Guest Post: A Reflection on Dr. Nigel Hewett’s Retirement

Nigel HewettDr. Nigel Hewett retired this summer after 12 years as the founding medical director of Pathway. He was also the founding Secretary and the driving force behind the development of the UK Faculty for Homeless and Inclusion Health, which we launched in 2011. I first met Nigel when Pathway’s founder, Professor Aidan Halligan, invited me to see a new specialist homeless service at University College Hospital in London (I didn’t realize at the time but Aidan was also checking me out as a potential CEO, for an organization that didn’t yet exist). Nigel was there following a similar experience.

Aidan had witnessed an awful episode of care involving a homeless patient and decided to do something about it. His first step was to search out the best homeless health doctor in Britain, someone who really understood homelessness and its consequences for our health. This led him to the Dawn Centre, Nigel’s incredible community-based specialist homeless service in Leicester in the West Midlands. Aidan was always assessing people’s potential and he rapidly decided that Nigel was the doctor he would ask to come and examine homeless patient care in a prestigious inner-city London hospital. He invited Nigel to London under this pretext but in fact Aidan was looking for someone who might help him to lead much wider-scale change across the UK’s NHS. His judgment was right. In Nigel he had found one of the most skilled and experienced doctors in our field; a calm, considered, profoundly compassionate man, and someone of considerable bravery. Nigel was willing to challenge poor practice, and was a huge champion for the most excluded. In those early days Trudy Boyce, the first Pathway team nurse, herself with 40 years of experience, told me quietly that Nigel was the best doctor she had ever worked with in terms of the rapport he could build with the most challenging patients, and the strength of his moral purpose.

Nigel HewettOver the next 12 years Nigel’s lightly-worn but increasingly apparent gravitas, his personal charm and his ability to keep us focused on the most important issues shaped Pathway’s direction and the ethos that underpinned our success. For the first six years Nigel continued to lead that first team at UCLH, while also convening multiple research studies, training new teams, and attending countless meetings with NHS bureaucrats, funders, and charity sector partners. Nigel could build trusting relationships with people at every level from patients and lived experience colleagues (and Nigel insisted from the beginning that we had to bring lived experience intimately into Pathway’s work) up to Presidents of Royal Colleges and professional bodies, professors and politicians.

Nigel’s contribution to the development, indeed to the creation of the discipline we comfortably now call ‘inclusion health’ has been immense. He compiled and edited three editions of the Faculty’s National Standards document. In 2018, with the 3rd edition out, and on the back of two seminal papers in The Lancet (he was co-author on both of course) he engineered a joint statement between us and the Academy of Medical Royal Colleges (the umbrella body of all the medical associations in the UK). The statement agreed a definition of inclusion health. UK national policy documents now routinely reference inclusion health and services and the first ever official UK NICE guidance on homelessness was published this spring.

Although retired Nigel has not disappeared. We keep in touch regularly and of course he can’t help but to contribute to several research projects. We published his farewell speech on Pathway’s web site, which as ever, contains real wisdom for everyone working in our field.

Alex Bax is Chief Executive of Pathway, the UK national homeless and inclusion health charity, and host of the Faculty for Homeless and Inclusion Health

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