Disruptive Collaboration – the role of the AHP leader

Disruptive Collaboration – the role of the AHP leader by Derek Barron

Over my career I’ve have greatly enjoyed working with many of my AHP colleagues. As my background is in mental health my clinical experience of working with AHPs has been predominately with occupational therapists (O/T), occasionally dietitians and physiotherapists (please don’t tell @susandmunro that I didn’t mention SALT). I’ve converted a nursing post into an O/T to work in the Crisis Resolution and Home Treatment Team I managed. In a previous role I represented AHPs at the Senior ‘table’ in the Mental Health Partnership, while in my current substantive post I’ve been an active supporter of the Ayrshire AHPs in delivering their actions under Realising Potential. This little canter through my history is by way of demonstrating some commitment and understanding of aspects that face our allied health professionals on a day to day basis; however I don’t think it can adequately prepare me for every aspect of being the executive lead for this diverse group of highly skilled clinicians.

PathHarnessing Expertise

However throughout my time, as Executive Director for AHPs, here in Orkney it is also clear to me that there is no singular pathway that actually fully prepares you with all the knowledge re challenges and opportunities that each of these professions bring, even if your background is as an AHP.

My role therefore is to harness the expertise, knowledge, skills and enthusiasm of our AHPs to support us delivering on the standards and actions set out in the National Delivery Plan

Actions 1.1 and 1.2 are clear in relation to the role and importance of professional leadership to support and drive improvement. It is my personal (professional) view that without distributed leadership across and within our services at NHSO level and nationally, we will stagnate and lose the momentum that AHPs have worked so diligently to achieve.

Disruptive collaboration

TableHealthcare continues to face ongoing change and uncertainty – although, in my experience, it has always been so. However change presents not only challenges, but also great opportunity. I read a great phrase in a blog recently ‘disruptive collaborator’ – someone unwilling to just settle for the status quo, for ‘how it’s always been’.

And yet critically they do their disruption ‘collaboratively’, they work with others to shift ‘the way it’s always been’ to ‘the way it can be’. The thing about them is they don’t just have great ideas (important thought these are), they gather collaborative effort to execute these ideas into actions, to deliver improvement.

Too often we feel helpless in dealing with the day to day realities Everywhere I’ve worked and in every time period there are people who consider that what they face is unparalleled in all of history, no-one’s has had it quite like them (“we’re unique”). People have always struggled with: doing more with less; reduced capacity, increased demand, more complex procedures, underappreciated and so on …

In another blog (by Anabel – sorry I’ve lost the reference) I read about the ingredients every change maker needs:

• Realisation that I can only change myself. We need to develop the awareness, skills and responsibility for our own choices. We can support other through change, but we can’t make the change.

• If we’re not willing to stretch, we will not reach our potential. What impact will that have on our teams and importantly the people we serve – optimism? role-modelling? Are we (as leaders/change makers) being the best we can possibly be?

• Emotions are driven by needs. When there are ‘big emotions’ from you or from the team, don’t ignore them, they are a signal of an important need. Find out what is at the heart of it (fear of change, fear of the unknown, has anyone explained how to implement the change). By addressing the emotion, we go to the heart of the challenge.

OrkneyWhat requires mastery, for us here in Orkney, is to consider our circumstances differently. People who take on personal accountability bring their own motivation and engagement to everything they do.

Wakeman says “suffering is optional … so ditch the drama” he considers our circumstances are what they are, but our reaction to them is up to us. Some of our challenges in Orkney are very different from other areas, however it’s up to us as a team how we respond to them – our success will not be measured by everything staying the same, but on our readiness for what’s next – the National Delivery Plan is our ‘what’s next’.

Lisa Rodrigues, writing in Guardian Healthcare talked about innovative leadership, she reflected on a point made by Henry Ford: if he’d asked people what they wanted, they would have said faster horses.

My final thought relates to innovative leadership – are you a leader who innovates or do you simply want faster horses.  Can you envision different ways of doing things, or is your answer always – more staff?  I know in Orkney I’ve definitely met some innovative leaders who don’t simply want faster horses.

It’s my role to support them

Derek T Barron is Interim Executive Director of Nursing, Midwifery and Allied Health Professions in NHS Orkney.  Twitter: @dtbarron


Lisa Rodrigues is chief executive of Sussex partnership NHS foundation trust: Guardian Healthcare


Cy Wakeman is author of Reality based leadership: ditch the drama and turn excuses into results and The Reality Based rules of the Workplace



  1. Interesting take on an age old problem. How to make national guidance fit local needs, especially relevant to the diversity of Scottish Health Board areas.

    Jacqui Hirst Paediatric Occupational Therapist Peedie Sea Children’s Centre Pickaquoy Loan Kirkwall Orkney KW15 1BZ

    Tel: 01856 885593


    1. Thank you Jacqui – I agree it’s an ongoing issue, not sure it’s national guidance per se that is the issue: for me it’s ensuring local services deliver on the direction of travel of national action plans i.e. not everything fits exactly the same, it’s knowing which parts fit and which require shaped by local circumstances without a blanket rejection of everything because ‘we’re different’.

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