At Clarity's Associate event in Birmingham, guest speaker Dr Sarah Schofield spoke about the future for Clinical Leadership
Current status of clinical leaders
Clinical leaders are embedded in a plethora of NHS organizations, most of whom are passionate about effective change in their area. However, attracting future clinical leaders can be a challenge. If a GP or hospital doctor want to do more than just their job, previously they have gone into education, as trainers are recognizable, accredited and there is a long-established training programme.
In the past often, people did not volunteer for clinical leadership roles, but were volunteered by others! However, recently, a more structured approach for helping people reach these senior roles has been developed. The need for a professional body was recognized and the Faculty of Medical Leadership and Management (FMLM) was created. It awards fellowships to doctors, which means there is now more recognition for clinical leaders.
Typically, Boards have been set with only one doctor and one nurse, which is the only representation from the medical workforce. In 2014 for the first time, female GPs outnumbered male. Recent data shows that only 15% of CCG chairs and vice chairs were female, even though over 70% of the CCG workforce is female. Encouragement and support should be given to change this so Boards are more representative of the organizations they serve.
Many doctors have a negative opinion of the clinical leadership role, believing that it takes them away from direct patient care and adds little value. This has been further compounded by the financial pressures faced by the NHS causing Boards to spend more time focusing on finances – there are examples of clinical leaders stepping down as a result of becoming dispirited. Recruitment of clinical staff is particularly challenging currently, for example in specialties such as A&E, psychiatry, GP and acute medicine. In terms of retention, experienced doctors are also threatened by the pension changes and choosing to retire early. Being unable to recruit and also to retain experienced doctors is a major challenge for patient care, but also for clinical leadership.
The NHS delights in 3 letter acronyms! ACOs (Accountable Care Organizations) have changed to become ACSs (Accountable Care Systems), which have then changed to ICSs (Integrated Care Systems)! New models of care have been embraced in many parts of the country, but sharing of best practice is slow. There is a fantastic opportunity to improve systems, but support is needed to rapidly promote what is actually working on the ground.
Leaders of the future
It is astonishing that new consultants and GPs would not want to shape their future working environment so this is the time to be involved with developing and implementing new and improved models of care. It is a good time to get the right people with the right skills involved, making it possible to put developmental programmes in place. The choice to become a clinical leader also needs to become a positive one. One way to change views would be to give people the opportunity to shadow current clinical leaders, enabling them to gain an insight into the role. Another is to alter the focus of board meetings back to improving care for patients, and supporting staff and colleagues so they can make a real difference.