Medical engagement should be central to hospital leadership

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Medical engagement should be a central element of hospital leadership, not an optional extra, concludes a new report published today by The King’s Fund. Based on case studies from four trusts with high levels of medical engagement, the report states that sustained commitment from board to ward can improve medical engagement, which is closely linked to better clinical and organisational performance. 

The report reveals several common themes that are linked to strong medical engagement:  

  • long-term stable leadership, creating a firm foundation for cultural change based around improving quality and safety 
  • clear strategies for improving quality of care and staff involvement in leadership roles   
  • a strong medical leadership structure, with doctors in leadership roles at divisional and departmental levels with dedicated time to fulfil these roles
  • an emphasis on devolving authority to divisional and departmental leaders and creating a culture that encourages innovation 
  • recruitment of medical staff based on their values, not just their clinical expertise – this includes the use of psychometric tests and simulations against the organisation’s values and competency frameworks 
  • well-developed appraisal and revalidation processes with deeply ingrained talent management and succession planning and a broader focus on education and training 
  • a focus on encouraging young talent and on junior doctors participating in service improvement initiatives 
  • an organisational willingness to learn from national and international examples of best practice.

Vijaya Nath, Assistant Director of Leadership Development at The King’s Fund, said: 

‘High levels of medical engagement are strongly linked to good clinical and organisational performance. This is not something that should be left to chance, but should be central to an organisation’s leadership strategy. Many organisations still have poor medical engagement with few doctors taking up leadership positions. It is important organisations make medical engagement a priority to improve and sustain high-quality compassionate care.’  

Notes to editors

For further information, for a copy of the report or for interviews, please contact the Fund’s Press and Public Affairs team on 020 7307 2603 (if calling out of hours, please ring 07584 146035) or by

The report was based on interviews with a range of executives board members, and senior and junior doctors at the trusts. The four trusts are: 

  • Northumbria Healthcare NHS Foundation Trust 
  • Salford Royal NHS Foundation Trust 
  • Southern Health NHS Foundation Trust 
  • University College London Hospitals NHS Foundation Trust.

The King’s Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.