My job

As a manager, I’m still a nurse first and foremost

Chief executive Katie Fisher took a role outside the NHS ‘where I could make a difference’


Katie Fisher

Although she’s been a senior manager in large organisations for several years, Katie Fisher often puts on a healthcare assistant’s uniform and works a shift.

‘In every job I’ve ever done, I’ve retained an element of clinical work,’ says Ms Fisher, who qualified as a nurse in 1996 at Kingston University. ‘It’s really important for me. The further I get from a direct patient interface, the less happy I become.’

‘The very best we can be’

In June, Ms Fisher was appointed as the new chief executive of St Andrew’s Healthcare, a charity providing highly specialised secure care for patients with multiple mental health conditions, referred by either the NHS or the prison service.

The charity cares for more than 800 people across four sites, with most living in its main hospital in Northampton.

‘Throughout my career, everything has always been grounded for me in what’s the right thing to do for patients’

‘The vast majority of our patients are those the rest of society would prefer to pretend don’t exist,’ says Ms Fisher. ‘There’s no one else coming, so they deserve to have us be the very best we can be, to help them on their path to recovery.

‘Throughout my career, everything has always been grounded for me in what’s the right thing to do for patients, with my motivation being how can we make things better for them,’ she adds.

Over the past couple of years, the charity has been criticised for its treatment of some patients, including recent press reports highlighting how a teenage girl with autism was detained in seclusion.

Difficult circumstances

‘As we provide services that others can’t or won’t, we lay ourselves open to criticism, whether that’s founded on fact or not,’ says Ms Fisher. Among her responsibilities is to support staff who are facing these difficult circumstances, along with ensuring that patient care is independently reviewed and assessed.

This role is Ms Fisher’s first outside of the NHS. ‘If I’m brutally honest, I’ve fallen out of love with it,’ she says. ‘The politics – both with a large and a small ‘p’ – of being an NHS chief executive have become intolerable to me. I felt that I couldn’t get on and do my job and found myself becoming demoralised.’

After qualifying, she worked in surgery and critical care at St George’s Hospital in Tooting, south London. She was eventually promoted to senior sister and helped to reinvigorate a busy ward with high staff turnover.

‘I was put into the nursing box and felt I couldn’t communicate what needed to happen next. I thought if people won’t listen, I need to learn this language’

‘But when I tried to make more broad suggestions, I just couldn’t get heard. It was very frustrating,’ recalls Ms Fisher. ‘I was put into the nursing box and felt I couldn’t communicate what needed to happen next. I thought if people won’t listen, I need to learn this language.’

After completing NHS management training, she worked in various primary care organisations, eventually moving to the Royal Free as a director of integrated care.

‘I use my nursing experience every single day’

Before joining St Andrew’s she held a number of senior positions at West Hertfordshire Hospitals NHS Trust, and had progressed to chief executive. ‘I don’t see myself as an ex-nurse or someone who has gone over to the dark side,’ says Ms Fisher. ‘Although I’ve not maintained my registration, I use my nursing experience every single day, and that’s how I see myself first and foremost.’ 

New challenges are also core to her choices. ‘If someone says can’t or won’t, it becomes irresistible to me,’ she says. ‘A feature of my career has always been taking on things that are broken and fixing them. Even clinically, I was always drawn to the most challenging and vulnerable patients.’

Her current post offers exactly what she needs. ‘I really wanted a role where I could make a big difference to patients who needed my help,’ says Ms Fisher. ‘This is the perfect blend of patient contact, working with some truly inspiring colleagues from all disciplines and doing some very important work – but with the flexibility to do what’s right.’ 


Lynne Pearce is a health journalist


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