This site is intended for health professionals only
Acclaimed as a pioneer for BME leaders in the NHS, Manjit Darby is a Queen’s Nurse, a regional director for NHS England and a magistrate. Kaye McIntosh asks where her drive comes from.
It was a poor experience of the NHS as a child that gave Manjit Darby the drive to change things for the better. As one of six children, Ms Darby lived with her parents in a tight-knit Sikh community.
Back then, her parents didn’t have good English language skills. That created a major barrier between them and health professionals: ‘Compassion and understanding weren’t great. I wanted to do something about that. To make sure that when my mother went to the doctor she would be understood and people would be kind to her.’
Her parents weren’t keen on nursing as a career: ‘They didn’t see it as a profession that would look after me and respect me. And there was the cultural perspective of nursing, seeing it as being a handmaiden to the doctors.’ But Ms Darby has proved them wrong, showing leadership skills from the very start of her career.
An early knock back taught her a vital lesson. ‘It was my fi rst placement on a ward and the sister said, “Can I have a word?” and told me, “I think you are rather bossy,” I thought I was doing something wrong and went to see my tutor, in tears.’ But tutor Mary Neary had a surprising response: ‘She said, it is because you are a leader of the future and that I should value those leadership skills.’
Having people who ‘look out for you’ is important, Ms Darby feels. On the morning we spoke she talked to a nurse who felt stuck and asked for help. ‘As BME [black and minority ethnic] nurses we are sometimes not very good at finding opportunities and I help people to do that. It’s about connections.’ And confidence – she feels that BME nurses ‘often feel we don’t deserve to be here [in senior positions].’ Something as simple as a senior colleague who says you are doing well is incredibly powerful.’
First switch your thinking, she says, and ask yourself ‘what this job can do for me’ not just ‘what you can do for this job’. Next, what are you learning and getting out of this job? Then, what’s next after this job?
A high-flyer by accident
If this all sounds very ambitious, Ms Darby insists she hasn’t been single-mindedly climbing to the top. ‘It’s more by accident, not always design. I’ve seen a job and thought it looked interesting.’
It’s an approach that’s taken her from that first nurse placement through to acute and terminal care on to mental health nursing and then management. A master’s degree in healthcare management gave her a new set of skills. She was director of clinical services at an inner city primary care team (PCT), working across NHS and social care boundaries.
When her path had been blocked, she’d worked out how to get around it – for example, leaving the NHS to be a freelance consultant when she didn’t get the top job she wanted at the PCT.
She returned to the NHS a few years later as assistant clinical director in the Leicester City, Leicestershire County and Rutland PCT cluster, and was then asked to act as interim director of nursing and quality with NHS England Midlands and East – Central Midlands, before being confirmed in the permanent post. She is also programme manager for nursing and midwifery revalidation for England.
In 2014, Ms Darby was cited as one of Health Service Journal’s 50 BME pioneers, for creating a BME leadership network steering group. It aimed to improve the career experience, success and progression of nurses, support staff and students in the East Midlands. Colleagues described her as putting enormous energy into supporting and mentoring others, a role model, and one of very few BME women working at a regional level.
Lessons will be learned
In her current role as director of nursing and quality, she has a particular focus on learning from service failure. A fifth of her work is devoted to serious incident analysis and finding out ‘how we can improve’. The solutions are multi-faceted and across the systems and organisations.
‘Services have to be delivered in the community, it is not just a problem the NHS can solve on its own – it needs to work with education, social services, housing and the police,’ she points out.
‘Serious case reviews often show common features. Communication always comes up,’ she says. ‘For the NHS, our learnings have to be about how we talk to each other and to people at different agencies – and how do we use that information to make sure the child or vulnerable adult remains at the heart of our practice.’
She has a particular insight into child protection, as the former chair of an Independent Foster Panel, and a magistrate – in fact, she’s just done the training for working as a family magistrate. ‘Understanding the struggles that families face – the position that they find themselves in when they have to give up their children – really gave me a desire to make a contribution.’ She is also an adoptive mother, with a seven-year-old daughter.
Ask the difficult questions
At work, her role in service improvement is ‘about holding up a mirror to the NHS, to the experience of BME staff and the experience of our patients’. The problem is the service does not echo the diverse population it serves. That causes difficulties in areas such as service redesign.
Looking at it from the patients’ point of view and thinking about how services are going to be received is vital. ‘Rather than saying, this is how it is, having the perspective to know that families often think ill people need to be in hospital, that’s where they will get better.’
The things that hold BME staff back are subtle, she says. There are problems with shortlisting applications and progression at all levels. ‘What we are doing as a region is to shine a light within organisations. If you don’t have senior nurses at 8C level, why is that? What’s happened at your organisation?’ Boards should be representative of the people they serve, she believes. When you design a model, will that work out in the community? ‘We should all be asking those questions, not just me.’
She doesn’t feel she’s experienced discrimination herself. But it’s hard to know – why are there so few Asian women working at regional levels? ‘When you look with the benefit of hindsight, you think, was it racism? When you sit in front of a panel and don’t get the role, is it my suitability or is it because I’m Asian?’
Ms Darby describes her approach as ‘refusing to be disempowered’ by any obstacles. ‘I’ve asked, is it something I can change? If I can, then I will. If not, I have left [the role].’
Her advice to BME staff looking to climb the career ladder? Ask what your current job, and your next one, can do for you and not just what you can do for the organisation. And build a network. ‘Make connections. Find people who can help you. Who looks after you?’
Now, after a 30-year career, Ms Darby is thinking about the future. Retirement is just a few years away. ‘I’m happy to keep working at this level, and then to look at other things.’ She is a registrant member of the NMC’s Fitness to Practice Panel and would ‘love to do more’. She takes a very pragmatic view of cases. Something that refl ects her approach in general – it’s about what works, about finding ways to deal with obstacles, and spotting opportunities.
Kaye McIntosh is a freelance health journalist