Putting the individual at the centre of clinical leadership

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As a leadership consultant with a psychology background, I'm primarily interested with the individual, and here I'm looking at clinicians as individuals. What does the individual need in order to grow, develop, learn and ultimately make an impact across the wider system?

I read an article in the HSJ recently, NHS leadership in the recession, that talked about 'innate natural leadership [being] required to inspire a hard-pressed workforce'.

I think this is fascinating, as it brings us back to the individual first and foremost and an exploration of their leadership capacity and capability. How do you capture and articulate the concept of innate natural leadership?

The same article also talks about leaders as superstars who 'can adopt a new toolkit that embraces creativity, innovation, commerciality and deep financial awareness'. Of course these areas are vital, but we also need to ensure that the leader is grounded and confident at an intrinsically personal level.

For any leader (in this case the clinical leader), this includes an awareness of and belief in self, an awareness of their impact on others and being highly attuned to their own and others' emotions. It also requires them to reflect, support, challenge and be creative.

Lord Darzi's report one year on, High Quality Care for All: Our journey so far, highlights the need for a culture that enables 'all clinicians [to] feel able and obliged to step up and lead the changes required to improve quality for patients'. While this won't be easy, and isn't helped by the NHS facing tough financial times, it's still an exciting and remarkable opportunity.

It's right that clinical leaders should take ownership of budgets and be accountable for financial performance and quality.

However I think we shouldn't forget that when many clinicians entered their profession, these things were unlikely to have been top of their priority list. They were far more likely to have entered their profession with strongly held beliefs around direct and tangible patient care.

I believe that most clinicians, irrespective of their background or specialism, will strongly identify with their practice and hold values that are deeply rooted in patient health and wellbeing. When developing clinicians as leaders, we need to work with and develop that identity and truly appreciate the importance of those core values.  

The QIPP (quality, innovation, productivity and prevention) programme is key to building on the progress made with High Quality Care for All, and clinicians have a central and key role to play in delivering this.

We should support and develop clinicians as leaders who can make progressive and innovative changes at an organisational level.

At the same time, we also need to nurture clinicians as individuals. I strongly believe that only a leader who is in a healthy state of mind, both emotionally and behaviourally, can make a fundamental difference to the wider system.

But what do you think? We’d like to get your thoughts on what's important through comments on this blog, to feed into the content and design of our clinical leadership programmes.

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Mary E Hoult

Comment date
24 November 2009
This article is excellent (text book infact) sadly you only get good leadership when you recognize bad leadership and take the appropriate action.
There has been a great movement of senior leadership within the NHS to new key positions some good, but there are a number who should have been sacked for failure in their previous roles. We all know who they are.

Donna Lee

Comment date
10 December 2009
Thank you Gerard. This article is a timely reminder that, in both challenging and plentiful times, leadership requires authenticity, innovation and resilience but opens the debate about "where from and how"? By unlocking self-awareness at the core of in a person, there is a greater possibility for consistency for effective, yet more importantly, enduring leadership behaviours.

tricia woodhead

Comment date
11 December 2009
Leadership evolves from self awareness and confidence- we coach and develop these skills too late in the careers of medical staff to gain maximum benefit- We should start immediately post graduation.
Leadership requires on going coaching and learning- this is more frequent now but often conflicts for time with operational priorities ( of which there are far to many)
Leading is as much about the understanding and behaviour of followers and the realisation of where one needs to focus ones energy in an organisation. I sense that this too is ignored in clinical education enabling the balance of talents to be swayed towards one to one patient care and less towards continuous improvement of the way its delivered.

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