From reconciling an account to leading the network

Mandate

Expand a diagnostics network while making the patient’s complete service route visible in executive decisions.

Outcomes

• Introduced itemised expected-visit estimates in a six-centre pilot.
• Assigned an accountable service owner to unresolved report-delivery routes.
• Added whole-visit reviews to centre-level operating reports.

Decisions in context

The CEO appointment required me to explain why a service problem that appeared small at one centre could deserve investment across the network. I brought examples to the board with their scale, cost and limits, rather than relying on a compelling patient story alone. The charge-estimate pilot and the report-delivery review each exposed a boundary between departments that had looked acceptable in separate reports. My six direct reports include clinical and functional leadership, and professional judgement remains with qualified colleagues. I decide how the organisation funds and coordinates the work around it. The founders’ majority ownership and the investor’s growth expectations both shape the discussion, but neither removes the need to show what a proposed expansion asks patients and staff to absorb. I remain accountable for the company’s performance while keeping those consequences visible.

Reason for the move

Appointed by the board following five years as chief operating officer; continues in the role.

Mandate

Coordinate centre capacity and administration while preserving practical access for patients with differing visit requirements.

Outcomes

• Ran the four-centre appointment-access pilot covering 186 assisted visits.
• Made the 24-slot daily capacity cost visible in operating reviews.
• Separated centre appointment counts from the resources required for different visits.

Decisions in context

I moved from comparing nearby centres to understanding the assumptions behind a network-wide operating plan. The appointment-access pilot challenged a familiar measure: available slots. Reserving more time for a person who requested assistance could look inefficient unless the review also considered what an ordinary slot expected that person and the staff to accomplish. I asked regional managers to make that trade-off explicit, including the lost capacity. The functional expense budget covered administration and operating support, not authority over clinical requirements. I also worked on how managers explained exceptions to the executive team. A centre should not have to disguise a sensible local arrangement to make its figures resemble the average. The promotion to CEO followed a broader assessment of my operating leadership, and required me to take responsibility for investment and commercial choices beyond this function.

Reason for the move

Promoted to chief executive and appointed an executive director in January 2021.

Mandate

Develop consistent administrative ownership across centres without confusing local coordination with clinical authority.

Outcomes

• Introduced complete-visit observations alongside departmental measures.
• Established a named centre contact for administrative requests crossing departments.
• Developed centre managers’ ability to explain local service differences in regional reviews.

Decisions in context

Joining a diagnostics network meant learning where an operating manager should intervene and where a specialist decision needed to remain independent. I was responsible for the regional service and its commercial plan within agreed limits. I was not authorised to reinterpret a clinical request or promise a reporting time that the professional team had not accepted. The eight-centre remit gave me enough proximity to follow individual administrative journeys and enough breadth to see recurring problems. I asked centre managers to show how an unresolved request moved through the organisation, including who remained responsible when another department became involved. The work often involved changing a small instruction rather than launching a programme. It helped managers distinguish a genuine local requirement from a practice maintained only because nobody had questioned it. That experience prepared me for network operations without assuming every location should operate identically.

Reason for the move

Promoted to chief operating officer as the network expanded and regional management matured.

Mandate

Coordinate reception, scheduling, billing and administrative records around the patient’s visit.

Outcomes

• Followed complete visits to identify repeated administrative queues.
• Clarified responsibility for questions that crossed reception, billing and service departments.
• Introduced written handover notes for unresolved administrative requests.

Decisions in context

Clinic administration gave me responsibility for the desks whose separate records I had previously reconciled. I discovered that improving the speed of one desk could simply transfer unfinished work to another. Following complete visits made that visible. I worked with the medical lead to separate questions that administrative staff could answer from those requiring professional judgement, and asked a named colleague to stay involved when an issue crossed the boundary. The role involved staff allocation, service explanations and routine expense decisions within an approved budget. It did not allow me to alter clinical requirements to meet a queue measure. I learnt to listen when employees explained why a seemingly simple instruction failed during a busy morning. By the time I moved to Niravel, I wanted to understand how those lessons would hold across several centres with different managers and patient populations.

Reason for the move

Joined Niravel for a multi-centre regional operating role in July 2010.

Mandate

Reconcile billing records and investigate discrepancies for authorised correction.

Outcomes

• Documented the source of discrepancies before requesting an adjustment.
• Explained the distinction between booking records, departmental receipts and final accounts.
• Kept unresolved questions visible when another department needed to respond.

Decisions in context

My first role made me comfortable with an account that balanced and uncomfortable with an explanation that did not. A patient could bring several correct documents and still be unable to understand the expected charge. I checked the entries, identified the colleague responsible for a discrepancy and prepared a correction for approval where appropriate. I could not change the tariff or answer a question about the clinical basis of a service. Learning to state those limits clearly was part of becoming useful, not a reason to send the person away without help. I began keeping a record of unresolved questions so the next colleague would not ask the patient to repeat the entire account. That modest practice drew me towards broader administration, where I could work on the sequence that had produced the confusion in the first place.

Reason for the move

Promoted into clinic administration after increasing responsibility for coordination across service desks.