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Choosing the right road to your leadership style

Rhian Monteith looks at the importance of building on strengths rather than correcting weaknesses

Rhian Monteith looks at the importance of building on strengths rather than correcting weaknesses


Picture: Getty

Clinical leadership is a skill and an art. That it is a skill means it can be deconstructed and learned; being an art means that you can apply one set of principles and rules in one situation and have a positive outcome, and the next time apply a completely different set of rules and still get a positive outcome. Leadership in any context is not a linear or prescriptive process, which is why I love it.

My approach may be unconventional but the following principles of what I feel and think when I lead others really works for me.

The 'them' out there

When I worked in the ambulance service as a paramedic, I had so many ideas about improving patient care, moving my organisation forward and solving age-old problems. I was convinced it was somebody’s job to notice I had good ideas and to pluck me out to act on them. I waited for 15 years for ‘them’ to come forward, and nobody came. I eventually realised it is me who had to put my head above the parapet and push for change. The ‘them’ out there was me.

In 2009, when I became an advanced paramedic, I started my role by copying peers, who I now know were copying someone else. I became stand-offish, with a steely exterior, mean and mysterious, or so I thought. Being someone else is exhausting and it got me nowhere fast. Until I realised I’m a five-foot-two Yorkshire lass and I’m not made that way.

Then I swung the other way and tried to be inclusive of everyone’s thoughts and feelings, and asked people's opinions all the time. All this did was to devalue me in their eyes and my own.

After I was burnt out, I decided to start again and use what had served me well before: intuition and experience. So I developed my leadership style to:

  • Listen to people.
  • Then make decisions boldly.
  • Acknowledge publicly when you’ve evidently made a bad one.
  • Have the inner strength to keep going even when you are mentally or emotionally injured.

It takes experience, humility and courage. I’ve been a paramedic for 18 years and now lead on two national programmes of work; one is around high-intensity users of healthcare, for NHS England, and the other is about ‘rotating paramedics’, for Health Education England. I work on different work programmes that involve many different people and challenges inside and outside the NHS, but I am myself throughout: one person, consistently me.

Be consistent

There is real value in being consistent. Whether I’m at work, or doing some public speaking, down the pub or on the school run, people who know me recognise me as the same person. I am the same person at home and at work as I am with friends. It’s taken me 39 years to be the person my father raised.

The overarching reason I love what I do and can always be myself is that I follow the principle of building on my strengths rather than correcting weaknesses.

Some people think that, if you have weaknesses, you must address them to make you a more rounded person. I’m not interested in that one bit. I work on the theory that, if you make someone more rounded, you make them more average and they will never have the energy or space to really excel at anything. So that’s how I shape my work life.

Let people in

You can learn how you should lead based on who you are; that way you won’t burn out trying to be someone you’re naturally not.

Most important of all is to humanise yourself. Let people in to know who you are so they can connect with you. It isn’t a show of weakness but one of human connection; that’s at the heart of my leadership style and it encourages others to be open about themselves.


Rhian Monteith is an advanced paramedic, clinical lead for Health Education England’s Rotating Paramedics programme and national lead for high-intensity users at NHS England

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