Richard began his career in the private sector, working for a US-based management consultancy, specialising in strategy and organisational redesign. His move into the NHS via the Gateway to Leadership scheme in 2003 came around the same time that he was elected as a Councillor in Haringey, and he retains an interest in local government and social policy where it overlaps with health care in the community.

He has worked at Board level  across a range of NHS sectors including primary care, acute, community before moving into his current role in mental health in January 2017.