Digital leadership in the NHS is often framed as a technical problem to be solved – the right systems, the right infrastructure, the right roadmap. But that framing misses something fundamental. When Melina and I spoke with Monica, it became clear very quickly that she sees digital leadership as a human responsibility first. Technology matters, of course, but it’s relationships and the accountability that comes with them which determine whether digital services actually work.
A Career Grounded in People
Early on, I asked Monica what first drew her into technology and service delivery. Her answer wasn’t surprising, but it was telling. She didn’t talk about platforms or systems. Instead, she talked about people. Monica described herself as someone who feels most at ease when she’s helping to fix a problem – stepping in, figuring it out, and making things better. It’s an instinct, she admitted, that shows up everywhere: at work, at home, even among friends.
Listening to her, it was easy to see why service delivery suited her so naturally. For Monica, service delivery isn’t about ticking boxes or hitting SLAs, it’s about meeting expectations, earning trust and following through. That mindset has shaped every role she’s taken on and it still sits at the centre of how she leads today.
When I mentioned how relationship-led her approach felt, Monica didn’t disagree. She talked about her current role in terms of business relationship management – not as a function, but as a responsibility. Building relationships across the Trust, listening carefully to what people are struggling with, and working alongside them to find solutions is what energises her most.
From International Development to NHS Digital
Monica’s route into digital leadership wasn’t linear and that’s part of what makes her perspective so grounded. She began her career at the Department for International Development working as an Executive Officer based in London but covering South Africa and Namibia.
When Melina asked what that experience gave her, Monica spoke about travel, partnership and working closely with African embassies to solve problems through funding and collaboration. What stood out underneath all of that was a lesson she learned early: progress depends on trust. It was during this period that she realised she wanted a career built around relationships, not titles or technical authority.
Her later move into IT took her through DFID and major law firms such as Clifford Chance. When I asked how that compared to the NHS, she laughed. “These organisations weren’t financially constrained,” she explained. “If something needed to happen, the funding was usually there.”
After a role in a cash-rich Australian company, Monica moved into the NHS and described it as the most rewarding move of her career – not because it was easier, but because it mattered more.
That sense of purpose came through strongly when she spoke about Barnet Hospital. Monica worked there, and she also had her children there. Experiencing the Trust both as a member of staff and as a patient gave her a perspective that’s hard to teach. “It feels like home,” she told us – a connection that had clearly strengthened her commitment to improving experiences for everyone who walked through its doors.
On Barriers and Why Confidence Still Matters
When I asked Monica about barriers she’s faced as a woman in technical and operational leadership, her answer was honest and direct. She hasn’t experienced significant obstacles because of her gender or ethnicity, and she’s clear that she’s progressed through hard work and merit.
That doesn’t mean the conversation stops there. Monica was also clear that the landscape has changed significantly over the last 15 to 20 years. Opportunities for women in leadership are more visible and the NHS has worked hard to position itself as a fair and open employer.
When Melina raised the topic of mentorship, Monica spoke warmly about the support she’s received throughout her career, including now. What stood out was how much she values recognition – particularly being seen by other women in senior roles.
Her message was simple and worth repeating: women shouldn’t hesitate to apply for roles they’re capable of doing. “We focus on what you can demonstrate” she said, “not on assumptions about who looks right for leadership.”
A Leadership Mindset of Possibility
One of the strongest moments in our conversation came when I asked Monica about the principles that guide her leadership. Her response was immediate: “No should never be the first answer.”
It’s a deceptively simple idea. Monica explained that even when a “yes” comes with caveats – funding, resource, or capacity – it creates movement. Shutting ideas down too quickly, on the other hand, creates friction and disengagement. Starting from a place of possibility, she believes, invites collaboration and builds trust – something digital services rely on far more than most strategies acknowledge.
Trust, Not Control
As our conversation turned to team culture, Monica spoke passionately about appreciation. When I mentioned how sometimes digital teams can go unrecognised, she nodded. She makes a conscious effort to thank her team at Royal Free London NHS Foundation Trust openly and ensure credit sits where it belongs.
What came through just as clearly was the respect Monica has for her team. She spoke openly about how central they are to everything she delivers – that her role only works because of the people around her. She talked with genuine warmth about their expertise, their commitment and the trust they place in one another. It’s clear she wants the very best for them, not only in terms of performance, but in their growth and development too. That mutual respect has fostered a strong, lasting relationship within the team – one she clearly values.
Her views on micromanagement were just as clear. When Melina raised the topic, Monica questioned whether micromanagement is often rooted in insecurity or a lack of trust. With eight direct reports and more than 30 people in her wider team – soon to grow further – she has neither the time nor the appetite to control every detail. Trust, for her, isn’t a leadership style; it’s a requirement.
Communication Above All Else
When I asked which skills have mattered most in her move from service delivery into infrastructure leadership, Monica was unequivocal: communication.
She described how she approaches change; by proposing ideas, not imposing them. If her team challenges her and makes a convincing case, she’s willing to change course. Inviting her team to help shape their own structure, she said, reinforces collective ownership over top-down decision-making.
Listening, she emphasised, is just as important as leading.
Innovation Without the Noise
Monica was measured when we discussed innovation. There was no appetite for chasing trends or being first for the sake of it – particularly when it comes to AI.
Instead, she spoke about practical, user-focused improvements: a self-service portal now used by around 60% of users, short support videos designed to encourage self-help, and regular feedback loops that lead to real service improvements.
When Melina asked about AI specifically, Monica was clear that healthcare demands caution. She believes being a mid-adopter, can often be the most responsible choice. Patient data, risk, and governance shape every decision. Tools like Copilot are being explored – but thoughtfully, and as part of a wider strategy rather than a headline-grabbing initiative.
Trust Through Responsiveness
Towards the end of our conversation, I asked Monica what really builds trust with stakeholders. Her answer was immediate: responsiveness.
People don’t expect perfection, she explained, but they do expect to be heard. Keeping people informed, especially when something has gone wrong, builds confidence and long-term trust in digital services. For Monica, this isn’t theoretical; it’s something she practises deliberately and consistently.
Looking Ahead – and Back
When we talked about advice for future leaders, Monica was clear that confidence matters, but not the performative kind. You don’t need every skill perfected or every requirement ticked off. What matters more is being yourself, being willing to learn, and trusting that capability grows with experience.
That perspective felt even more grounded when I asked what she would say to her younger self, back in 2003 as a Service Desk Manager. Monica spoke honestly about imposter syndrome – something she still experiences at times – and about sitting in rooms with people who looked, spoke, and were qualified very differently to her. What she’s learned is simple: if you know your role, can explain your thinking, and are prepared to speak up, you belong. You don’t have to be everything, or know everything, to lead well.
Listening to her reflect, it was clear that the confidence she now encourages in others is something she’s had to build herself, step by step.
