Planning for the future and encouraging a diversity of perspectives

Sciana Fellow Adam Doyle discusses leadership, his hopes for Sciana, and effecting change

Adam Doyle is the chief executive officer of NHS Sussex—the Integrated Care Board for Sussex—and the national director for system development at NHS England. Adam has worked within the Sussex system for the past seven years, including as the chief executive officer for the former three Sussex Clinical Commissioning Groups (CCGs). He has overseen the significant turnaround of the commissioning system across Sussex, having taken the original seven CCGs from an inadequate to a good position and reshaping the Sussex Integrated Care System into one of the most improved systems in the country. 

In April 2023, Adam was appointed the national director for system development at NHS England, which he undertakes alongside his chief executive officer role in Sussex. In this role, Adam helps to lead the work around the future operating model of the NHS and works with all integrated care systems to respond to their individual health and care challenges. 

Adam started his NHS career as a physiotherapist and has held several senior healthcare roles, including advising government departments on key strategic public policy reforms. He is a member of Sciana's fourth cohort. 

This interview has been edited for brevity and clarity.

"We're human beings and layered, and leaders in health policy and health delivery need to understand the human beings they're responsible for," Adam said. "Our job is to now understand who our communities are."

A physiotherapist by training, Adam transitioned to management to be more active in making the changes he wanted to see in the health system he was involved in. "I was very conscious that I couldn't affect as much change as only a clinician, so I thought I'd be able to effect more change by doing management work, which gave me sort of a wider remit. 

"I like to use data, facts, evidence, and typically test that with non-objective measures and then say, 'Okay, let's tackle it this way.' I try to get people to come up with the solutions, and then my job is to sort of make sure that plan gets delivered."

Previous involvement within leadership programmes inspired Adam, and the opportunity to be part of Sciana excited him greatly. "I was really very interested in on three levels, […] the first because it was very clear that it was a recognised programme that had a number of really eminent people involved and that want to be part of it. So that gave me the great option to learn from different people. 

"[Second], I'm interested in different cultures and people in general. So, the idea of working across different countries to understand how people think and to have my thoughts challenged was really, really interesting. 

"And then, [thirdly], the experience of being away somewhere very different and also to be fully immersed in it […]. Having the time to clearly focus, the time to reflect and the time to consider these key areas is a great opportunity." 

He is excited about what being involved with the Sciana Network can mean for him and his work. "I am one of the youngest members of the group, I think, but I've been a chief executive for 10 years. And I think what this will give me, first of all, is a network of colleagues that I can call upon in terms of having the ability to ask a question. And I've still got a long career to run. 

"And also, […] it helps to bring you out of the day-to-day operational things. So, I'm already thinking, 'Okay, so how do I create an organisational culture that really is looking much, much further forward and looking out of the health care sector to the solutions? And how can we help those solutions?' And whilst I know that, the conversations [and] the different perspectives are making me think much more clearly."

For Adam, developing and maintaining an equitable and dynamic leadership style has been key to any success he has had and expects to have. "I believe leadership is about taking perspective of the context and the people which we're trying to lead. It means you need to know people, and they need to know you because you've got to be technically proficient to do the job. 

"But the implementation of leadership [involves] three things. So, my key parts are [that] you need to like people, first of all, to be a leader. You've got to want them to understand you. You've got to communicate well and be able to take communication to you, including positive and, at times, critical feedback, which you may not want to hear. 

"The most important thing I've learned in leadership is that your role is to set the tone, be the tone, and constantly keep checking that that tone has been heard. 

"And the final part I feel for leadership that I'm quite clear about is that decisions are made best when there's a diversity of thought in the room and a diversity of perspectives – I see this in my Sussex role and from a national perspective and from the systems that I have visited and experienced.

"A very big part of my leadership practice has been to make very diverse teams in terms of race, gender, LGBTQIA+, [and] age. And I try to really encourage people to listen to what people are saying and create a culture by which diverse thought is prevalent in every conversation. Seventy-five per cent of my workforce are female, and we now have a 75 per cent management team that is female. I am proud of that when very few, if any, organisations in the country have that. And I feel it is my job as a leader to give a voice to the areas that I have privilege in. 

His identity and experiences have shaped who he is as a leader. "I identify as a gay man, and I recognise that at times, a lot of LGBTQIA+ people feel unable to have a voice or have been through things that, therefore, mean that they're not comfortable with how they're going to operate in the workplace. This is very important to me, and together we have a role to change this."

Adam wonders about – and has some firm hopes for – the future. "I firmly believe that we don't spend enough time developing the talent of leaders that we need. So, we know roughly what the health care issues will be in 10 years. But we're not growing the leaders to address that.

"Ten years ago, I was the youngest person in the room. I'm still the youngest person in the room now. And that tells me that people are scared of leadership roles because they carry heavy responsibility and heavy reputational risk. 

"So, what I'd like to start working [on] with the [Sciana] Network is 'How do we get a talent pipeline of people? What will the world look like in 15 years with the [children who have gone through] COVID?' I don't know. But perhaps we should start to involve them in how we're going to shape and manage services and leadership."