‘Leadership is everybody’s business’: Jennifer Keane on why radiographers make such good leaders

Jennifer Keane has worn many hats throughout her career but the common thread is leadership, a quality she has honed and championed from the very beginning.

Jennifer gained her radiography degree from Ulster University in 1996 and went on to work as a Therapeutic Radiographer in Belvoir Park Hospital, Northern Ireland. It was rising through the ranks at Belvoir that made her realise the efficiency a radiographer could bring to a patient’s treatment pathway. “I worked my way up through the normal grade process to senior radiographer, but then I became the first site specialist radiographer for managing patients with a diagnosis of head and neck cancer,” she says.

“That was when I first started to move outside of the core radiography role and realised the impact a radiographer could have across an entire pathway for patient care.”

Jennifer began to manage the implementation of this process, attending multi-disciplinary team (MDT) meetings and taking the lead on integrating radiotherapy and radiographer expertise into the MDT process. At that time, there was a strong focus on improving the standard 31-day and 62-day targets for cancer treatment for category one cancer patients, who were falling behind.

This – combined with assigning a radiographer to coordinate the MDT input into managing radiotherapy patients’ treatment – decreased how long patients needed to stay in hospital. It also allowed the hospital’s radiography departments to manage more patients in an outpatient capacity. “That had a massive impact both on the outcomes for patients and on resource utilisation,” Jennifer explains. “A combination of those things really increased the profile that radiographers had within the Belfast Trust.”

With support from Charlotte Beardmore, the SoR's executive director for professional policy, Jennifer and her team were able to share this process all over the UK, highlighting the importance of radiographers in optimising the treatment pathway.

Move to government

In 2019, Jennifer became the chief AHP officer for Northern Ireland. Here, she spearheaded change in Northern Ireland’s healthcare sector, particularly in workforce planning and progressing AHP professions. “When an opportunity came up to apply for the chief AHP officer’s job, I had learned from my experience that, if I moved into that role, it would allow me to have an influence at that level, particularly in relation to workforce planning and the types of posts that were being commissioned,” she continues, “and also in relation to advanced practice, which was the thing that was preventing a lot of the AHP professions – including radiography – from being able to move into those roles.”

“It also meant that I would be able to influence how the budget was being allocated into different programmes of work.”

When a national role with NHS England became available in 2021, Jennifer was once again ready to try something different – and bring her leadership qualities to new heights. “I moved to NHS England into the national director role for discharge and rehabilitation,” she tells Synergy. “I arrived in that role at the beginning of the Omicron [coronavirus] wave.

“I really had to get up to speed quickly to be able to implement the discharge to assess work, and influence to get funding to make sure that people were not just hothoused in care homes, but they could recover and rehabilitate after a time in hospital.”

It was this role that saw Jennifer change how the Better Care Fund budget was proportioned towards rehabilitation services for those recovering after a hospital admission.

Emboldened by her work in improving rehabilitation – and influencing it as a key priority for the government and NHS England – Jennifer’s next role was as national director of intermediate care and rehabilitation urgent and medical care. Here, she successfully influenced the 10-year workforce plan in England and emphasised physiotherapy and occupational therapy as critical elements of rehabilitation. “Having done that, I’ve always had an interest in the out-of-hospital space and the fact that we should be looking after people at home if possible,” Jennifer says.

“I always had in my mind that the only way to do that effectively was to not bring people to hospital unless they needed to be there. The key to that was prevention and admission avoidance.”

Making waves

The next step for Jennifer was to apply to become the national director for pre-hospital access, which brought her into her present role as director of UEC delivery. As national director for pre-hospital access, Jennifer was the national director for ambulances, 111 and any pre-hospital services. “It was perceived as quite a strange move – for someone who was often quite community focused to want to go into something that was very blue light,” she explains. 

“But I went in with the idea that I needed to shift the dial in that space to say: ‘The focus shouldn’t be on how fast and how many ambulances take people to hospital. It should be around whether you are taking the right people to hospital, and are you supporting more of those people to stay at home?’”

In the year since she took on that role, Jennifer has improved the national targets for ambulances by ensuring there are alternatives to patient admission and driving focus towards ‘hear and treat, see and treat’. “In the last month – because of the success I’ve had in improving the national target for ambulances – I’ve been asked to now focus on the four-hour target for emergency care,” she reveals. “From now, I’m the director of responsibility for the two big UEC targets in England – the ambulance response time and the emergency department time. I think I’ve gone full circle.”

What can radiographers learn about leadership?

Though some view leadership as something you need to step into, Jennifer believes that a radiographer’s role is inherently leadership centred. “Once you start in your career, you immediately have a leadership role,” she says. “It’s quite a schmaltzy thing to say, but leadership is everybody’s business.”

And as a radiographer’s career progresses, this leadership affects more and more patients, regardless of whether this is in a specific patient’s pathway or across a whole trust. This opportunity to exalt leadership has always been a driving force for Jennifer. “The core knowledge and skills that you have when you graduate are unique,” she explains. “There’s an opportunity for you to lift those skills as you move up through the radiography profession.

“I always saw it as, when you move into a leadership role, the impact you have is not just on one patient. It increasingly becomes that you’re responsible for all of the patients on that pathway, or all of the patients in that waiting room. So your core skills and knowledge are being used for the benefit of more patients and more staff as you move up.

“That’s always what’s driven me – for the same input, being able to have a greater output for a bigger proportion of patients.”

As for what leadership advice she would give to radiographers, Jennifer urges them not to underestimate the extent of their transferable skills. “The thing I would say to radiographers as they’re further on in their career is that the experience that they have in a diagnostic department or in a radiotherapy department can so easily be applied elsewhere, not just within radiography,” she concludes.

“Without exception, any of the radiographers that I have seen move from a mid-management role in either radiotherapy or diagnostics, either wider into cancer or elective fields, have flourished. Because, as a radiographer, you get exposed to so much more than a lot of your peers in other professions do.”

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