When Ben Gowland left the NHS to set up his own company he was publicly accused of immorality. He himself questioned whether he would be able to retain his public service values in the “outside” world. Here he reaches a conclusion.

Are people who work in the NHS more value-driven than those who work outside the NHS? This is a question that came quickly to mind when I decided to resign my role as Chief Executive of a CCG and establish my own company. When my decision to quit was announced in the local media, the message board on the Northampton Chronicle and Echo website erupted into life with furious comments condemning me as a villain and a leech. The tone is summed up by this one:

“Ben Gowland has no better morals than the bankers & corrupt politicians of late that we all have witnessed…When are politicians and the media going to wake up and expose these people? Their only desire is to milk us dry and take even more money for themselves…I wish every failure for him and his venture. He’s wrecked our services now he wants to set up a company supplying services back to us to cream off even more monies from the public purse!”

And this was one of the more moderate comments. I must admit to being surprised by the reaction. I wasn’t expecting a ticker-tape parade and dancing in the streets of Wellingborough when I left but, like anyone who has worked hard for a long time, I thought I might just leave with a warm glow and appreciation of a job well done. How naïve!

At the heart of my decision to leave the NHS had been a growing disillusionment with my ability to effect real change from within the Service, and a belief that the freedom of working for myself would make this more possible. Shifting from being paid directly by the NHS as a salaried employee to working alongside the NHS, contracting services in, didn’t feel like a decision to move to the “dark side”. But was it? Had I now become, as owner and only employee of a private company, a person lacking in morals as the comments suggested? Did my new position inevitably place me as a self-interested capitalist, no longer interested in social values?

I found even the suggestion that this might be true to be difficult. It took me several months before I could even read the comments written in the paper in full and they made me variously cringe and become indignant. Deep down I knew that, whatever others might think, I personally could add more social value from outside the NHS than from within it. I understood it was going to take time to prove this to others, particularly those who don’t know me but my whole career has been driven by my values – so prove it, I would.

I started by writing down the mission of Ockham Healthcare, and published it on the website. It finishes like this,

“Ockham Healthcare is here to create practical steps to a better future for healthcare: to support those who embody the ideas of the NHS but that the NHS seems to work against; to help those who want to create a new future for the values underpinning the NHS; and to enable change and innovation in a system without incentive to change.”

The opportunity I now have is to use my position outside of the NHS (and the freedom this brings) to provide help where I think it is needed most, and to focus on areas of my choosing -rather than those chosen by others. Now it is up to me to embrace that opportunity.

The whole experience has actually made me far clearer about my own personal values and about what I am trying to achieve with my life and my career; far clearer than I had been for many years operating within the NHS.

Can one enter the cut-throat world of commerce and remain value-driven? Using my experience as a sample of one, the answer is “yes”. Not only is it proving possible to be value-driven in the private sector I find that, by being single-minded about what I believe in and without the distracting influence of other agendas, my values have led my actions in Ockham Healthcare even more forcefully than when I was in the public sector. And long may that continue.

Ben Gowland considers what happens when the meetings stop and you suddenly have time to think.

I was having a drink with an old colleague recently and he asked me what life was like, now that I am working for myself. Frankly, I replied, there are a lot less meetings.

There is something about working in the NHS that draws you into this culture of meeting after endless meeting. I remember a new Finance Director joining an organisation I was at who proudly placed a framed quote on his desk that read, ‘People who enjoy meetings should not be in charge of anything’. Within a few months he was complaining about the meetings just like the rest of us, and the quote mysteriously disappeared.

At a different hospital, when a new HR Director started she announced she would not be having any meetings before 9.30am. That is going to be tough, I thought to myself, given the consultants would only meet you at 7.30 in the morning (or earlier – there seemed to be some sort of competition amongst the general surgeons as to who would arrive the earliest). I remember meeting her six months later, at about 7.45am on a dark winter’s morning in the half mile queue for the coffee shop in the main hospital concourse, and I asked her about her initial pledge. She looked like she had aged 10 years in that time. She had dark circles around her eyes, and that constantly distant look that comes with one too many employment tribunals. She just stared at me and denied all knowledge of anything so idiotic. ‘Double espresso to go’ she barked at the hapless barista…

I have to admit there was a transition, moving from a diary packed from dusk to dawn with meetings to one with virtually none. What do you do? How do you stop yourself checking whether Supermarket Sweep is still on in the mornings? I searched the web for advice. It turns out it requires discipline: only look at emails for half an hour twice a day; focus on the ‘one big thing’ you want to do each day before you do anything else; and don’t, whatever you do, turn on the TV.

Now I like it. Admittedly it took me a while to get used to it, but now I really enjoy being able to spend my time working on the things I want to do. It has meant I was able to ensure that Ockham produced its first White Paper, ‘5 Years to the End of General Practice?’ in February, that we could generate a suite of tools for the ‘Practical Steps’ programme for GP practices, as well as have the capacity to write two regular blogs – this one and one on general practice.

Life without meetings has its own challenges, but in the quest to make a difference it feels like a step in the right direction. And (I know you are wondering) there is currently no sign of Supermarket Sweep anywhere…

I was gutted when they announced Chris Moyles was to be axed from the Radio 1 Breakfast Show. He was appealing to the wrong demographic. Radio 1 is apparently supposed to attract 18-25 year olds and yet “old” men in their forties, like me, were clinging onto their youth and still enjoying the daily banter from the larger-than-life Yorkshireman.

So where to go then? I tried Radio 2 (despite his devoted audience Terry Wogan was never going to be for me), Radio 4 (made listening to the radio feel too much like work), Radio 5 Live (all over the place), and even local radio (couldn’t cope with the adverts). It was then that I first came across podcasts. Podcasts are basically pre-recorded radio shows, but the beauty of them is that you can choose exactly what you want to listen to and when. I discovered that on iTunes there are literally thousands available.

So I found ‘Coffee Break Spanish’ and started to learn Español. I discovered The Fantasy Football Scoutcast to feed my unhealthy addiction to fantasy football. And I really enjoyed ‘The Tim Ferriss Show’ because I love his books (‘The Four Hour Work Week’ changed my life, but that’s another story…), and he interviews some fascinating people.

I also looked to see whether there were any good healthcare podcasts. There is Radio 4’s Inside Health and a number of other examples from the “pills and piles” school but I couldn’t find anything for someone like me working in healthcare.

When I started up Ockham Healthcare one of the things I really wanted to do was see if we could create such a podcast: one about the delivery of healthcare specifically targeted at people working in healthcare. I wanted it to provide examples of good practice that could go into more depth than a written summary, which could really get underneath how people were able to make the changes they did, and overcome the resistance that they inevitably faced along the way.

But where do you start? Is making a podcast easy or difficult? Well, it turns out there are various technical challenges, but nothing insurmountable. Yes, I have found myself on the end of a frustrating Skype call with someone miming ‘I can’t hear you!’, and yes I have had to record a 30 minute call in 5 minute bursts because I didn’t realise the ‘free’ version limited you to 5 minutes of recording. But, as it turned out, there was plenty of freely available information on the internet to get me through.

On February 9^th 2016 we published on iTunes the first episode of ‘The Ben Gowland Podcast’ – a name which, unsurprisingly, I came up with myself. We publish a new episode every week and I have had the privilege of speaking to some fantastic people along the way. These have, so far, ranged from a practice manager in Gateshead explaining how their work with the local community saw her organising Christmas dinner and a tea dance, to finding out what is going on behind the scenes in the development of the largest ‘super-practice’ in England.

Will anyone listen to a healthcare podcast? It is early days but it is beginning to look like they will. More and more people are listening every week. Have a listen here and let me know what you think. Be brutally honest with me, I want it to get better and I can take it. Plus if you think there is anyone I should be interviewing on the podcast let me know.

In the end I think the controllers of Radio 1 did me a favour when they axed Chris Moyles. It was clearly time for me to recognise I am no longer in my twenties, and to “update” my listening behaviour. If they hadn’t I am not sure I would have even discovered podcasts, let alone have my own show. You could say it changed my life…

Some of you might know me, but some of you won’t, so let me introduce myself. After working for 20 years in the NHS, in April 2015 I resigned from my job as Chief Executive and Accountable Officer of a Clinical Commissioning Group, and ‘left’ the NHS. I started up a new company, Ockham Healthcare, which is part think tank, part consultancy. But is it possible for someone like me, ‘born and bred’ in the NHS, to build a successful company outside of the NHS?

A colleague said to me a few years ago that public sector executives are not, and never can be, entrepreneurs. He said we lacked whatever it is that is required to make a new company successful. His rationale was that we have all become too indoctrinated by the public sector mentality of days filled with quality committees and audit committees and the like, and of doing whatever we are told from on high, to ever be able to build something from the bottom up.

Maybe he is right. I don’t want to believe it, and in many ways what I am doing now is an experiment in proving the validity (or otherwise!) of his hypothesis. I don’t mind being the guinea pig!

One thing that I can say is that I now earn a lot less money. There is a frightening statistic that 50% of new businesses fail in the first year, and 95% fail within 5 years. So far outgoings have indeed exceeded incomings, but I am told that if I can end the first year even with a small loss I will be doing well. But for me this isn’t the point. The challenge I have set for myself is whether I can put my energy and effort into creating something that I am proud of, that feels like a force for good, and that makes a positive difference to all those that it touches (whether they are staff, clients, partners or patients).

That said, I still have to make a living. I had saved enough to make it through a year. Whether I can make it through two remains to be seen! I plan to share my adventure into the unknown through this column, to share whatever I learn about life after the NHS, and to discover whether it is even possible for me to stay outside the NHS.

My starting point is general practice. I am trying to find ways of providing support that can help general practice get through the genuinely difficult position it is in right now. Whether or not general practice wants my support is another matter, but I am putting together tools to help GP practices who are in real trouble and need to make big changes. If you know GP practices that could benefit from my help please put them in touch – help me make a difference!

My next column will be in two weeks’ time. In the meantime, if there is anything you want to know, experiences that you can share, or advice that you think can help, please get in touch via ben@ockham.healthcare.