A year on from arriving as Chief Executive of NHS Lanarkshire, I want to take a moment to share my reflections on our journey together so far – along with my perspective on the progress we’ve made as an organisation and the priorities that lie ahead.
First impressions
Over the last year, I have had the privilege of visiting services, meeting many teams and listening to more than 1,000 staff and GPs from across the organisation. What has been clear in every conversation I have had is that we all share the same goal: to deliver for patients across Lanarkshire.
From the day I first arrived, I have been genuinely impressed by the dedication, energy and commitment of everyone I meet. The staff here are exceptionally hard-working and consistently face challenges with unwavering care. Sometimes these pressures mean that significant efforts happening across the organisation don’t always receive the recognition they deserve.
Early on, a senior clinician asked me what I planned to do about one of these challenges – A&E performance. “This isn’t a ‘me’ issue,” I said. “It’s a ‘we’ issue.” That moment crystallised for me that the way forward was to embrace the importance of taking shared ownership to improve the care we provide.
Wherever I go, I see people who want the very best for our patients. I also see that we sometimes make things more complicated than they need to be. To achieve lasting improvement, we must design systems with patients and staff at the heart. We must make it easier to do the right thing, cut down on bureaucracy, minimise unnecessary handoffs and focus on practical solutions. Change may take longer with this approach, but the reward will be a system that is truly owned and shaped by those who use it and work within it.
This approach is guiding our improvement work at University Hospital Hairmyres and inspiring the launch of the Quality Improvement Academy this year. By bringing together clinicians, nursing staff, programme management and quality improvement colleagues, we are driving meaningful and sustainable changes across NHS Lanarkshire.
Recognising key achievements
Our growing and ageing population is a reminder that we must do more to support our most vulnerable. Last year, we invested £1.2 million in the Frailty Unit at University Hospital Wishaw, driven by the belief that older people should not have to endure long waits in A&E. The unit, led by Alison Falconer, a highly talented geriatrician, opened in December 2025 and has already made a positive impact, with more patients being seen and average length of stay falling from 12 days to four. This year, we are committing nearly £1 million more to frailty services to support our other two acute hospitals, and we are conducting a review of all off-site facilities to better align resources and improve outcomes. Our cancer teams also continue to provide sector-leading services.
Although fewer people are attending A&E, providing timely care remains challenging with more patients experiencing longer waits. This is a safety concern we are actively addressing. I am particularly grateful to staff in A&E for their tireless work in difficult circumstances.
Thanks to the dedication of staff across specialties, we have made strong progress with planned care. The number of patients waiting over 52 weeks for a new outpatient appointment has reduced considerably over the last year. Each of those numbers is a person no longer living with the uncertainty, pain or the anxiety of a long wait. But there is more to do, particularly to address long waits, productivity and Did Not Attend rates.
Innovative approaches are everywhere. To name just a few, I have been impressed by the work of dermatology, the Bloods and Go service in primary care, speech and language therapy, and Child and Adolescent Mental Health Services (CAMHS). Innovation is clearly embedded in NHS Lanarkshire’s culture. Flow Navigation Centre Plus (FNC Plus) and the use of technology are proving to be new ways of working that are improving outcomes for people.
By investing nearly £2 million in community services, we have seen a reduction in delayed discharges. That is testament to the hard work, partnership working and creativity of our teams. We also recognise the importance of focusing on population health and providing earlier interventions, and we are collaborating with partners in the council and third sector to reimagine and deliver services differently.
Looking ahead
There is much to be positive about, but we also need to recognise that everything we have achieved has been within financial constraints and that these pressures remain in the coming years. That means we need to be focused and disciplined in how we redesign services, while also recognising the pressure staff are already under. As I often say, we are trying to fly a plane while building a new one at the same time.
We are currently refreshing our healthcare strategy, Our Health Together, which is due for relaunch at the end of September 2026. This will give us a chance to align our new corporate objectives and set clear priorities for the coming year. These have been shaped by input from over 60 senior leaders when we met for our first Senior Leadership Forum in March. I am also excited about work continuing towards creating a new hospital in Monklands.
The establishment of the Culture Programme Board marks another milestone – getting our culture right is foundational to enabling change and creating the right conditions for progress. Listening to our staff sits at the heart of it.
Even small improvements, like reducing sickness rates by just one per cent, could not only support a healthier workplace and better continuity of care, but also release up to £3 million to reinvest in a better system for everyone.
A heartfelt thank you
I want to close by expressing my heartfelt thanks to all staff for your ongoing commitment. There is more to do and there are real challenges ahead, but together I know we can focus on what matters most – our patients.
People often identify closely with their own teams, services or site. That is understandable and important. But my message is always that we are all part of Team Lanarkshire. I am in your team, and you are in mine. By working together, we will deliver the best outcomes for the people of Lanarkshire.
