King's College London, Medicine, 2005
Children's Hospital, Boston; Dept of Health, London; WHO, London; NHS, London
Health Care Club, Business & Government Club, Management Consulting Club
A physician who had practiced pediatrics in the U.K. before coming to Harvard for her joint MBA/MPP degree, Nabihah Sachedina was already a seasoned medical professional when she returned to England after completing her studies. Once again, she assumed a health care role—but this time as the program director of the London Health Commission, an independent review panel backed by city's mayor, to "look at care in the capital, and how to improve the health of Londoners."
"It broadened my perspective," Nabihah says, "because I was looking more upstream. In addition to learning how to use health care services as effectively as possible, we wanted to find ways to make prevention work and see how local government could support health."
For the U.K., where health care is nationalized, this local approach to health was something new. For Nabihah, it meant applying an entirely new set of skills, and even a new mindset. "It was quite a step up for me coming out of business school," she says.
Lessons learned become practices implemented
Nabihah believes that HBS and Harvard Kennedy School prepared her with new know-how that has had both practical and strategic consequences. On the practical side: "All those finance and accounting classes I dreaded? Without them, I could never have managed a budget of that [the Commission's] size. I can say without uncertainty that before HBS, I couldn't look at financial information without getting palpitations."
Negotiation, a practice developed in both schools, played a huge role in Nabihah's work. "As you can imagine," she says, "our work could potentially create disruption, causing anxiety among the current stakeholders. The negotiation skills I learned helped me understand their positions. What were their absolutes? Where might they compromise? As a result, we were able to resolve potential conflicts before they escalated."
On a strategic level, Nabihah's biggest challenge was "trying to understand and then get agreement on an overall vision of health and care in London. For something this complicated, you have to understand the interrelations among different parts: education, industry, housing, private business, public governance."
After a year of study, the Commission published a report, Better Health for London, that included sixty-four recommendations that, Nabihah says, "were grounded in stakeholder expectations so that they would get support when released." Today, these recommendations are the foundation for the Healthy London Partnership, established in April 2015, of which Nabihah is director of strategy.
Tactically, the Partnership is responsible for thirteen priority programs, ranging from mental health and cancer to childhood obesity and diabetes. But strategically, it's changing the very way health care is managed and delivered in London and the U.K. "By design, National Health Services is a centralized, top-down organization," says Nabihah. "Now we're looking at devolution, at how less centralization and more local authority would work across all programs, across all of London. For the U.K., this is historic."