Responsive leadership development for medical leaders

A recent report from the Health Services Management Centre at the University of Birmingham and The King’s Fund provided an up-to-date picture of the state of medical leadership in NHS trusts today. Chris Ham, Chief Executive of The King’s Fund, argued that the view is not a positive one, suggesting that ‘medical leadership remains a minority interest on the margins of the NHS.’ 

‘There are many reasons that this might be the case,’ explains Vijaya Nath, Assistant Director in the Leadership Development Directorate at The King’s Fund. ‘Doctors put great focus on learning and developing their clinical skills but less on understanding their own development needs. Indeed, before the introduction of medical management and leadership development for doctors in the 1990s, they were not encouraged to think about this at all. Alongside this, management and leadership responsibilities are often seen as less attractive than clinical commitments.’ 

Vijaya argues that the focus of recent high-profile reports on quality of care and culture in the NHS mean that now, more then ever, we need to better support and develop our medical leaders. ‘The Francis report, the Keogh review and the Berwick response to Francis, all highlight the role of everyone involved in providing care. They emphasise the role that doctors, and others, have in being a part of the conversation around the quality of care, and call for individuals to work together as an effective multidisciplinary team for the good of the patient.’ 

Diagnosing and describing 

With these challenges in mind, how can we better support medical leaders to take on and excel in leadership roles? Vijaya has been working with her colleagues at the Fund to develop a new suite of medical leadership programmes: ‘All of our development programmes are based on the same premise: first, understanding specific needs and then developing tailored interventions which respond to that.’ 

The first step in the process to develop our programmes was to send a survey to all the doctors, and their sponsors, who have been involved in a Leadership Development programme at the Fund. ‘We asked them to tell us, in the current context, what they wanted us to pay more attention to,’ says Vijaya. ‘The responses reinforced content which was helpful and highlighted what worked well, what we should do more of and different ways of working with people.’

Following the survey, there was an engagement day for medical and clinical directors from England, Scotland, Northern Ireland and Wales. Vijaya explains the aim of the day: ‘We wanted to share the results of the survey and probe further, to help us better define what our new and revised programmes might look like.’ Attendees were asked questions about the leadership and development challenges facing doctors now and in the future, and how these might be addressed.

‘Participants were helping us to diagnose and describe the challenges they face; they were passionate about being involved and welcomed the opportunity to help shape our thinking,’ says Vijaya. ‘Their input gave us robust intelligence to base our revised programmes on their reality.’

Leading through change

‘The discussion prompted by these questions was insightful and wide ranging,’ reflects Vijaya. She notes recurring themes: ‘The flux in the system, and the pace of change, were issues that were raised, as was the drive to move to better integrated care models in the future. Doctors need help to make sense of these changes so that they can better understand what’s needed from them to lead.’

Vijaya explains how she and colleagues have used these insights to develop the programmes on offer: ‘We will be helping medical and nursing directors to understand how they can shape supportive and effective organisational cultures and the role of patient leadership and engagement in that. There will be opportunities for both multi- and uni-professional learning, with networking opportunities for emerging and senior medical leaders to work together to build medical engagement in their own systems.’

The programme for GPs is designed to make sense of the new NHS: ‘Many GPs want to understand their position in the wider health and social care system,’ says Vijaya. ‘This programme is designed for GPs who aspire to take on leadership and commissioning roles in the future, and it has been designed to take account of the time pressures which GPs told us about at the engagement day.’

Looking ahead to the upcoming programmes, Vijaya is excited about what they will offer: ‘The programmes will provide focused and responsive development for medical leaders, which will equip them well to deliver at a time of unprecedented change and challenge for the health service.’

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