Question 1

Why do you want to be a clinical director, and how will you balance the role with your clinical work?

Accepted Answer

I've been a consultant here long enough to notice that most of the things that frustrate me and my colleagues aren't clinical problems. They're problems with how the service is organised. Clinics booked in a way that guarantees overruns, a rota with gaps everyone knows about weeks in advance, a governance meeting where the same themes come up every quarter and nothing quite changes. For a while I did what a lot of consultants do, which is grumble in the coffee room. Then a couple of years ago I took on the governance lead role for the department, and I found I actually enjoyed the work of fixing things. We redesigned how we reviewed our incidents, and within a few months colleagues were bringing learning to me rather than dreading the meeting. That's when I started to think seriously about this job. So the honest answer is that I want to be the person who can change the conditions my colleagues work in, because those conditions are what patients feel. I'm not doing it to step away from patients. I'd want to keep a meaningful clinical commitment, because I think consultants follow a clinical director who still does the work, knows what a Monday clinic feels like and is on the rota. On balance, I've thought about it practically. I'd want the clinical director sessions written clearly into my job plan and protected, rather than squeezed around a full clinical load, and I'd want to agree with the general manager which meetings genuinely need me and which can be covered by the…

Question 2

Clinical directors usually work in a triumvirate with a general manager and a head of nursing. How would you make that relationship work?

Accepted Answer

I think the triumvirate works when the three of us are genuinely jointly accountable for the directorate, and everyone outside can see that we speak with one voice. It breaks down when the doctor assumes they're the senior partner, or when the general manager ends up carrying performance on their own while the clinical voices only turn up for governance. So early on I'd want us to sit down, probably for a couple of hours away from the usual meeting room, and be explicit about how we'll work. What each of us leads on, where we expect to decide together, and how we'll handle it when we disagree. In practice I'd expect to lead on medical workforce, job planning, consultant behaviour and medical governance, the head of nursing on nursing workforce and fundamentals of care, and the general manager on operational delivery and finance. But things like the budget, the waiting list and the quality of care are all three of ours. I'd want a short weekly huddle just for the three of us, separate from the formal performance meetings, so we can raise worries early. And I'd want us to agree that we don't undermine each other in public. If I disagree with a decision the general manager is making about, say, cancelling a clinic to release capacity elsewhere, I'll say so firmly in private and we'll work it through, but once we've decided, I'll stand behind it with my colleagues. I've had a taste of this already as governance lead. The matron and I co-chaired the governance meeting, and I…

Question 3

A consultant colleague raises a concern that another consultant's surgical outcomes seem worse than the rest of the team. As clinical director, what would you do?

Accepted Answer

The first thing I'd do is take the concern seriously and thank the colleague who raised it, because it's not an easy thing to say about a peer. I'd ask them what exactly they've seen. Is it a feeling, a run of complications they've noticed, or something in the data? I'd write down what they tell me and be clear that I'll look into it properly and fairly. My next question would be whether there's any immediate risk to patients. If there's a pattern of serious harm, I'd need to act quickly, and I'd talk to the medical director's office and the responsible officer that day. Usually, though, a concern like this needs facts before anything else. I'd look at the outcome data with our clinical governance team and, ideally, someone with audit expertise. Are we comparing like with like? This surgeon might be taking the complex cases, or the emergency lists, or have small numbers where chance plays a big part. I'd check national audit or registry data where it exists, the incident log, complaints, and morbidity and mortality reviews. Under the trust's policy for managing concerns, which in England is based on Maintaining High Professional Standards, I'd usually take early advice from HR and the medical director's office, and the trust can also seek advice from NHS Resolution's Practitioner Performance Advice service. If it looks like there's something real, I'd meet the consultant, explain the concern honestly and hear their view. In my experience doctors are often aware something…

Question 4

Your directorate has a long waiting list with some patients waiting well beyond the national standard. How would you approach it?

Accepted Answer

I'd start by remembering that each line on a waiting list is a person, often in pain or worried, and some of them are deteriorating while they wait. So for me it's a clinical risk and a fairness issue first, and a performance issue second, although the two usually go together. Practically, I'd want to understand the list properly with the general manager and the performance team. How many people, how long they've waited, at what stage of the pathway, and how clinically urgent they are. I'd want assurance that patients are clinically prioritised and that the priority codes are kept up to date, because a priority set a year ago may not be right today. I'd also want to know who is coming to harm while waiting. Are we doing harm reviews for long waiters, and is anything showing up in incidents or complaints? Then I'd look at why we're where we are. Sometimes it's demand. Often it's flow and productivity: theatre lists starting late, outpatient slots lost to unfilled clinics, follow-ups that could be patient-initiated, or advice and guidance that could stop a referral being needed at all. These are things consultants can genuinely change, and I'd want to make it their project, not something done to them. I'd also look at fairness. I'd want to break the list down by deprivation, ethnicity and whether people have learning disabilities, because we know from wider evidence that some groups wait longer or don't attend. If that shows up locally, we can act on it, for example with…

Question 5

Two consultants in your department are openly in conflict, and it's starting to affect the team and patient care. How would you handle it?

Accepted Answer

I'd act sooner rather than later. In my experience, consultant conflicts that are left alone tend to harden, and the people who pay for it are the resident doctors and nurses caught in the middle, and ultimately patients when communication breaks down. My first step would be to check whether it's affecting safety right now. Are handovers happening properly? Are referrals between them being delayed? Has anything been raised by the team or logged as an incident? If so, I'd put a practical arrangement in place straight away, for example agreeing a clear handover routine or making sure decisions are documented, while I deal with the relationship. Then I'd meet each consultant separately, somewhere private and with enough time. I'd listen properly, because there's usually a real grievance underneath, often about workload, fairness of job plans, a clinical disagreement or something that was said in front of others. I'd also be clear and direct with each of them about the effect their behaviour is having on the team, and that this needs to change. I'd try not to take sides or relay what the other person said. If both are willing, I'd bring them together with a clear purpose: not to agree on everything, but to agree how they'll work together in front of patients and the team. If that doesn't work, trained mediation, usually through HR or an external provider, can be really effective with senior clinicians. I'd also look at whether there's a structural cause I can fix, such as an…

Question 6

Your directorate is significantly over budget on medical locum spend, mainly to cover rota gaps. What would you do?

Accepted Answer

I'd want to understand the spend before I tried to cut it, because locum spending is usually a symptom. With the general manager and the medical staffing team, I'd break it down. Which rotas, which grades, which shifts, agency or bank, and at what rates. I'd want to know how much is covering long-term vacancies, how much is sickness or parental leave, how much is gaps on the deanery rotation, and how much is extra activity like waiting list work. Once I knew that, the answers tend to be different for each bit. For long-term vacancies, the question is why we can't recruit. Is the job unattractive, is the advert poor, are we competing with a neighbouring trust? We might create a substantive post, a specialty doctor post with a good development offer, or a locally employed doctor post with some protected training time. Those roles often cost less and give more continuity than agency cover. For rota gaps, I'd look at the rota design itself. Sometimes a rota is built in a way that guarantees gaps, and redesigning it with the rota coordinators and the doctors who work it can make a real difference. Bringing internal bank rates in line with neighbouring trusts can move work from agency to bank. I'd also check that the escalation process for approving agency shifts is clear and that we're following any regional rate caps. What I wouldn't do is simply refuse to fill shifts. Leaving a rota short can quickly become unsafe, and it pushes risk onto resident doctors who then exception…

Question 7

You receive information that a consultant in your directorate has been arrested in connection with an allegation involving a child outside work. What would you do?

Accepted Answer

I'd treat this as a safeguarding matter first and an employment matter second. Even though the allegation is about something outside work, a doctor's role gives them access to vulnerable patients, and children may come into contact with them here. So my immediate question is whether there's any current risk, for example are they due to work tomorrow, and does their work involve children or vulnerable adults? I wouldn't try to find out the details myself or contact the doctor to ask about the allegation, because that could interfere with a police investigation. Instead, the same day, I'd speak to the trust's named or safeguarding lead and the medical director's office, and HR. In England, allegations that someone working with children may have harmed a child or poses a risk need to be referred to the local authority designated officer, the LADO, usually within one working day, and the trust will have a named person who does that. The LADO coordinates with the police so that the employer's actions don't compromise the criminal process. Decisions about whether the consultant can work while this happens would be taken through the trust's process, with the medical director, HR and the responsible officer, informed by advice from the LADO and police. That might mean restricting their practice or excluding them from work while it's investigated, which in a case like this may well be justified, but it should be a considered, recorded decision, not a knee-jerk one. The responsible…

Question 8

A patient has come to serious harm in your directorate after a delayed diagnosis. As clinical director, what is your role in the response?

Accepted Answer

The first thing is the patient and family. I'd want to know they're being cared for clinically and that someone has spoken to them honestly. Under the statutory duty of candour, when a notifiable safety incident happens we need to tell them, apologise and explain what we'll do to find out what happened, and follow that up in writing. Depending on the circumstances, I might do that conversation myself with the treating consultant, because it matters to families that someone senior takes responsibility. Next, I'd make sure it's been reported on the incident system and that immediate safety actions are in place. If the delay happened because, say, an abnormal scan result wasn't acted on, I'd want to know today whether other results might be sitting unactioned in the same way. Under PSIRF, the trust's patient safety team will decide, in line with our patient safety incident response plan, what kind of learning response is right. It might be a full patient safety incident investigation or a smaller response like an after action review or a multidisciplinary review. My role is to make sure the directorate engages fully, that the family is involved in setting the questions, and that the staff involved are supported and spoken to as part of learning, not as suspects. PSIRF is deliberately about systems, things like how results are acknowledged, staffing, IT, and handover, not about finding someone to blame. I'd also look after the clinicians. A doctor involved in serious harm can…

Clinical Director Interview Questions & Answers

About this NHS interview question bank

Free NHS interview questions and model answers

Question 1: Why do you want to be a clinical director, and how will you balance the role with your clinical work?

Question 2: Clinical directors usually work in a triumvirate with a general manager and a head of nursing. How would you make that relationship work?

Question 3: A consultant colleague raises a concern that another consultant's surgical outcomes seem worse than the rest of the team. As clinical director, what would you do?

Question 4: Your directorate has a long waiting list with some patients waiting well beyond the national standard. How would you approach it?

Question 5: Two consultants in your department are openly in conflict, and it's starting to affect the team and patient care. How would you handle it?

Question 6: Your directorate is significantly over budget on medical locum spend, mainly to cover rota gaps. What would you do?

Question 7: You receive information that a consultant in your directorate has been arrested in connection with an allegation involving a child outside work. What would you do?

Question 8: A patient has come to serious harm in your directorate after a delayed diagnosis. As clinical director, what is your role in the response?

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