LEADERSHIP AND MANAGEMENT
The further development of clinical leadership in acute trusts is reliant on managers and clinicians working in partnership, according toKate Hall, policy advisor for Monitor.
C
linical leadership has been the sub- ject of heated debate for some time,
with many seeing it as crucial to delivering more effective and efficient outcomes for patients.
Doctors will effectively be handed the reins in terms of overall spending through GP commissioning, but clinical leadership within hospitals is still open to debate.
Kate Hall, policy advisor for hospital foun- dation trust regulator Monitor, which is due to gain a much more prominent role under the reforms, said: “It is important to acknowledge that we have made signifi- cant steps forward in relation to clinical leadership in this country over the last few years.
“That said, there is still much opportunity for strengthening clinical leadership in our health system. One of the main challenges is that management is often something which is simply bolted onto doctors’ jobs, particularly at the clinical director level.
“We often do not enable doctors to fulfil or do justice to the role; training is insuf- ficient and support is not always provided. At the moment medical management is not a formally recognised route for doctors.
“There is often a skills gap, which could easily be addressed by offering training. In which other industries would we ask people to manage budgets and teams with- out appropriate training? In some cases it is unclear what our expectations of clinical management roles are; we do not always articulate these as well as we could, which does not help.”
According to Hall, the opportunity for in- creased clinical leadership is significant, with a particular need to focus on both quality and outcomes but also the non- clinical elements of leadership within hos- pitals.
She said: “There is a large part of the clini- cal director role which is non-clinical: lead- ing and influencing teams, holding people to account, and taking responsibility for efficient service delivery.”
So what efforts are being made to bring about these improvements?
38 | national health executive Mar/Apr 11
“A wide range of development programmes are available to clinicians either already in leadership positions or those who aspire to be; these range from programmes focusing on specific skills training, such as finance and marketing to general leadership de- velopment. Increasingly organisations are restructuring their clinical services to sup- port the medical management model.
“Many organisations have adopted or are beginning to adopt the Service Line Management approach. SLM identifies specialist clinical areas and enables their management as distinct operational units, normally headed up by a clinician.
“If you ask consultants what their main development needs are they would iden- tify training in areas such as finance, marketing and business planning. Whilst clinicians have an in-depth understanding of their clinical areas, they often need sup- port in addressing the more general areas associated with medical management.
“Clinicians have an in-depth knowledge of their particular areas and are best placed to understand the changes needed and the best way to do this. Non-clinical managers of course still have a role but it might well look quite different in the future.”
There is often a stereotypical image of cli- nicians and managers being at odds, but it is only when these two groups work to- gether that services significantly improve, she said: “When multi-professional groups work together as a team the results are
brilliant, not only for the quality and effi- ciency of services offered but also for the staff as well.
“This may seem obvious but too often it doesn’t work in this way and whilst there are many examples of great clinical lead- ership, we need to ensure robust clinical leadership is present across the whole health service, not just in pockets.”
Naturally as clinical leadership expands throughout the health service with GP con- sortia taking over control of NHS spend- ing, the development of clinical leadership within acute trusts will become even more important.
Hall states: “In the future I think clinical leaders will play a bigger role in the gen- eral management of services. My concern is that this transition might not be as quick as it needs to be.
Visit
www.monitor-nhsft.gov.uk Kate Hall
FOR MORE INFORMATION
“This could be a really exciting time for clinicians; they are in a position to truly lead service delivery but we have to train and support them to do this. At the same time we must learn to delegate the responsibility and all that goes with it, something which historically we have not been great at. Change for all of us.”
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