I saw an advert in BMJ Careers last week. It is searching for a cohort of newly CCT’d doctors to be Senior Fellows in Clinical Leadership. This is the first time I have seen a job advert that is seeking consultants primarily for their management and leadership potential (other than medical director type posts). Clinical leadership posts have traditionally been seen as mainly clinical, with leadership bolted on the side.
In my blog, I’ll do my best to decipher the latest health publications and news, from GMC reports through to the Francis Inquiry. Hopefully this will be as informative to you (especially those with interviews coming up) as it will be for me! As clinicians, we are often blissfully unaware of the what is happening within the political arena of the NHS, even though much of what is decided in Whitehall will ultimately have an impact on the clinical environment we all work in.
The language of leadership permeates the NHS and often contains cliché and jargon. In June 2011 David Cameron gave a speech on the NHS reforms which was highly figurative and peppered with metaphor and simile. Here are some examples of the language he used – ‘frontline’; ‘in the driving seat’; ‘level playing field’; ‘cherry picking’; ‘sticking with the status quo is not an option’; ‘a National Health Service not a National Sickness Service’; ‘one size fits all’; ‘reinvent the wheel’; ‘let me be absolutely clear’.
A friend of mine suffers from bouts of anterior uveitis, a painful condition of the eye. She was on holiday in America recently when it flared up, and she saw a local ophthalmologist. On finding out my friend was from the UK the ophthalmologist exclaimed, “Well, you know that the world’s foremost expert on uveitis works in the UK? He is a professor of the anterior chamber of the eye. I was never ambitious enough to do all that. Me, I’m happy running my own clinic!”
I am known at my hospital for having worked at the National Patient Safety Agency. People approach me frequently with queries about the surgical safety checklist. Nearly all questions I can answer easily, but last week I was posed a problem that I still haven’t really got a good answer for.
Over the past year I have been fortunate enough to work on the North West Leadership Schools pilot, an initiative funded by the Strategic Health Authority and supported by the National Leadership Council. It involved trainee-led leadership schools across five different healthcare professions, with each group employing different approaches to develop their members’ leadership skills.
At present while 40% of doctors are female, only 28% hold consultant posts and only 8% of all consultants are female surgeons (Elston, 2009). This raises interesting questions about the nature and future of clinical leadership in surgery.
During an evening locum A&E shift recently, I referred a child for an orthopaedic opinion. An FY2 doctor discharged her home, after discussion with his registrar. The child was subsequently recalled to hospital the following morning following the morning consultant review of overnight X-rays, and underwent urgent surgery a few hours later.
I tell this story not to point fingers at the on-call orthopaedic team, who acted to the best of their considerable ability, but it brought to mind the thorny issue of senior clinical decision-making “out-of-hours.”
It’s week four, day three of the NHS Medical Director's Clinical Fellow Scheme with NHS Kidney Care for me and I’ve been thinking about what I’ve learned so far. For me, the key lessons of this first month have been: