A Small Fish in a Big Pond: Megan Bailey

What working with senior NHS leaders taught me about confidence, leadership and belonging

One of the biggest surprises of my first few years in the NHS was not learning how to manage projects. It was learning that senior leaders are human too.

Paddling in the shallows

As a junior member of staff in my first NHS role, I remember feeling incredibly nervous about joining one of my first projects with the NHS Transformation Unit. I had been told about the project management support our team provided to a network known as the Association of Groups. After attending an initial learning session, I quickly realised the complexity of the work and the seniority of those involved. I felt intimidated and wondered whether I belonged in that space.

Like many people early in their careers, my responsibilities began with the administrative tasks that often sit in the background but are essential to keeping complex networks running. Over the next few months, I grew in confidence and started to realise that I could do it. Looking back, those responsibilities gave me an important foundation for understanding how senior partnerships operate.

Diving in at the deep end

Around nine months into supporting the network, a key member of the project team stepped back from leading the support offer, and I was asked to step up. I was given the opportunity to lead the team myself. At first, that filled me with dread. The seniority of the members, the complexity of the network and my own lack of confidence made it feel like too much to manage.

After an honest conversation with a colleague about my worries, she reassured me that she believed I could do it and would be there to support and guide me when I needed it. Her faith and trust in my abilities gave me the courage to accept the challenge, even though I still felt nervous and unsure of myself.

Finding my stroke

My first task in this new leadership role was to bring the team together and understand what the next year’s agenda for the network should look like. Supported by my colleagues, I planned the timeline for the year, engaged with members about the topics that mattered to them, and eventually brought a paper to the network’s CEO forum proposing the themes for discussion and learning in the year ahead.

After that meeting, my confidence began to grow. I realised that senior NHS leaders were not as scary as I had built them up to be in my head. Yes, their seniority and wealth of knowledge can feel intimidating, but they are people too, with more experience to share. That insight helped me feel more comfortable following up actions, planning sessions and contributing in conversations. Over time, my confidence in the network began to show in other projects too.

But like every journey, growth was not linear. The annual in-person network conference was approaching, and in my new role I thought I had to do everything myself. In reality, that made things harder. I spent weeks worrying about whether the event would go well, but struggled to let others in to help.

Despite the trust my colleagues had placed in me, I became visibly stressed, and the pressure I had placed on myself began to affect me inside and outside of work.

When the event came around, it was a huge success. Because I understood the event planning and delivery in detail, I felt confident speaking with senior leaders about my area of responsibility. The feedback from attendees was positive, and I felt proud of what we had delivered.

In the debrief with my colleagues, we had another honest conversation about what leadership can look like. I realised that although the event had gone well, it had come at a cost to my wellbeing. I learned that leadership is not about holding everything yourself. It is about trusting the people around you, asking for help when you need it, and creating the conditions for the team to succeed together.

The following year felt much smoother. As a team, we created a psychologically safe space where we could support each other, develop our confidence and step outside our comfort zones, knowing support was there when we needed it. That environment helped us deliver another successful event, but it also helped the team feel more confident, connected and able to grow.

Finding confidence beneath the surface

My experience within the Association of Groups network taught me a lot. I developed the skills and confidence to interact with senior leaders, learned how to manage upwards, and began to believe that I deserved a place in those spaces. My confidence as a leader also grew. I started to see that leadership does not mean having all the answers; it means being willing to learn, to ask for help and to create space for others to do the same.

The most important thing I learned through working with senior leaders is that they are human too. They experience uncertainty, self-doubt and difficult decisions just like everyone else. The difference is often not confidence, but experience, and experience only grows when people are given the opportunity, support and trust to step forward.

Creating ripples of confidence

For colleagues earlier in their NHS careers, my reflection is this: feeling nervous in senior spaces does not mean you do not belong there. It may simply mean you are stepping outside your comfort zone and growing.

For leaders, it is a reminder that the way we welcome, support and encourage people can make a lasting difference to their development, confidence and sense of belonging.

For me, this also reflects something important about the NHS Transformation Unit’s work: supporting complex programmes is not only about delivery, but about creating the relationships, confidence and trust that help people and partnerships succeed. So perhaps the question is not whether early-career colleagues are ready to step into unfamiliar spaces, but how we create the conditions that help them feel able to try.

Looking back, I was not a small fish in a big pond after all. I was someone at the beginning of my journey, surrounded by people who were willing to help me grow.