Return to practice: an opportunity to reconnect with patients and redefine leadership

That decision led me to my first significant management role as breast operational lead. This post marked a pivotal shift from individual clinical responsibility to operational accountability. For the first time, I was responsible not only for what care was delivered, but how it was organised, monitored and improved. The role exposed me to workforce planning,  performance management and service delivery. I began to understand how leadership decisions ripple outward, affecting staff morale, patient flow and quality outcomes. 

One of the most formative aspects of this role was my exposure to quality improvement. I learned that improvement is not about fixing isolated problems, but about understanding systems, variation and human behaviour. Engaging with audits, service reviews and improvement methodologies challenged me to think analytically while remaining grounded in compassion for staff working under pressure. Quality improvement gave structure to instincts I had developed clinically: that care could always be safer, kinder and more efficient if we were willing to examine how we worked. 

This naturally led me into a clinical governance manager role, where my perspective broadened further. Governance required me to step back from day-to-day operational tasks and look across risk, safety, compliance and learning. I gained a deeper appreciation of how incidents, complaints and outcomes are interconnected, and how organisational culture shapes whether staff feel able to speak up and learn from error. This role strengthened my belief that governance should not be punitive or detached, but embedded, transparent and supportive. It also refined my leadership style towards more collaboration and increasingly focused on influence rather than authority.

My subsequent progression into a senior operational manager role represented the culmination of many years of gradual skills-building and reflection. The breadth of this post was both daunting and energising. I was responsible for a diverse portfolio including the North West Regional Spinal Injuries Centre, ophthalmology, oral and maxillofacial surgery, medical secretaries, trauma and orthopaedics. Each service came with its own clinical priorities, workforce challenges and operational pressures, including Covid-19 response and recovery. Managing across such varied specialties demanded adaptability, strong relationships and an ability to move between strategic planning and frontline realities with ease. 

The Spinal Injuries Centre, in particular, reinforced the importance of integrated, multidisciplinary care and long-term thinking. Patients’ journeys extended far beyond acute episodes, requiring coordination, continuity and sensitivity to complex needs. In contrast, managing high-volume surgical services highlighted the necessity of efficiency, flow and robust operational grip. Balancing these demands taught me that effective leadership is rarely about having all the answers, it’s about asking the right questions and empowering others to contribute solutions. 

Returning to mammography was not about nostalgia, but about alignment. Breast imaging places practitioners at the intersection of diagnosis, communication and patient vulnerability. Re-entering this environment allowed me to bring together my clinical skills with the broader perspective I had gained through management. I returned not as the clinician I once was, but as a practitioner shaped by years of leadership, governance and system-level thinking.

This transition also challenged deeply ingrained assumptions about success and progression. In stepping away from a senior operational role, I had to confront internal and external narratives that equate advancement with hierarchy. Letting go of title and authority required humility and confidence in my own values. It reaffirmed that career fulfilment is not defined by seniority alone, but by impact, integrity and personal sustainability. 

My management experience has fundamentally influenced my clinical practice. I approach my role with a heightened awareness of quality, risk and patient experience. I better understand the pressures faced by managers and the importance of efficient systems, clear communication and supportive leadership. This dual perspective has strengthened my ability to act as a bridge between frontline staff and organisational priorities, and to contribute constructively beyond my immediate clinical remit. 

Ultimately, returning to practice was an act of professional self care. It allowed me to reconnect with patients, regain balance and rediscover the meaning that sustains a long career in healthcare. Rather than closing the door on leadership, this move has redefined it. Leadership does not exist solely in boardrooms or job titles, it is present in how we care for patients, support colleagues and model reflective, values-driven practice. 

Looking back, my career has not followed a linear or predictable path. Limited opportunities did not deter me, they forced me to be intentional. Leaving a familiar organisation was not a rejection of my roots, but an acknowledgement that growth sometimes requires distance. Each role has added a layer to my professional identity: clinician, operational lead, quality improver, governance specialist, senior manager – but what has remained constant throughout is my commitment to patient-centred care and to staff who deliver it.  

Returning to practice programmes, mentorship and ongoing training are vital. These initiatives bridge knowledge gaps, especially in areas such as technological advancements, procedural changes or updated clinical guidelines. Returning to practice can be a daunting process, and organisations that offer guidance, peer support and encouragement foster a sense of belonging and confidence in the returning clinician.  

These efforts are not just for the benefit of the individual, but also for the organisation itself. A well-supported returnee brings a wealth of knowledge and experience, strengthening the clinical team and contributing to a culture of resilience and adaptability. Investing in such transitions benefits patient care, improves retention and ensures that the workforce remains agile and well equipped for the challenges of modern healthcare. 

I would like to personally thank Liz Read, Elaine Chesworth and Bolton Foundation Trust for  kindly supporting me on my return to practice journey.