Clinical leaders can improve care quality and help lead change – the NHS needs to do more to identify and train them

10 November 2015

The NHS is changing. Over the next four years it must integrate services, move care into the community, deliver a step-change in productivity and foster a new relationship with patients. That, very briefly, is the Five Year Forward View’s vision for the health service in 2020.

At the same time, the NHS is working to eradicate the pockets of poor-quality care that were revealed by the Keogh and Francis inquiries during the last Parliament.

Effective leadership will be vital to achieving both of these goals.

Reform’s latest health-policy report, An NHS leadership team for the future, released today, seeks to support this by exploring the potential contribution of clinical leadership. The authors, all young NHS doctors, draw on a body of international evidence to argue that clinical leaders – doctors who enter management roles after a period as front-line clinicians – are best placed to improve patient care and lead health service change.

The report evaluates the NHS’s existing approach to training clinical leaders and argues that it includes some examples of best practice but is fragmented. In consequence, the NHS is unable to consistently identify and train the clinical leaders of the future.

To rectify this, the report makes several suggestions for change. Firstly, it argues medical degree programmes need to incorporate management modules into their curricula.

Secondly, the report argues the NHS should invest in developing a transparent career pathway for clinician leaders. In the same way the academic clinical career pathway was developed to meet a need, a leadership career pathway could encourage medics to consider leadership and reduce the number who leave medicine to pursue other careers.

Finally, the report suggests the existing range of schemes for doctors to gain exposure to leadership needs to be rationalised into one national programme. This would enable to the NHS to assess the skills of its future leaders, train them to meet service requirements and deploy them to the best effect.

These measures, the report argues, would help to challenge the cultural divide between NHS management and clinicians. As Sir Hugh Taylor, Chair of Guy’s and St Thomas’ NHS Foundation Trust, writes in a foreword to the report, “…clinicians in our system have, too often, been encouraged to see leadership and management as a separate ‘dark art’ from which they are excluded and, too often, despise”.

It is the workforce who will make the NHS’s plan for its future a reality. The Five Year Forward View relies on harnessing their energy and talent. Reform to foster the clinical leaders of the future will help to harness this capability, support NHS transformation and give the NHS the greatest chance of delivering high-quality care in the future. As Sir Bruce Keogh, National Medical Director for NHS England, writes in a foreword to the report, “…clinical leaders of tomorrow must be developed today”.

Leo Ewbank, Researcher, Reform

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