What the head of UHD, Debbie Fleming said as she retires from NHS

In 1974, a 13-year-old began working part time in her local pharmacy in Oxford.

She loved it and carried on for around ten years through her school and university studies.

Now decades later Debbie Fleming is retiring as chief executive of University Hospitals Dorset after 38 years in the National Health Service.

"It was a great experience and I knew almost from the beginning I wanted a career in the healthcare sector," she said.

Of her long service and many high profile roles in the NHS both as a commissioner and a provider she added: "I can't say I have enjoyed every second of it but nearly every second, and that's not bad."

Mrs Fleming, who has oversaw the hard fought and protracted merger of Bournemouth and Poole Hospital trusts, is optimistic about the future of the NHS despite the constant challenges, financial issues and regular politically driven re-organisations.

"I am a relentlessly optimistic person and I think we can positive about the future, despite everything we have been through.

Royal Bournemouth Hospital and inset, Poole Hospital

“I would never have chosen to be leading constant reorganisations but I have had to do that my whole career.

“It’s become clear to me that where things are changing people need to know there is a sense of direction and whatever the rationale for that change, how are we still going to do well for our patients.”

She added: “It’s always been my purpose to being a sense of certainty and stability amidst the chaos.

"Reorganisations are disruptive and tiring and we do seem to be constantly in search of the Holy Grail and every reorganisation seems to be designed to put right what wasn’t quite right with the previous one.

“We are publicly funded and everyone cares about the NHS, it matters to people. We are yearning for the moon if we think it will ever not be political.”

“We all have short memories don’t we, there was a time recently where everyone was clapping the NHS and that was lovely. I don’t think I have ever known a time when staff felt quite so appreciated.

Royal Bournemouth Hospital

“But we know now after the pandemic that there are lots of things that aren’t okay about the NHS and we are all frustrated by that especially our patients.

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“Long waiting times are a big issue and it worries people. They sometimes forget there are real people trying to deliver these services and doing their best.”

She added: “If you are a patient on a waiting list and in pain or waiting for a diagnosis it’s understandable that you are worried and frustrated. There is a lot of anxiety out there. I still think we can do better on keeping people informed.

“I do think when people do come in for the care they need, they are appreciative. The perception is often about where you are on a pathway and your most recent experience."

Mrs Fleming's first job was a senior clerk in Coventry in community health which taught her that most health care is delivered out in the community, not in hospitals.

Debbie Fleming

"I also learned that not everyone loves managers. You have to earn people's respect."

She was appointed general manager for elderly services at Poole in 1989 and then managed the medical directorate, taking up the role chief executive for Bournemouth and Poole Primary Care Trust (PCT) and in 2010 chief executive for Hampshire PCT.

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After serving as area director for NHS Wessex she was appointed Poole hospital chief executive in 2014 and chief executive of both Poole, Bournemouth and Christchurch in 2019.

The merger took place last year.

Mrs Fleming who was awarded an OBE for services to the NHS in the Queen’s New Year Honours List 2022, said every part of the NHS was under intense pressure.

“Nobody is operating at the top of their game at the moment. They can’t be. We are operating at 97/98 per cent occupancy. The recommendation is 85 per cent. I have never known that.

"I think the foundations for recovery have been laid and we have some fabulous plans in plans around emergency department, same day emergency care, patient flow, discharge. But it’s only just beginning but everything is in place post pandemic.

“Staff need to headspace and headroom to feel excited about the future. And when you are head down every day just coping with that influx, worrying about how to get patients out again, having the same arguments about the delays in the system, that's not easy."

She said one of the most important lessons for the NHS was improving the health of young people from the very beginning and throughout their lives, so that services could be more proactive and less reactive.

And she added: “We can only be really brilliant if keep the brilliant people we have and recruit more.

“Important that the voice of the patient is heard. We all know that people will only do what they want to do.”