Robert Varnam coaching?

All change

It’s 2021 and time for change in my personal and work life. There are fond farewells, exciting new beginnings and a lot of connections and passions to reignite. I have stepped down as Director of Primary Care Improvement at NHS England, and will be focusing my time on training, leadership coaching and strategic consultancy for teams, networks and systems to innovate, improve and transform. But why the change?

Thirteen years ago I started working at the NHS Institute for Innovation and Improvement. I had the most brilliant time, designing and delivering new programmes to train and coach NHS staff to lead service improvement. Over time my interests broadened to include large scale change, system leadership, integrated care and clinical commissioning. I travelled the country and the world, inspiring and training leaders to put good ideas into practice.

I had a whole host of opportunities to pursue these interests and increasingly to contribute to the creation of new vision and policies for healthcare in England. I led national policy development as part of the NHS Future Forum team at the Department of Health, and advised government and the newly established NHS Commissioning Board about the establishment of clinical commissioning groups (CCGs).

As I got closer to the world of national policy, I saw an opportunity to address a longterm ambition, of helping to join up healthcare across traditional boundaries and organisational silos, and to make changes within and around general practice to unleash more of its potential. In 2013 I accepted an invitation to join NHS England to explore the potential for innovation, improvement and transformation in primary care. After extensive fact-finding around the country, and connections with colleagues internationally, I concluded that there was huge potential for primary care to play an even more significant role at the heart of the NHS, plenty of promising innovations we should spread, but also pressing problems to address.

Rather to my surprise, the vision of a reinvigorated primary care, with more power and resource to care for local populations, started to take off. I was asked to put together a strategy for how to begin the change. Over the next four years, the Prime Minister’s Challenge Fund, the NHS Five Year Forward View and the General Practice Forward View confirmed the commitment of the NHS to a new vision for general practice and wider primary care. 

This time it was accompanied by unprecedented new investment and (previously unheard of) a coordinated programme of practical support to help teams locally plan and implement change, and to build their own capabilities for improvement and leadership. We grew the Time for Care team and developed a whole range of support for practices and primary care networks (PCNs) to implement their choice of the 10 High Impact Actions to release time for care.

A new boat to paddle

I’ve managed to begin almost everything I hoped I would at NHS England. Now feels like a good time for a new challenge, as I continue slowly recovering from COVID-19.

Time for Care programme has now really taken root, supporting practices in almost every part of England to release clinicians’ time, improve access and care, and strengthen local collaborative working. I dreamed this kind of thing might be possible back when I was a teenager working in my dad’s GP practice in inner city Nottingham – and I’ve had the incredible privilege of being part of making it happen. 

But I’ve also been wishing I could spend more of my time again hands-on with leaders and teams who are improving what they do. It’s a huge privilege to work in the NHS national leadership team, and I’m enormously proud of our team and all they do. But it also means most of my time recently has been focused on corporate activities I’m not best suited to, while I’ve had to turn down requests to be more involved in local improvement and leadership work.

In 2020 I got COVID-19, and was pretty ill for two months. I also joined the thousands of others who suffered with so-called Long COVID. For months I struggled with my breathing, physical and mental energy, and my mental health. Work suffered, as did family life. Early in 2021 my family and friends ‘intervened’ and with the support of my GP and some fantastic other professionals, I began making big changes to support my recovery.

This has also been a time to reflect about where I’d reached and where I wanted to go now. Over time, and with help, I took the difficult decision to step down from my role as Director of Primary Care Improvement at NHS England. And I’m turning my attention to providing ideas, training, coaching and facilitation to teams and leaders as they improve what they do. I’m expecting a lot of my time to be in the NHS and with primary care transformation internationally, but it’s also exciting to be making connections with charities in the UK and South Africa, as well as with individual in other walks of life who are wanting some coaching.

On one level, it’s a really big change. I’ve worked in a national NHS organisation for nearly a decade and a half, with colleagues, teams, corporate systems and constant buzz all around (pretty much 16 hours a day, 365 days a year). But down where it counts, I’m still pursuing my ambition to be as useful as I can in helping people unleash their potential, and being part of making good things happen.

How can I help you?

I can help you, your team, your network and your system. I provide training in QI and leading change, executive coaching for leaders and boards, and strategic leadership consultancy. I’m currently working with people in healthcare, the legal profession, charities and churches.


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