Andrew Hodge emphasizes that clinical leadership is about giving a profession a voice at executive level, influencing system-wide decisions, and shaping culture through openness, learning, and collaboration. Effective leadership grows from broad experience across roles and settings, and the future lies in integrated, multi-professional teams that are flexible and patient-focused.
“Leadership and Culture in Healthcare – Clinical Leadership with Andrew Hodge
Host Matthew Winn interviews Andrew Hodge, Director of Paramedicine at a UK ambulance service, about clinical leadership, professional identity, and system-wide working in the NHS.
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Executive Summary
Andrew Hodge describes the emergence of clinical leadership within paramedicine as a turning point for the profession. He explains how the creation of board-level paramedic roles has given the profession a strategic voice within organisations traditionally dominated by medicine and nursing.
His leadership journey reflects a career deliberately broadened across multiple parts of the NHS — from frontline paramedicine to commissioning, clinical governance, patient safety, and consultancy roles. This system-wide experience has shaped his leadership style and belief in openness, learning culture, and multi-professional teamwork.
Hodge highlights that real leadership influence increases at executive level, where it becomes easier to shape strategy, represent the profession, and integrate paramedicine into wider pathways of care. He stresses that leadership now extends beyond ambulance services into primary care, hospitals, mental health, and prisons, positioning paramedics as system-wide clinicians rather than just emergency responders.
Culturally, he champions transparency, learning from incidents, professional respect, and integrated working. He sees the future of paramedicine embedded in neighbourhood teams, urgent care hubs, and cross-organisational models — where flexibility, collaboration, and system leadership are key.
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Leadership Themes
Paramedics finally have representation at executive level, shaping decisions affecting the profession and patient care.
Hodge’s influence comes from wide system experience — ambulance services, primary care, commissioning, governance, and consultancy.
Patient safety, openness, and reflection are foundational leadership responsibilities.
Leadership today is not just about leading paramedics — it’s about leading across systems and organisations.
Effective care comes from integrated teams, not professional silos.
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Key Quotes on Leadership & Culture (verbatim)
On professional leadership and representation
“At one time there was no chief paramedic on a board representing the profession.”
“It’s been a really important development… to have a chief paramedic on a board.”
“The role is to be the voice of the profession.”
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On leadership at executive level
“It’s been a lot easier… at exec level with directors to kind of just be alongside them, shaping it as you go.”
“I’ve got the opportunity to represent us and put things forward and try to steer the direction of travel for our profession.”
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On culture, learning and transparency
“Working on that serious incident agenda and how we learned from incidents and develop openness and transparency.”
“That was nothing to do with being a paramedic — it was just really good experience to be in a different part of the system.”
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On leadership as influence, not position
“The crossroads between clinical practice, leadership, research, education, supervision… that influenced the organisation in my small way felt really important.”
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On multi-professional teamwork
“Multi-professional working — that is much better.”
“If we can do that going forward as part of an integrated neighbourhood health team… that would really help the system and patients.”
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On future vision and culture change
“What excites me… is having more flexibility to go into different settings.”
“That would be really good for our profession — but it actually would really help us help the system and patients and partners much easier as well.”
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On leadership growth
“Learning to be on a board has been one of the steepest learning curves I’ve ever had.”
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Final Leadership Takeaways
• Leadership grows through experience across systems, not just promotion.
• Culture is led through visibility, honesty, and learning from failure.
• Professional influence changes when clinicians sit at board level.
• Integration, not siloed working, is the future of healthcare leadership.
• Clinical leaders must balance profession-first thinking with system responsibility.