South Thames Foundation South Thames Foundation SchoolSchool
Faculty BriefingFaculty Briefing
2929thth January 2010 January 2010
Clinical Leadership in Clinical Leadership in FoundationFoundation
“ The doctor's frequent role as head of the healthcare team and commander of considerable clinical resource requires that greater attention is paid to management and leadership skills regardless of specialism. An acknowledgement of the leadership role of medicine is increasingly evident. "
Aspiring to Excellence, Prof John Tooke, 2008
Hospitals where clinicians are engaged in strategic planning and decision making are better performers than those where
clinicians are alienated from the strategic processes of the hospital
(Goldstein and Ward 2004).
‘Significant change in clinical domains cannot be achieved without the cooperation and support of clinicians. . .
(Bowns and McNulty, 1999, 66–7)
A Staffordshire NHS trust whose standard of emergency care led to patients dying needlessly showed a "lamentable failure of clinical leadership"
There is a need for clear and visible leadership at the top but this has to be linked with the development of leadership at all levels, especially clinical leadership in both primary care and hospitals.
Chris Ham - Professor of Health Policy and Management 2003
Doctors in society: medicalDoctors in society: medicalprofessionalism in a changing worldprofessionalism in a changing world
We recommend that the General Medical We recommend that the General Medical Council revises its important document, Council revises its important document, Tomorrow’s doctors, Tomorrow’s doctors, to strengthen to strengthen leadership and managerial skills as key leadership and managerial skills as key competencies of professional practice. competencies of professional practice.
Report of a Working Party of the Royal College Report of a Working Party of the Royal College of Physicians of London. London: RCP, 2005of Physicians of London. London: RCP, 2005
Doctors in society: medicalDoctors in society: medicalprofessionalism in a changing worldprofessionalism in a changing world
Report of a Working Party of the Royal College of Report of a Working Party of the Royal College of Physicians of London. London: RCP, 2005.Physicians of London. London: RCP, 2005.
CHMS particularly welcomes the recommendations to CHMS particularly welcomes the recommendations to strengthen clinical leadership. Medical Schools firmly strengthen clinical leadership. Medical Schools firmly believe that good leadership is fundamental to the rolebelieve that good leadership is fundamental to the role
of each and every doctor and that all doctors should of each and every doctor and that all doctors should demonstrate the potential to act as leaders when demonstrate the potential to act as leaders when required. required.
Professor David GordonProfessor David Gordon, Chair of The Council of Heads , Chair of The Council of Heads
of Medical Schools of Medical Schools
Next stage review -2008Next stage review -2008
For those at a postgraduate or equivalent stage in their careers, we will explore ways to ensure that both the curricula and appraisal processes reflect the importance of learning leadership skills.
Ara Darzi
Defining clinical leadershipDefining clinical leadership
“ “The essence of clinical leadership is to motivate, The essence of clinical leadership is to motivate, to inspire, to promote the values of the NHS, to to inspire, to promote the values of the NHS, to empower and to create a consistent focus on the empower and to create a consistent focus on the needs of the patients being served. Leadership needs of the patients being served. Leadership is necessary not just to maintain high standards is necessary not just to maintain high standards of care but to transform services to achieve even of care but to transform services to achieve even higher levels of excellence.”higher levels of excellence.”
(Department of Health, 2007)(Department of Health, 2007)
Defining clinical leadershipDefining clinical leadership
“ “ Driving service improvement and the Driving service improvement and the effective management of teams to provide effective management of teams to provide excellence in patient / client care”excellence in patient / client care”
Scottish Executive, 2005, p4Scottish Executive, 2005, p4
‘‘Teaching leadership in clinical Teaching leadership in clinical settingssettings
Curricula will have leadership Curricula will have leadership competencies embedded competencies embedded
Local clinical and managerial champions Local clinical and managerial champions to set up teaching leadership initiativesto set up teaching leadership initiatives
Use of Local faculty structuresUse of Local faculty structures Development of local resourcesDevelopment of local resources Development of ES and CS in teaching Development of ES and CS in teaching
and assessing leadership competencies.and assessing leadership competencies.
Leadership FrameworksLeadership Frameworks
BAMMBAMM NHSIINHSII AMRoC Medical Leadership Competency AMRoC Medical Leadership Competency
Framework April 2008Framework April 2008 AMRoC common competency framework AMRoC common competency framework
based on good medical practice based on good medical practice May 2009 specialty curriculaMay 2009 specialty curricula
KSS leadershipKSS leadershipSt Richard’s HospitalSt Richard’s Hospital
Western Sussex Western Sussex Hospitals Trust Hospitals Trust December 2009December 2009
Current leadership activityCurrent leadership activity
Trainees encouraged toTrainees encouraged to
Engage in AuditEngage in Audit ResearchResearch Represent their peersRepresent their peers Take on roles of responsibilityTake on roles of responsibility Teach Teach
More recently…More recently…
Expose trainees to variety of leadership Expose trainees to variety of leadership learning opportunitieslearning opportunities Taster daysTaster days HImP (Health Improvement Projects)HImP (Health Improvement Projects) Provision of medical Student OSCEProvision of medical Student OSCE Highlight influence of external drivers eg Highlight influence of external drivers eg
NICE, CNST and NPSANICE, CNST and NPSA
Taster DaysTaster Days
Obtain consent from Trust LeadersObtain consent from Trust Leaders Explain aims to CEO etcExplain aims to CEO etc Provide feedback form Provide feedback form Highlight opportunities to trainees via Highlight opportunities to trainees via
Educational SupervisorsEducational Supervisors Trainee to impart experience to peers at Trainee to impart experience to peers at
later datelater date
HImPHImP
Open forum to highlight areas for Open forum to highlight areas for improvementimprovement
Identify most significant issuesIdentify most significant issues Summarise Summarise Feedback actions requiredFeedback actions required Facilitate project managementFacilitate project management Present findings/solutionsPresent findings/solutions
Medical Student OSCEMedical Student OSCE
Familiar to all junior doctorsFamiliar to all junior doctors Encourages overall leadership to Encourages overall leadership to
coordinate the whole sessioncoordinate the whole session Encourages “micro” leadership to set up Encourages “micro” leadership to set up
and design individual stationsand design individual stations Encourages need for professionalism, time Encourages need for professionalism, time
management, assessment and feedbackmanagement, assessment and feedback
Leaders in the NHSLeaders in the NHS
NICENICE CNSTCNST NPSANPSA KSSKSS
Highlight the influence of agencies and Highlight the influence of agencies and how they effect Junior Doctors working how they effect Junior Doctors working lives lives
Opportunities to corroborate or refute Opportunities to corroborate or refute guidelines and policiesguidelines and policies
SummarySummary
Are there better ways?Are there better ways? Does everyone have to “do” Leadership or Does everyone have to “do” Leadership or
just be exposed?just be exposed? Leadership in bite sized bits (OSCE)Leadership in bite sized bits (OSCE) Leadership in context/relevant to NHS Leadership in context/relevant to NHS
agenciesagencies
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