What is your job title?
Clinical director of a regional strategic clinical network (SCN) for mental health, dementia and neurological conditions within NHS England. The West Midlands is a region of England covering a population of 5 million. I am also a consultant psychiatrist.
What does your work involve?
Currently I wear 4 hats. My working day is usually fast-paced and sometimes pretty hectic.
I am a medical specialist in mental health. Within that, I set up a community service for younger onset dementia, a rare type of service in the NHS.
My role includes assessing and treating mental disorders, teaching and examining the skills of doctors in training and other clinicians, and I also do my bit towards research locally and nationally.
My second job within NHS England, includes providing strategic leadership and clinical engagement to support stakeholders to continuously improve dementia services across the region.
A valued ‘tool’ I frequently refer to is a regional dementia ‘pathway’ (a service map based on best practice).
I am based in Birmingham but I travel across the West Midlands and England.
The diversity of views, contacts, professional backgrounds, and aspirations is energizing and inspirational.
Thirdly, I work within a team linked to the Prime Minister’s Challenge on dementia, evaluating a pioneering concept focused on developing dementia awareness in schools, which incorporates intergenerational exchanges in primary and secondary schools across England.
Finally, I chaired the UK steering group behind a Department of Health part-funded European Union project, launched 28th March 2013 on the state of dementia services in Europe. England was tasked with making best practice recommendations for ‘timely’ dementia diagnosis.
Why did you decide to do this job?
As a clinician I was immediately attracted to the complex intertwining of psychiatric, physical and organic brain disorders, often in the context of social problems.
As a psychiatrist, you are part of a specialist team interfacing with primary and other specialist teams, social care, the Alzheimer’s Society toname but a few.
Much of the work takes place in people’s own homes.
I was very impressed with old age psychiatry as a specialty because I really valued this holistic approach to individuals, their families and carers.
As I embarked on service developments, I learnt that placing service users and their carers at the centre of all planning and delivery was essential to successful change management.
My roles go well together. With a finger on the pulse of local dementia services, I can draw upon my experience as a clinician in my regional and national perspectives.
Has this role changed?
As a career, old age psychiatry has expanded, nationally and internationally.
The arrival of memory enhancing drugs in the late 90s contributed to the higher profile of dementia.
Our knowledge is expanding fast, and it is now customary for many consultants in old age psychiatry to specialize further in clinical, academic or broader leadership roles.
Training in our specialty is organized and competency based. If applications for training posts are anything to go by, old age psychiatry is an increasingly popular career choice.
Today’s medical applicants need to demonstrate excellence in people skills, leadership qualities, and vision for service development, in addition to the requisite clinical expertise. We need to evolve.
The biggest future changes will have to be made by clinical leaders together with policymakers. Old age psychiatrists are well placed to contribute to a meaningful process of change leadership.
What won’t change in this role is the need for passionate, compassionate, articulate, assertive clinical leaders.
What has your career path been?
I graduated from the Faculty of Medicine, University of Alexandria, Egypt. I completed my training as a junior doctor in Scotland and England.
After my appointment as a consultant psychiatrist, as a ‘special interest’ I was tasked to set up a new service for younger people with dementia to meet a huge service gap.
This took 18 months of campaigning and planning and the multi-award winning community team is still going strong.
In 2007, NHS West Midlands asked me to chair and co-author a regional strategy for dementia. I then contributed to a number of regional, national and international projects and the rest is history.
What do you enjoy most about your work?
Clinical contact with patients, their carers and their families. My role as a clinician will remain central to my professional career.
What do you find most challenging?
What are your hopes for your future career?
I hope to contribute to a legacy of significant improvements in healthcare for people living with dementia.
What advice would you give to someone setting out?
Firstly, the only certainty in the NHS is change. Embrace it, harness it and influence it.
Secondly, old age psychiatry is a fine and thriving specialty.
I wouldn’t do anything else.
Thirdly, we understand more about dementia. Treatments more effective than cognitive enhancers will come along, either to stop the disease from progressing (effectively to cure it) or to delay the onset sufficiently to make an impact on the ever rising numbers (the dementia time bomb).
This is down to decades of raising awareness and to the hard work of a dedicated community of clinicians and scientists.
New treatments and fresh changes will usher in a transformation in dementia healthcare delivery to a scale difficult to predict in any other clinical specialty.
If you want to play your part, you have fire in your belly, and you aspire to develop the right skills, this could be a specialty for you.