“It’s fantastic. It keeps your mind active and you can really work on your people skills, communication skills, attention to detail and teamwork,” says Scott Diamond. That’s not his day job at NHS Lanarkshire or representing MiP members he’s talking about—it’s refereeing football matches in Scotland’s amateur and semi-professional leagues.

“I’ve always been interested in football but I was a terrible player, so I did a refereeing course years ago and absolutely loved it,” Scott explains. Local rivalries can be fierce enough “to put the Old Firm to shame” and some games get “really tasty”, he says. “You certainly develop plenty of resilience and awareness refereeing in those leagues!”

Scott’s experiences as a Glasgow paramedic—he still works “the occasional shift”—led him to join the board of the Scottish violence reduction charity, Medics Against Violence (MAV). “We work with a lot of people who are escaping violent lifestyles or have drugs or domestic abuse issues,” he explains. “Our staff are in emergency departments across Scotland, working day and night with these people, trying to make their lives better.”

Scott became interested in management after working in quality improvement for the ambulance service and studying for a “top-up” degree in healthcare management. Although Covid put him temporarily back on the frontline, he “just ended up progressing more and more into management”.

It was a “very strange career path”, he says. Rather than leading a local ambulance station team, Scott took what he calls “more of a health board liaison route”, working on improvement projects “rather than just heavy admin and teamwork”.

This grounding in “collaboration for the greater good” led Scott to NHS Lanarkshire where, as a capacity and flow manager, he manages access to acute services, performance standards and patient safety, working shifts in a team of three to provide round-the-clock coverage at the board’s hospital sites.

He also works on projects aiming to improve patient flow, reduce hospital occupancy and tackle delayed discharges—just as big a problem in Scotland as it is in England, he says.

“It’s council-led and the councils are really, really strapped for cash,” Scott explains. While Scotland’s closely integrated health and social care partnerships—including jointly employed staff— “allow us to collaborate a lot better”, he says, “the big thing it comes down to just now is a lack of money.”

Has being a working paramedic helped him as a manager? “Yes—firstly with the ability to talk to absolutely anybody about anything!” he says. “In Glasgow, you can go from someone in an incredibly affluent house to someone in almost slum conditions on the next call. Being able to connect deeply with both people and build trust has really helped me to develop leadership skills.”

Ambulance work also builds resilience, he explains: “It takes quite a lot to faze you when you’ve dealt with riots in the city centre. You know the day will always end—you just need to keep focusing on the job and looking after your staff as you get through it.”

Active in Unite as a paramedic, Scott found out about MiP, “by Googling”, after joining the health board. “It was an excellent find,” he says, “because I’d been thinking we have a management tier that nobody fully represents”. He subsequently trained as a rep and joined MiP’s National Committee earlier this year.

The big concerns for members at NHS Lanarkshire are pay—the Scottish Government is “quite good” with pay, he says, because NHS staff are “massive voting bloc”—and proposals to reduce the working week from 37.5 to 35 hours. “It’s fantastic that we can reduce people’s working hours and still pay them the same but there are a lot of management challenges with how to still deliver safe services with that chunk of resource reducing,” he explains.

Scott does see a “really difficult period ahead” for MiP, with job losses from the English reforms and the possible merger of Scottish health boards after the 2026 Holyrood elections. “The priority for me is to increase our presence in Scotland. We can only strengthen through numbers and ideas… so we need to be really responsive to members’ needs but also very proactive,” he says.

“We need to treat management as a profession with its own development pathway,” he adds. He sees MiP’s role as “supporting members to be the best managers they can be… Professional regulation may be coming but we can strengthen that through union work as well.” //