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So, the first thing to say is there’s no ‘typical’ day. One of the joys of working in these types of roles is that you never quite know what’s around the next corner. One of the things that I’m responsible for is getting NHS services to work well together with local councils and community organisations. So, typically, my day is making connections, joining up people, and creating an environment in which people can do great work together. It’s building productive and trusting relationships which allow people to take risks together and design services around how patients want to experience the services, and how patients experience their symptoms and conditions. My role really is to be the oil that makes those relationships happen, creating the right environment in which we can improve things for our patients and for people working in NHS South West London.

These chief executive roles are a massive privilege. We are public servants and custodians of a lot of taxpayers’ money. The NHS budget in South West London is approximately £5 billion and my budget is about £3.5 billion. So that's a big responsibility. The opportunity is making a difference and having a positive impact on the health outcomes and experience of South West Londoners interacting with healthcare services. Supplementary to that is creating the right environment in which people who work in NHS South West London genuinely have a great experience; can give their best; and can drive excellence in patient outcomes and experience. It’s that opportunity that makes me jump out of bed in the morning.

I think the biggest challenge at the moment is the level of uncertainty around the changing nature of the leadership structure within the NHS. It’s navigating a path through the uncertainty which that brings, whilst enabling the people who work in NHS South West London and the people who are receiving care to have confidence in our leadership. We want them to have confidence in our direction and know that we’re operating and making decisions that have their best interests firmly at heart.

I learned very early on in my career that I am drawn to fixing things and making things better; whether that applies to whole systems or individual patients. For instance, a particular patient on one of the wards I worked on clearly had some delirium, and because it was a surgical ward everyone was focused on the surgical issue, but we also needed to focus on the person and help the patient feel calmer and more able to engage with the treatment. So that was the bit that I wanted to focus on, and I think that's really defined everything ever since. If I can help a person to feel better about what they’re going through or what comes next for them, that's what’s motivating me. I’m not doing it because I’m some kind of ‘angel’: rather that's where I get my job satisfaction.

I’m probably a pretty average nurse. I see my daughter who’s just graduated and, clinically, she's a fabulous nurse – much better than me. I think my skill set was around getting to the heart of what needs improving and I realised I could do that for more people by moving into leadership positions.

That is what really tracked for me throughout all of it, wanting to improve outcomes and experience for people interacting with our care service and people working in the system. Pretty obviously, though, they are two sides of the same coin. If you have happy, well-motivated, valued people who have a clear sense of direction, then you will most definitely deliver better outcomes and experience for patients.

I think it was the time I had on Alexandra Ward at Epsom Hospital. It was one of my longest placements and it’s where I made so many decisions that have driven my career since then. It’s where I learned most how to be a good nurse and that the role of a good nurse is about people and relationships. It’s the choice about what impact you want to have on your patients and their families.

The lesson I would take away is that it’s about people and leadership, but that leadership isn’t always about the person who’s in charge. The nursing auxiliaries, as they were then, that I worked with on that placement taught me so much about leadership. It isn’t about status or position or seniority, it’s about role modelling behaviours and the values you exhibit that enable followership: people who want to follow you.

One of the finest clinical leaders I have ever come across in my 30 years was a healthcare assistant working in the infection prevention and control team at Watford Hospital. She was a stunning example of clinical leadership. You learn so much and gain so much inspiration from the leaders that you observe.

I got that most on Alexandra Ward. I really wanted to follow and would have walked over the proverbial hot coals because of the strength of the clinical leadership I experienced, and that’s what creates those good memories.

I think adaptability and responsiveness. To be able to critically appraise what is ahead of you and then deploy the right response rather than a rigid one because ‘this is how we always do it’. There’s very little in the way of black and white in healthcare, it’s all nuanced. So being able to adjust and adapt your response based on the evidence, but also the situation, is what is really powerful.

Nursing has changed profoundly over the time that I’ve been working in the health service. But the nursing skills that I still use every single day are my ability to apply my knowledge, my perception, and my critical appraisal skills to any number of different problems and to come up with a solution and a way forward.

I am a LEGO® demon! I’m very serious about my LEGO® because it’s just a wonderful way of switching my brain off. When you have a brain like mine it's going at 50 million miles an hour, thinking about fifteen things at the same time, and it can be exhausting. I have a busy family life: I’ve got four kids and I’m the carer for my dad, so there’s a lot going on. I have to be able to ‘switch off’, and LEGO® really helps me change gears and be much more present for my family. But it has to be an utterly difficult one! I’m building the Titanic at the moment. If you don’t concentrate for a fraction of a second, it all goes horribly wrong and then you have to start again.