Medical leadership: moving to the sunnier side

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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.

Comments

Marc Farr

Position
Director of Information,
Organisation
East Kent Hospitals
Comment date
19 December 2013
Important that we try and remain glass half full, face to the sun. Important that we embrace the intellectual challenge of doing more for less, right first time. Important to add to above that technology must be seen as central to delivery of transformational leadership, people brave enough to smash through the IG culture of saying no and insisting technology at work as simple as it is at home. Lead by banning pagers and paper

Vijaya Nath

Position
Assistant Director,
Organisation
The King's Fund
Comment date
19 December 2013
Thank you Marc, really important relevant to @TheKingsFund: On Day 19 we ask when will health care catch up with digital developments? http://t.co/1yT4feFU7m #kfadvent https://t.co/xa67Ob6w6P . All leaders including Medical have to lead in the utilisation of technology .

John Byrne MRCGP

Position
Clinical Director,
Organisation
SOuthern Health Foundation Trust
Comment date
20 December 2013
Participation by medics in healthcare leadership is vital, however it's not a divine right, the skills must be developed and competencies demonstrated. Crucially, it must not undermine our clinical our corporate colleagues by suggesting that medics are potential system saviours. Recent evidence suggest that it's about high functioning teams and not heroic individuals.

Vijaya Nath

Position
Assistant Director,
Organisation
The King's Fund
Comment date
20 December 2013
Thank you, agree and important to recognise that there are generations of Medical Leaders, unlike their counterparts from non clinical disciplines who have not had development in management , leadership etc. As the we move into modernising medical careers , and opportunities to be developed are provided we will begin to be on more equal footing. Team working and working across organisations critical to delivering healthcare in 21st century. Taking a more optimistic view ,recognising more to be done.

Kostas Agath, …

Position
Medical Director,
Organisation
Addaction
Comment date
20 December 2013
Medical leadership should be seen in a framework that is broader than the traditional primary/ secondary care delivery system.
The third sector has provided a fertile ground to medical leadership, especially in the recovery orientated treatment of substance misuse - not many medical leaders know much about this evolution though.

Michael West

Position
Senior Fellow,
Organisation
The King's Fund
Comment date
20 December 2013
Thank you for focusing on a positive vision of the future Vijaya - a future in which all working in health and social take collective leadership responsibility for achieving the goals of their organizations and for ensuring high quality and compassionate care for their communities.

Ruth Taylor

Position
Deputy Dean,
Organisation
Anglia Ruskin University
Comment date
20 December 2013
Interesting blog Vijaya - so important to focus on medical leadership and great to read about the positivity surrounding the work that you and others are doing. As others have mentioned in the comments, it is vital that health professionals work together in leadership roles - what good is medical leadership without nursing leadership for example. Organisations will need cross profession leadership to prosper and to address the concerns around patient care that continue to be highlighted (as well as continuing to move forward with excellent practice - not trying to suggest that care isn't excellent in lots of areas). Leadership development needs to start early - with undergraduate students who can be leaders as they deliver care and who can help organisations to see where practice can improve as they move across and within organisations.

Vijaya Nath

Position
Assistant Director,
Organisation
The King's Fund
Comment date
20 December 2013
The new configuration of health and social care will, I hope, make the contribution of the third sector even more appreciated . Marie Curie & Macmillan for example doing great work in this space as is Addaction and we look forward to supporting Medical Leaders from all sectors alongside all the professions that deliver care .

Vijaya Nath

Position
Assistant Director,
Organisation
The King's Fund
Comment date
20 December 2013
Looking forward to progressing work with you and colleagues on Culture & Compassion. Collective Leadership the foundation of success

Vijaya Nath

Position
Assistant Director,
Organisation
The King's Fund
Comment date
20 December 2013
Thank you Ruth , yes interdependence amongst all the professionals delivering care needs to be recognised as does the start point for each individual . Critical to success is supporting this early in in training Role design.This requires collaboration and change at Royal Colleges, LETBY & HEE and Academic providers to enable workforce which 21 st century patients deserve .

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