The topic of ‘clinical leadership’ has the habit of bringing up all sorts of responses which, with the increasing amount of airtime it’s receiving, are more and more frequently being debated. In my experience so far, views vary from those keen to understand more and get involved, to the unconverted who assume it’s just another means of a small group of clinicians drawing attention to their careers.
This brings me onto the next issue, of why clinical leadership actually matters and whether it’s relevant to all doctors. Well, leadership and medicine have a long history together. For as long as people have sought health advice, doctors have been seen as leaders. All doctors, even F1s, are asked to lead clinical colleagues albeit in different capacities as we move through our training. What are we doing when we run a crash call…? Running a ward round…? Leading an audit project…? Doctors end up using some fairly sophisticated skills to manage these situations from their first days on the wards: advanced communication skills, assertion, delegation, team work, identifying a problem, stepping up to deal with it, analyzing the issues at hand, working out the problems ahead, the risks, communicating this with the people around you, winning confidence and setting a team on the ‘right’ course of action. As we develop throughout our careers we are expected to lead larger teams and ultimately services, departments and even hospitals, developing and applying these skills to an increasingly diverse set of situations. Yet I am not sure we always see these as examples of leadership. Nor do we always recognise how fundamentally important these skills are to good outcomes for our patients.
There is also a growing body of evidence demonstrating the link between services with good patient outcomes and satisfaction, and good clinical engagement with leadership and management. And conversely services that have poor outcomes, are often shown to have poor leadership and poor clinical engagement with managers. Personally, I see clinical leadership as an emerging field with similarities with the ‘evidence based medicine’ movement of about 30 years ago, which too was an emerging field itself. During this time, there were some strong proponents who felt it was key to the future of medicine, however the majority of doctors initially just didn’t understand how or why it was important to their everyday clinical practice. Yet today it’s an integrated part of every doctor’s education and the basis upon which clinicians make decisions about their patient’s care every day. I would argue clinical leadership is similar. In the future it’s set to be an integral part of all of our education and although there will be a minority who work exclusively in the field, it’ll be something we are all thinking about and taught in a much more conscious and structured manner.
A growing number of clinicians are recognising the opportunity we have to influence the way our NHS and healthcare services are organized and run. Many others also recognise that clinicians may be best placed to understand the needs of patients and that we may be best placed to understand how services can be developed to meet our patient’s needs.
At the end of the day, being a good medical leader is about inspiring others to look after patients better, not about improving doctors' CV’s. We, as doctors, need to take back and embrace our responsibility for the NHS. Our responsibility to make the NHS the best it can be; with our patients at the very heart of a safe and effective health system.
Anna Moore
Psychiatric Core Trainee from the Oxford Deanery
Currently seconded to Faculty as part of the Department of Health’s Clinical Fellow Scheme
This brings me onto the next issue, of why clinical leadership actually matters and whether it’s relevant to all doctors. Well, leadership and medicine have a long history together. For as long as people have sought health advice, doctors have been seen as leaders. All doctors, even F1s, are asked to lead clinical colleagues albeit in different capacities as we move through our training. What are we doing when we run a crash call…? Running a ward round…? Leading an audit project…? Doctors end up using some fairly sophisticated skills to manage these situations from their first days on the wards: advanced communication skills, assertion, delegation, team work, identifying a problem, stepping up to deal with it, analyzing the issues at hand, working out the problems ahead, the risks, communicating this with the people around you, winning confidence and setting a team on the ‘right’ course of action. As we develop throughout our careers we are expected to lead larger teams and ultimately services, departments and even hospitals, developing and applying these skills to an increasingly diverse set of situations. Yet I am not sure we always see these as examples of leadership. Nor do we always recognise how fundamentally important these skills are to good outcomes for our patients.
There is also a growing body of evidence demonstrating the link between services with good patient outcomes and satisfaction, and good clinical engagement with leadership and management. And conversely services that have poor outcomes, are often shown to have poor leadership and poor clinical engagement with managers. Personally, I see clinical leadership as an emerging field with similarities with the ‘evidence based medicine’ movement of about 30 years ago, which too was an emerging field itself. During this time, there were some strong proponents who felt it was key to the future of medicine, however the majority of doctors initially just didn’t understand how or why it was important to their everyday clinical practice. Yet today it’s an integrated part of every doctor’s education and the basis upon which clinicians make decisions about their patient’s care every day. I would argue clinical leadership is similar. In the future it’s set to be an integral part of all of our education and although there will be a minority who work exclusively in the field, it’ll be something we are all thinking about and taught in a much more conscious and structured manner.
A growing number of clinicians are recognising the opportunity we have to influence the way our NHS and healthcare services are organized and run. Many others also recognise that clinicians may be best placed to understand the needs of patients and that we may be best placed to understand how services can be developed to meet our patient’s needs.
At the end of the day, being a good medical leader is about inspiring others to look after patients better, not about improving doctors' CV’s. We, as doctors, need to take back and embrace our responsibility for the NHS. Our responsibility to make the NHS the best it can be; with our patients at the very heart of a safe and effective health system.
Anna Moore
Psychiatric Core Trainee from the Oxford Deanery
Currently seconded to Faculty as part of the Department of Health’s Clinical Fellow Scheme
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