I am sharing my experiences of leadership and the journey of a healthcare entrepreneur. I hope that this will inspire others into following the same journey and create opportunities for all!

The Maslow Foundation aims to ensure social inclusion, using the voice of lived experience to create services that meet their ambitions and I am proud to be Chair of Trustees creating hope, joy and meaning in our lives. Our services include creating safe spaces to ensure meaningful conversations, being able to connect individuals into wider services with a model of trauma stabilisation and connection. We are pleased to be offering housing to those who cause harm from domestic violence and enabling their partners to remain in their local community. This has revealed the challenges with employment and our move to creating an entrepreneurial laboratory and microbusiness support. We are champion the Child Impact Assessment to support mothers who may be sent to prison and their children to inform judges and provide a robust plan for the family. To support the charitable sector I have launched Urban Nest Housing Solutions to access housing with safety at our heart.

Nurture Health and Care Ltd has been co-founded by myself and my team to nurture workforces across the public sector. This is built on a model of Psychological Safety and recognises the need for connection, sense making and action. By creating sense making structures through our supervision model or decision making groups in our investigation team, we can enable people to make sense of risk and uncertainty. We are proud to be offering services to the NHS for investigations and the Prison and Probation Ombudsman/NHS England for clinical reviews. In addition, we are providing sexual offence examiners to sexual assault referral centres, with a unique workforce strategy which includes the accredited Sexual Assault Nurse Examiner programme (SANE) and our inspection ready governance delivery. We use our four ways of knowing to help provide understanding, equality of voice and values based decision making to create new insight for our services. We provide post graduate preceptorship programmes and enjoy the contribution of our Nurse Ambassadors and run a Nurture Ripple and Cultural Architect Programme generating psychological safety to embrace the ambition and creativity of our workforce enabling success.

I am interested in how language can represent culture and be measurable through artificial intelligence and have set up a new organisation, the Centre of Artificial Intelligence Interface (CAII), with the launch of our new website and first product which acts to create different perspectives as a basis of decision making: https://www.3friends.ai/ and looks how ethical AI solutions can contribute to healthcare.

As a Trustee for Survivors In Transition, I continue to support my passion of providing services to those who have experienced sexual violence and am lucky to work alongside Fiona Ellis, who as CEO has created a values based innovative organisation to provide therapeutic interventions.

I am also exploring setting up a microgrant funding system to create financial support, coaching and an incubator of change recognising how passion, entrepreneurialism and the agency of people can support change in our services. I look forward to sharing this journey.

Alexis Hutson (https://www.alexishutson.com/) facilitated the Faculty of Medical Leadership and Management course – Tomorrows Strategic Leader which I attended and highly recommend. She was an excellent resource and identified the concept of ‘Taking a Thought for a Walk’ which I have named this blog after. Simon Bennett (http://www.simonbennettcoaching.com/) is my personal coach and I advocate this support, It enables us to explore the journey that we are all undertaking in a psychologically safe space.

I believe that without aiming for the impossible, miracles cannot happen and through authentic leadership, we can enable every person to be able to reach their own potential.

I have always believed that we are learning every day. I take the opportunity to make small changes to my own practice if I notice something that we should be doing differently. I also encourage my teams to do the same.

This requires us to be open to the concept that the world is not black and white, or that there is a right or wrong way to do things. We often place a defensive wall around ourselves if we do not adopt a flexible mindset as we often confuse disagreement with rejection.

By being open forms the foundation stones for change.

We can all be change agents, champions and influencers of new thinking.

A wicked problem is an entrepreneurial opportunity.

They are a problem that’s difficult to solve, normally because of its complex and interconnected nature. Wicked problems lack clarity in both their aims and solutions and are subject to real-world constraints which hinder risk-free attempts to find a solution.

What are wicked problems in healthcare?

• Environmental challenges with a need for regenerative design
• Radicalisation and extreme perspectives from part of social communication
• Complicated technology and integration including artificial intelligence
• Consumer led health and social care solutions with limited resources
• Poverty and Health Inequity
• Knowledge management in a rapidly evolving world
• Personalised medicine
• Patient and human subjects’ privacy and protection
• How to build trust in our health and social care systems
• How to have a workforce that is competent, confident and happy

In the beginning of my career, expert opinion and consensus view led the evidence base. We now analyse our data, initially retrospectively to make changes and create evidence based medicine and solutions nut now have moved to real time data to visualise today in real time. This gives us lots to think about but rarely builds creative thinking or generates new solutions.

In our complex worlds, multiple stakeholders have different opinions, have different values and priorities and work within different organisational structures. Although we all want to be more collaborative, our systems are not designed to be integrated.

This is where the entrepreneur can try something new and experiment.

My own unique talent is to be able to look at new service design recognising that skills can be taught and develop governance systems and shared values to ensure safety and effectiveness. This can lead to an improving service where resources can be used more effectively but with improvement of quality.

In the 90’s, I was part of the advanced practice movement sharing the burden of diagnosis and treatment with new models of service design with a sider professional group able to assess patients.

In the 00’s, I continued to identify models in healthcare moving from doctors towards a wider multidisciplinary team with improvements in capacity but ensuring that they were caring, trauma informed and met high quality standards.

In the teens, I founded my own company based on these principles in forensic healthcare which grew to be one of the largest providers of forensic services in England.

What next? We need to turn our attention to the workforce shortages and the experience of distress. Those who use our services have complexity of needs and we have limited resources. Mental health and understanding of our behaviour are all wicked problems.

So which wicked problem?

New opportunities include:

Being able to make a difference to those who experience disadvantage and create a new workforce of those with lived experience harnessing their power and ambition to pull together the existing infrastructure to meet their goals – so The Maslow Foundation was born.

Being able to make a difference to health and social care and the crisis of staffing, with a model of psychological safety, ensuring safe spaces to nurture our talent and build confidence and competence in forensic healthcare, investigations and clinical reviews, expert opinion and wider healthcare – hence Nurture Health and Care Ltd was born.

Other organisations; Urban Nest Housing Solutions and Centre for Artificial Intelligence Interaction Ltd have formed out of the need to support The Maslow Foundation and Nurture Health and Care Ltd.

In these organisations we can:

• Frame the problem without worrying about the systems
• Bring together diversity of thought
• Identify the purpose
• Design solutions
• Experiment
• Scale what worked or learn from those things that did not go well
• Share our knowledge and create an open learning system to showcase our design

I loved this video as feel it solved a wicked problem and hope you create your own health and care incubators to nurture your ideas and implement through action.

I love being able to consider the wicked problems in the world of health and the wider world. I have the privilege of listening to amazing people, ‘taking a thought for a walk’ and considering their perspectives to try and co-create new solutions.

I would like to share one of the first challenges of a healthcare entrepreneur – what corporate structure do you utilise for your new venture?

• Charity
• Community Interest Company
• Partnership or Sole Trader
• Limited company

This is particularly challenging when you are a passionate advocate of the NHS and believe that care should be free at the point of access. My experience as a shareholder of a limited company, is that you may be perceived as being a corporate machine redirecting public monies to the greedy 1%. I also realise that as a charity or community interest company, you may be limited in the investment you can attract and that the charitable purpose can be its own burden.

So how do you decide?

How can you consider your ethical and moral responsibilities?

In considering your options, you must be brave and set out your vision:

• How large could this organisation become? Technology and private equity might be needed to ensure a safe financial foundation.
• Who will be your partners? Potential collaborators may be corporate organisations or the voluntary and community sector.
• Our thought leaders including doctors and other professionals and wider communities may believe that their intellectual property should lead to a financial reward. If we wish to retain our talent, do we need equity with other industry standards.

It is not possible to be a healthcare entrepreneur if you do not have a fit for purpose vehicle as a legal entity to be able to sell services or products.

As a founder of a charity ‘The Maslow Foundation’, a Community Interest Company ‘Urban Nest Housing Solutions’ and a limited company ‘Nurture Health and Care Ltd’, I have had to consider these elements recently. Collaboration provides another layer of complexity which our structures are not able to facilitate with ease.

The Maslow Foundation has the vision of social inclusion using the lived experience of the community for whom it serves. They should identify their own services and providing a workforce of lived experience practitioners who collaborate with the widest partners to create the evidence base for best practice. As a charity status, this allows the sharing of assets and transfer of leadership to those whose diversity of experience will exceed my own.

Nurture Health and Care Ltd, has been founded to nurture our workforce, so they can nurture others. As a workforce partner, it will require the use of digital technology, working collaboratively with industry leaders with the possible need to scale rapidly.

 I believe that limited companies and corporate structures are essential, and our supply chains are testament to that. These organisations must then be held to account so that we meet public scrutiny and are distributive and regenerative by design.

We should expect our organisations to be embedded with the principles of equality and justice. Instead of aiming to accumulate only economic forms of capital, it should explicitly value social, human and natural capital. In healthcare, we need all our energy and passion to be harnessed through collaboration to create the best services for all and to drive a thriving economy.

We should be celebrating the success of our organisations, our workforce and those who use our services expanding best practice and I look forward the lived experience of entrepreneurial spirit setting up their own visions and participating in the journey of improvement which may address the social determinants for health as well as create culture change for the NHS.

I share the ‘donut model of economics’ from Kate Raworth and aim for organisations that seek to thrive not chase the dream of never ending growth for shareholders working collaboratively with all our partners, both statutory and voluntary, community and social enterprise.