The conventional view is that clinicians should look after patients while administrators look after organisations. Yet clinicians have a role in both providing care and finding ways to improve it at an individual, organisational and system level. This means adopting a new set of leadership behaviours – not as a one-off task or project, but as a core part of professional identity.
When doctors and other clinicians lead, patient care improves, and the organisation performs better financially and clinically2. Practice managers, clerical and reception staff have an equally crucial leadership role.
The Skills for Primary Care Leaders
“Collective leadership” is where staff at all levels are empowered as individuals and in teams to act to improve care – ‘leadership of all, by all and for all’. This is in contrast to command and control cultures which are not conducive to achieving high quality care3.
To achieve collective leadership involves adopting a broad range of non-technical skills and behaviours to supplement clinical knowledge4:
- Understanding how health care is provided, funded and the political, economic, social and technological drivers for change
- Creating and communicating a vision, setting clear direction, service redesign and healthcare improvement, effective negotiation, awareness of both self and others, working collaboratively and networking
- Balancing competing interests and priorities and placing the patient at the centre of decision-making, rather than the organisation
- Managing oneself effectively and allowing others to lead (“followership”)
- Demonstrating personal values and beliefs that impact positively on staff
- Paying close attention to all staff, really understanding the situations they face, responding empathetically and taking thoughtful and appropriate action to help
- Understanding people are different and progressing equality
Ways To Develop Leadership
Leadership skills are developed in a variety of ways, through courses, mentoring, coaching, networking, action learning, quality improvement projects and on the job, self-directed learning. Please select the courses and articles tabs to explore what these mean and what’s available.
In Essex we provide a variety of leadership development opportunities for example by bringing the Next Generation GP programme to Essex in partnership with the ARU Medical School.
We also develop a range of local leadership programs and initiatives for example the Clinical Leadership Development programme in North East Essex delivered by the Kings Fund. Keep an eye out for newly released courses on our training and development page.
The NHS Leadership Academy also offers a range of programmes to support individuals wishing to pursue medical, clinical and business leadership development. More details can be found on the national and local websites.
References
1. Commission on Leadership and Management in the NHS (2011) Kings Fund
2. NHS Improvement (2016). Developing People – Improving care. Evidence-based national framework to guide action on improvement skill-building, leadership development and talent management for people in NHS-funded roles. https://improvement.nhs.uk/resources/developing-people-improving-care/
3. Bohmer R, (2012)The instrumental value of medical leadership Kings Fund
4. Mountford J, Webb C, Clinical leadership, unlocking high performance in health care. Mackinsey & company
Diagnostic Tools
A range of diagnostic tools are available to help individuals assess their leadership skills using a 360° appraisal mechanism and identify their learning needs.
Nine dimension Health care leadership model
Local 360 feedback facilitators
Quality Improvement
Quality improvement is a vital aspect of leadership and means “achieving better patient experience and outcomes through changing provider behaviour and organisation using a systematic change method and strategies6”. All methods focus on:
- Understanding the problem using data
- Understanding the patient pathway
- Analysing demand, capacity and flow
- Choosing tools to bring about change e.g. leadership, clinical engagement, skills development, and staff and patient participation
- Evaluating and measuring the impact of a change
See courses tab for programmes and learning sessions organised by NHS England
Experiential Learning
Experiential learning includes actively reading about leadership and taking on leadership projects, new jobs, secondments to other organisations, or part-time roles alongside ongoing clinical work.