The Next GenCast

Dr Rammya Mathew is a GP, Medical Director for Brent Integrated Care Partnership, BMJ columnist and GP appraiser. She has built a portfolio career across clinical practice, leadership, writing and population health, while working part-time around family life.

In this episode, Rammya shares the story behind her career - including how she got her first leadership opportunity, why she doesn't believe you need a grand career plan, dealing with rejection and imposter syndrome, becoming a BMJ columnist, and building a career that works around the rest of your life.

We also talk about motherhood, boundaries, networking and why sometimes you simply need to get into the arena...and so much more:

00:00 - Introduction and Rammya's portfolio career

04:00 - Working part-time and building a portfolio career

06:00 - How Rammya first got into leadership

12:00 - Putting yourself forward when you don't have the experience

13:00 - Why networking doesn't have to feel like networking

16:00 - Imposter syndrome and saying yes when you're nervous

18:00 - Failure, rejection and losing your sense of career identity

22:00 - Leadership, motherhood and doing things on your own terms

28:00 - Building a portfolio career around clinical practice

30:00 - Staying clinically confident while doing less clinical work

34:00 - Why diverse voices matter in leadership

38:00 - How Rammya became a BMJ columnist

43:00 - Career plans, values and choosing where you can make an impact

46:00 - Quick-fire questions: goal setting, networking and joy

You might also enjoy some of our earlier conversations with leaders at the start of their careers:

Episode 10 - Backstage with Sonali Kinra

Listen to Sonali Kinra

Episode 12 - Backstage with Imogen Staveley

Listen to Imogen Staveley

Episode 14 - Backstage with Rachel Steen

Listen to Rachel Steen

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The Next GenCast is hosted by Dr Nish Manek, founder of Next Generation GP.

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It was an absolute pleasure to record this conversation live at NHS Confed Expo 2026 with one of the NHS's most respected leaders.

In this special live episode of Next GenCast, I sat down with Dame Caroline Clarke, Regional Director for NHS England in London, to explore the leadership journey that took her from NHS finance trainee to leading health services for almost 10 million Londoners.

What followed was one of the most open and honest conversations I've had about leadership, resilience and staying true to your values.

We talked about:

• Her unexpected route into NHS leadership and why she never had a grand career plan
• Leading one of the UK's largest health systems through enormous change
• Imposter syndrome - and why it never completely disappears
• Living with multiple sclerosis while managing one of the NHS's biggest leadership roles
• Mindfulness, exercise and protecting your energy in demanding jobs
• Raising an adopted daughter alongside a national leadership career

…and so much more.

Whether you're an aspiring leader, an experienced clinician, or simply interested in what leadership really looks like behind the scenes at the highest levels of the NHS, I think you'll really enjoy this conversation.

03:30 Early influences and entering the NHS

06:30 The finance perspective in healthcare

09:30 From finance trainee to CEO

13:30 Royal Free, technology and transformation

15:30 Imposter syndrome and finding your voice

20:30 Listening as a senior leader

22:00 What it's really like at the top of the NHS

26:00 Health, family and managing stress

30:00 Mindfulness, teams and work-life balance

33:00 Authenticity, inclusion and leadership

36:00 Failure, mistakes and learning

38:00 Career highlights and proudest moments

39:30 Neighbourhood health and primary care

41:30 Quick-fire leadership questions

42:00 Advice for the next generation

• Sign up to the monthly newsletter to learn how to join one of our funded GP leadership programmes coming soon
• LinkedIn
• Twitter/X

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What really happens behind the scenes when NHS policy is made?

In this episode, Nish speaks with Dr Amanda Doyle OBE, National Director for Primary Care and Community Services for NHSE, to unpack how national decisions are actually negotiated, challenged, and delivered into frontline care.

From GP partner in a deprived practice to shaping national primary care policy, Amanda shares a rare inside view of leadership, pressure, and influence at the top of the system - and how it really works when ministers, money, and medicine collide.

00:00 - Role overview

03:00 - Early life & medicine

06:00 - Becoming a GP

09:00 - Life as a GP partner

13:00 - Leadership emerges

17:00 - Family & career balance

21:00 - From local to national roles

26:00 - Imposter syndrome & confidence

30:00 - National leadership reality

34:00 - Ministers & policy

38:00 - Criticism & scrutiny

42:00 - GP contracts & access

46:00 - PCNs & neighbourhoods

49:00 - Advice for future leaders

• Leadership often emerges, not planned
• NHS decision-making is shaped by tight constraints
• Clinical grounding matters at senior level
• Policy is negotiation, not control
• Opportunity comes from saying yes, not chasing titles

• How NHS decisions are really made
• Primary care and GP contract politics
• Leadership at national level in healthcare
• Real-world career progression in medicine 

• Sign up to the monthly newsletter to learn how to join one of our funded GP leadership programmes coming soon
• LinkedIn
• Twitter/X

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In this rare and candid conversation, Dr Nish Manek speaks with Jim Mackey, CEO of NHS England, about leadership at the very top of the NHS.

Jim reflects on his journey from a working-class upbringing to leading one of the largest healthcare systems in the world, and speaks openly about the reality behind senior leadership - the burden of responsibility, the privilege of making a difference, and the self-doubt that even the most senior leaders experience.

This is an honest and thoughtful conversation about leadership, imposter syndrome, career journeys that don’t go to plan, and what it really feels like to lead during one of the most challenging periods in NHS history.

Timestamps:

• 00:03:00 – Childhood, early influences & competitive swimming
• 00:07:00 – Career journey from accountancy to NHS CEO
• 00:12:00 – Experiencing imposter syndrome in senior roles
• 00:16:00 – Managing responsibility, stress & family life
• 00:29:00 – Navigating elite spaces & staying true to yourself
• 00:36:00 – Introversion, coaching, and personal energy management
• 00:39:00 – Taking the helm at NHS England during major challenges
• 00:49:00 – Shifting care to the community and the future of healthcare

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From sleeping rough at 15 to becoming one of the UK’s youngest female Chief Fire Officers, Sabrina Cohen-Hatton’s story is extraordinary- but this episode goes far beyond inspiration.

This is a masterclass in high-stakes leadership, cognitive bias, psychological safety, and refusing to let your childhood define your ceiling.

We explore what it really means to lead when decisions carry life-or-death consequences - and why the most powerful leadership lessons often come from outside healthcare.

If you care about resilience, systems thinking, and building braver organisations, this conversation is unmissable.

⏱ What we cover

04:00 – Growing up, early trauma, and becoming homeless at 15

09:00 – Survival mode: what rough sleeping really does to your mindset

14:00 – “Homelessness is an experience, not your identity”

20:00 – Joining the fire service and choosing a different future

27:00 – Decision-making under extreme pressure

33:00 – Cognitive bias in high-stakes environments

41:00 – Psychological safety: why it’s built in relationships, not policy

49:00 – Failure, imposter syndrome, and redesigning systems instead of blaming people

🌍 Connect with Sabrina Cohen-Hatton on social media to follow her work and leadership journey.

🔔 Follow Next GenGP on LinkedIn for leadership insights and episode updates.

📩 Subscribe to our monthly bulletin for exclusive leadership resources and updates on programmes to come

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In this episode of Next Gen Cast, Dr Nish Manek speaks with Paul Corrigan, one of the most influential figures in modern UK health policy.

From advising Tony Blair inside No.10 to shaping the NHS 10-Year Plan today, Paul brings rare institutional memory and sharp insight into leadership, reform, and why meaningful change in healthcare is so hard to deliver.

Together, we explore what leaders get wrong, why policy alone never works, how clinicians can step into system leadership, and why neighbourhoods, patient agency, and proactive care are central to the NHS’s future.

A candid, wide-ranging conversation for clinicians who want to understand - and shape - what comes next.

✨ Episode Show Notes

00:00 – From academia to No.10

05:00 – Inside Downing Street

08:30 – Do leaders understand the NHS?

12:00 – Clinicians as leaders

17:00 – Risk and standing still

22:30 – What makes a good Secretary of State

27:30 – Returning to DHSC at 75

32:30 – Why reform keeps failing

36:30 – Technology and patient agency

40:30 – “No money” myth

45:30 – Neighbourhood healthcare explained

52:00 – Advice to early-career clinicians

✨ Links/resources:

• Paul's book- Shakespeare on Management

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• LinkedIn
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• Monthly bulletin

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In this episode, we welcome back Hannah Miller — the only guest I’ve ever invited for a second conversation so far.

Hannah Miller is the Founding Director of Sidekick, a coaching and training company that helps individuals and leaders understand and use their strengths. She’s a certified CliftonStrengths coach, and the creator of The Purpose Pursuit, a programme designed to help people gain clarity and live with more intention.

Hannah consistently receives some of the highest feedback scores in the entire Next Gen programme. Participants repeatedly describe her sessions as practical, energising, and transformative, often remembering and applying her insights years later. Hannah’s first episode (28) remains one of our most downloaded to date.

Together, we dive into the practical wisdom behind her brand new book The Purpose Pursuit, which is about to be published.

We explore how we reconnect with purpose, navigate life’s seasons, handle comparison and imposter feelings, and make small, everyday course-corrections that bring more meaning into our lives. This is a grounding, hopeful, and deeply useful conversation for anyone feeling a bit off-track, stretched thin, or ready for more intention in their day-to-day.

⏱️ Timestamps

• 01:00 — Hannah’s background and coaching journey
• 03:00 — Moving from strengths to purpose
• 06:00 — What people consistently underestimate about themselves
• 09:00 — Purpose in high-pressure, purpose-driven roles
• 11:00 — Why we drift off-course
• 14:00 — Everyday course-corrections
• 18:00 — Seasons of life explained
• 30:00 — Comparison and how to handle it
• 34:00 — Social media + scarcity patterns
• 40:00 — Imposter feelings and the four types
• 48:00 — The Four-Point Pursuit
• 54:00 — Hannah’s advice to her younger self

Links/resources:

• Hannah's first episode with us
• Hannah's new book- The Purpose Pursuit
• Her website and podcast

🎉 Giveaway! 🎉

Pre-order Hannah’s new book and you could win a one-hour coaching conversation with Hannah, valued at £150!

Here’s how to enter:

1. Pre-order or order the book.
2. Send your receipt to [email protected]
3. You’ll be entered into a competition draw.

✨ The winning coaching session can be taken anytime until March 2026.

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In this episode, Professor Sir Jonathan Van-Tam, former Deputy Chief Medical Officer for England, shares his remarkable journey from a market town in Lincolnshire to the national stage during the COVID-19 pandemic.

Known for his honesty, clarity, and trademark analogies, JVT reflects on his family’s extraordinary story, the challenges of breaking into medicine, and the pivotal choices that shaped his career in public health.

He talks candidly about stepping into leadership “by accident,” managing the pressure of being thrust into the spotlight, and navigating the uneasy intersection of science and politics. Along the way, he opens up about imposter syndrome, the personal costs of public service, and the lessons he hopes will inspire the next generation of leaders.

02:00 – Early Life & Family Influence

04:00 – Getting Into Medicine

06:00 – Path to Public Health & Pharma

12:00 – Becoming Deputy CMO

17:00 – Thrust Into the Spotlight

25:00 – Imposter Syndrome

32:00 – Science, Politics & Pressure

39:00 – The Power of Communication

49:00 – Work-Life Balance & Personal Cost

58:00 – Reflections & Legacy

57:00 – Quickfire Round

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🎧 Re-release

As many of us take a well-earned pause over the summer, we’re revisiting one of our most popular and inspiring episodes: our conversation with the legendary Don Berwick. Whether you’re listening for the first time or returning to it with fresh ears, this episode is packed with wisdom on leadership, purpose, and finding joy in work.

For the past 30 years, Donald Berwick has been one of the leading authorities and innovators of quality and improvement both in the U.S. healthcare system and in the NHS. A paediatrician by background, Don was for 19 years the founding CEO of the Institute for Healthcare Improvement (IHI).

In 2010, he was appointed by President Barack Obama as the Administrator of the Centers for Medicare and Medicaid Services. He has served on the faculties of the Harvard Medical School and Harvard School of Public Health, has written over 160 articles and 6 books, and has provided trailblazing leadership to improve the ways health care providers and institutions care

📝 Highlights:

• His leadership story to date (3 mins)
• Mentors (12 mins)
• Balancing clinical work with leadership and academia (16 mins)
• What it was like working for President Obama (19 mins)
• The job of a leader (24 mins)
• Coping with failure (27 mins)
• Handling criticism (33 mins)
• The future of the NHS (36 mins)
• Morale in primary care (41 mins)
• Finding joy in work (45 mins)
• Quick fire: including favourite books, his proudest moments, advice to his younger self, and top tips for new leaders (52 mins)

📚 Resources:

• A Promise to Learn, A Commitment to Act – Berwick Review (2013)
• IHI Framework for Improving Joy in Work
• Book: Ministry for the Future by Kim Stanley Robinson

📱 Social Media:

• Follow @donberwick and @nishmanek

📬 Stay in the loop!

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🌐 nextgenerationgp.co.uk

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Jason Leitch on Leadership, Public Trust & Fixing the Hoover

In this powerful and personal episode, Professor Jason Leitch – former National Clinical Director of the Scottish Government – joins Dr. Nish Manek for an honest, insightful conversation on what it truly means to lead through crisis.

From storytelling and the imposter syndrome to the pressure of daily COVID briefings, Jason reflects on his remarkable career and the lessons that still resonate today.

Whether you're a healthcare leader, or simply curious about the human side of leadership – this one’s for you.

04:30 – Growing up in a working-class household: family, faith & humble roots

08:00 – The early influences that shaped Jason’s values and work ethic

09:30 – Being headhunted into government – and why he left surgery

10:30 – The fellowship at Harvard & IHI that changed everything

13:45 – Systems thinking, safety, and why fixing one jaw wasn’t enough

17:00 – Creating the Scottish Patient Safety Programme – and saving lives

20:00 – “Where are the clever people?” – the moment Jason realised he was in the room

23:00 – What most people misunderstand about civil servants and politicians

27:30 – Imposter syndrome in senior roles — and how to work with it

30:00 – From dentist to national spokesperson: leading communication during COVID

32:00 – Behind the scenes of daily press briefings with Nicola Sturgeon

36:00 – The Grinch moment: “I cancelled Christmas in October”

38:00 – Social media abuse, threats — and how he stayed grounded

42:00 – Running, audiobooks, and the daily 5K: mental health strategies

46:00 – Why being wrong publicly was part of the job

48:00 – The monkey and the golf ball: Jason’s dad and the story that stuck

51:00 – Full circle: why “fixing the Hoover” might be all the leadership advice you need

53:00 – Biggest career mistake? Waiting too long to step beyond dentistry

54:00 – Final reflections: don’t over-design your career. Build relationships. Fix the Hoover.

• Catch up with Episode 25 with Don Berwick, Jason's role model and mentor
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