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Medical leadership: moving to the sunnier side

We must change our language and behaviour about the capability of medical leadership, says Vijaya Nath.

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‘Medical leadership remains a minority interest on the margins of the NHS.’ So said Chris Ham earlier this year as he threw down the gauntlet to leaders in health.

I – and my colleagues in Leadership Development – have responded to this by trying to understand the roots of this issue and thus what changes we could make to support medical leadership while retaining the Fund’s commitment to developing the broader clinical and non-clinical community in the NHS. My previous blog on changing the systems of care sets out the challenges and the possible remedies.

In trying to determine how best to support medical leaders at all levels, we held an initial engagement day, followed by a series of masterclasses and then, on 6 December, our first development/network event for medical leaders from across the UK. We attended the Faculty of Medical Leaders and Managers (FMLM) annual conference and have continued to engage with leaders in our day-to-day work – for example, from our work on the views of responsible officers in London on revalidation. We have also redesigned our suite of medical leadership programmes.

Listening to the current challenges of doctors at different levels it is evident that although there is much more to do, there is also enormous optimism and a lot of positive energy that can be tapped into, which my colleagues and I are increasingly buoyed up by. This got me thinking about the language we use around medical leadership, and my wish as we move into 2014 is that we celebrate this optimism and, instead of talking about medical leadership moving to the ‘dark side’, talk about medical leadership moving to the ‘sunnier side’.

The panel of medical leaders at our development event last week had very diverse backgrounds, journeys to and experiences of medical leadership. The calibre of the participants, as well as their commitment to making a difference, was remarkable. We should do everything we can to celebrate that energy and to take forward the issues they have identified as important in increasing clinical engagement.

The challenges they identified – which reflected themes raised at other events – included: professionalising medical careers, listening to and harnessing the talent of junior doctors, and involving and recruiting more women to medical leadership roles. Several of the presentations illustrated the value of investing in medical leadership. Dr Tony Stevens of the Belfast Trust provided insight into the challenges of being a medical leader coming from a non-surgical, non-medical background. He observed that medical leaders often prefer to lead external initiatives, and he made a plea for them to focus their energy on leading their own organisation – including managing conflict and handling peers.

Dr Chris Jones, Deputy Chief Medical Officer in Wales, reminded us of the challenges presented to health professionals by the public holding up the NHS as a national treasure, and clinical leaders need to play their part in re-educating the public about the costs of and choices that need to be made about health care, especially if our vision of integrated care is to be achieved.

Celia Ingham Clark, who recently received her MBE for services to the NHS, reflected on the positives and negatives of being a woman in surgery – being referred to as 'poppet ' by a senior male leader, but also being encouraged to plan her next move by a forward-looking CEO. Although it was a difficult decision for her to step down from her role as a colorectal surgeon to become National Clinical Director for Enhanced Recovery and Acute Surgery for NHS England, her appointment is an important one in acknowledging and promoting talented and competent women into senior clinical roles in the NHS.

Probably the greatest endorsement for why we need to achieve a more positive outlook for medical leadership was the presentation by Dr Carolyn Johnston. Newly appointed as a consultant and a Darzi fellow, Carolyn reflected on what it is like to be on the sharp end of delivery, juggling motherhood and the sometimes unrealistic expectations of our youngest doctors. Her plea that we should be optimistic about what junior doctors can contribute to creating medical engagement and improving patient care should be heard at all levels of leadership in all sectors.

I started our development/network day with a quote from the late Nelson Mandela which included these words ‘...part of being optimistic is keeping one’s head pointed towards the sun, one’s feet moving forward…’  In the spirit of this quote, we must change our language and behaviour about the capability of medical leadership.