Over the past four years, having been handed the role full-time, she has commanded an annual budget of £4m and ascended to NICE’s senior management team. In the past year she has also been forced into the limelight to defend the eight-year-old body’s role in the face of some highly charged challenges from media and pressure groups.
Fish is precocious then, to say the least, but is quiet and unassuming with it. She appears vastly intelligent and fiercely protective of the work NICE does.
‘Decisions about healthcare are always difficult, and we have to show those decisions have been made in a scientific and responsible manner,’ says Fish.
NICE is the national arbiter of which drugs the NHS can prescribe, and also produces clinical guidelines for use across the health services. Last year, the organisation came under intense pressure to rubber-stamp breast cancer drug Herceptin. Over the past few months the pressure on NICE, and thus also on Fish, has become even greater thanks to a legal challenge over its judgment to limit the prescribing of certain Alzheimer’s drugs.
The case, backed by pharmaceutical companies and charities and heavily stoked by the Daily Mail, was largely won by NICE last week. But the body did not come out unscathed, coming in for some harsh criticism, particularly in the right-wing media.
‘I deal with a lot of journalists who have a job to do and in person they are always friendly, personable,’ says Fish, before admitting that there is little you can do to stem the tide of a Daily Mail attack.
‘You have to appear calm and reasoned,’ she adds, talking about her comms strategy during the recent court case. ‘There are a lot of emotions around any case like this; by appearing calm it shows the decisions you made were taken seriously and rationally.’
Fish recalls the final judgment last week: ‘Sitting behind me there was an elderly lady who burst into tears when the verdict was revealed. Our work affects people’s lives and that’s who we have to think about. It’s not absout our reputation,’ she argues.
Fish’s work throughout the case was generally well-received. Weber Shandwick public affairs director Tamora Langley praises the way she used the agency.
‘She used us in an intelligent way and was a clear thinker,’ says Langley. ‘She was always polite and friendly throughout, which is a sign of any good comms professional. It’s also great to see a relatively young woman in a role like this – there is still prejudice in the industry that a woman might not be able to cope, but she has proved she can.’
Fish’s comms career has been punctuated by stints in worthy positions. Following an initial job helping the Liberal Democrats through the 1997 general election, she worked at charity Action for ME, and then on the Nuffield Hospitals account for Fishburn Hedges.
‘I prefer to work in a position where I feel I’m doing some good,’ reveals Fish. This goes some way to explaining why, having left the Liberal Democrats in 1998, an attempted law career proved abortive.
‘I wanted to get a “proper” job,’ she says. ‘I leave that bit off my CV though, no-one has noticed yet!’
That Fish achieved such an impressive career trajectory was probably helped by an early career working ‘in the thick of it’ alongside Paddy Ashdown and seasoned Lib Dem campaigner John Cleese. She started campaigning for the party because of ‘too much free time at university and not enough money to fill it with’.
‘Funnily enough though, the place I learned most, and the thing that gave me the confidence to do this job and apply for it full time, was a King’s Fund Senior Manager Programme,’ says Fish.
‘It showed me the emotional side of management, rather than the practical, which I’d never thought about before. It gave me the tools to command a team like this,’ she adds, gesticulating outside her office.
Initially NICE had looked for a replacement for her predecessor while Fish filled the interim role. But her managers were suitably impressed over the course of a few months to be more than welcoming when she officially applied for the position.
Fish seems particularly ambitious. She is currently studying for a Masters in Business Administration through Warwick Business School to help ‘figure out what to do next’.
It also adds to the impression that she is a dedicated learner, a characteristic observed by a journalist who covered the Alzheimer’s case.‘During the final results of the hearing of the Alzheimer’s case I was sitting behind Louise,’ she recalls. ‘It was important, but deadly boring. Everyone was falling asleep, but she was nodding away at each point, listening and concentrating intently.’
Not that Fish’s life has been a complete success story, though. As an ardent Bolton fan (she watches with her father), she clearly understands struggle. Maybe the experience will serve her well at NICE, where the role is far more high profile and contentious than when she first took it.
‘I think NICE still has public support.’ says Fish. ‘People don’t question the fact that someone has to make a decision. We just have to show we’re doing it properly.’
What was your biggest career break?
Being an acting comms chief twice – at Action for ME, and here at NICE. It provided me with amazing opportunities to learn my trade at the deep end and look confident in front of the right people. I think the roles helped me find my feet.
What advice would you give to someone climbing the career ladder?
Volunteer to take on responsibilities. Chat to your boss and ask to try out new things to expand your role. Training and shadowing will help you get where you want to go – once you’ve figured it out!
Who was you most notable mentor?
I haven’t had a single mentor as such, although I’ve obviously learned from the people that managed me. But also, when taking on this role, I learned from the people in publishing and new media at NICE, which was an area I had little experience in. The King’s Fund course helped me hugely too; Nicholas Bradbury and Valerie James were the people that taught me and it made me very self-aware.
What characteristics do you prize in new recruits?
Good self-awareness. Knowing when to step back and where your limitations are. Also being able to work as part of a team – it’s a large organisation that deals with very difficult subjects – everyone needs support occasionally.
Comms director, NICE
Senior comms manager, NICE
Corporate comms manager, NICE
Comms consultant, Fishburn Hedges
Comms officer, Liberal Democrats