnightly. We also set up and curate a national WhatsApp group for 257 clinical COVID19 leads based across the UK.  This group remains very active, supporting each other sharing national and local guidance and research evidence to care for patients. 

 

We also had the first meeting of our Legal and Ethical Advisory Group which we launched in December 2019.  In May we set up a multi-professional National Rehabilitation Collaborative to bring together those clinicians who were supporting patients as they recover from COVID19 and their ICU experience. 

 

We have published a wide range of guidance for both the intensive care multi-professional community and also patients and their relatives and the public. All freely available on our website.  

 

Since April, we have been running weekly webinars on various aspects of intensive care clinical practice, legal/ethical decision making, and wellbeing.  We record these and make them freely available on our YouTube channel.  We have also held several “knowledge sharing” large webinars with up to 900 delegates where we invited clinicians from those hospitals most effected in the first wave to share their early experience of COVID19 and how the disease was responding to non invasive ventilation, mechanical ventilation, the unexpected higher incidence of blood clots in the lungs. 

 

We also have five Directors of Research leading critical care clinical trials across the UK and also involved in international trials.  We supported them to promote patient recruitment to these important research trials and communicated with ICUs across the UK.  We are currently recruiting more Directors of Research to support us to expand the evidence base for intensive care treatments.

 

Sustaining our mental health as staff in HQ when members are on the front line

Me and my team have sustained our mental health by living and breathing our core values and remembering our critical enablers.  The staff working in the charity are part of the charitable cause – they have each chosen to work for the Intensive Care Society because they believe in what we do, how we do it and the impact we make for our intensive care community and all our members and beneficiaries.  During COVID19, working remotely in makeshift office space while living at home has been a challenge physically and mentally for staff.  We supported each other throughout and communication and adherence to our core values was key to this.  I met staff in an open forum twice a week where we all listened to each other carefully and supported each other.  We also benefitted from reviewing the Wellbeing guidance we were producing for members of the intensive care community as we published posters to support them and prepare them in February 2020.

 

On a personal level, it is very lonely as a Chief Executive and I relied on the support of my husband and my peer group – the CEO forum - during weekly zoom meetings to be able to speak confidentially about the challenging situations I was experiencing during COVID19.  I also had fortnightly meetings with one or more of our clinical trustees and despite their immense clinical workloads I knew they would always be there for advice if I needed it.  I also remember my own personal values as a leader.

Be kind

Be brave

Be authentic

Believe the best in people

 

We punch well above our weight as a small membership society and charity.  We’ve done that by working as a team, keeping communication open and frequent, trusting each other and following our core values.  Culture and core values have helped us to not only survive but thrive and support our members and  beneficiaries through the most difficult of times.  

 

To find out more about the Intensive Care Society and to donate to their fundraising campaign please go to www.ics.ac.uk  and click on the donate button at the top of the page.