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The importance of integrated care has been emphasised in all healthcare systems across the UK. All recognise the interdependence of systems of care and the need for multi-disciplinary team working, across the whole continuum of care needs and pathways. A more inclusive and collaborative leadership approach is essential to maximise effectiveness, efficiency and outcomes. This involves an eagerness to understand the perspectives and challenges of other parts of the healthcare system in which they work, including consideration of the impact on local, regional and national populations.

Systems leadership is a critical component of medical leadership and can be defined as: “Leadership across organisational and geopolitical boundaries, beyond individual professional disciplines, within a range of organisational and stakeholder cultures, often without direct managerial control.” [1]

The effective medically qualified leader understands and contributes positively to the healthcare system. They are adept in dealing with complexity and ambiguity. They translate policy into practice and negotiate effectively with organisations across the system to meet the needs of the population.

Application for FMLM Fellowship

Effective system leadership is crucial in optimising future patient care within the UK. The combination of an increasing elderly population surviving illnesses, the increasing likelihood of co-morbidities, the cost of improved medical technologies and the need to effectively manage the healthcare budget necessitates the development of medical leaders capable of understanding complexity and driving appropriate interventions.

To deliver this, a medical leader will require an appropriate level of experience and be able to demonstrate the qualities defined above. This forms a major requirement for the award of Senior Fellowship.

System leadership

An effective medically qualified manager or leader who meets the Standards:

  • Demonstrates effectiveness in contributing to and influencing policy development
  • Seeks to understand and positively influence strategy and culture within and beyond their own organisation
  • Demonstrates ability to negotiate effectively
  • Demonstrates situational awareness in the handling of complex, challenging or ambiguous circumstances
  • Demonstrates sensitivity when working with a wide range of stakeholders
  • Demonstrates respectful communication and engagement, considering the perspectives, considerations and feedback of stakeholders
  • Promotes the alignment of clinical colleagues within the system in which they operate
  • Exhibits awareness and knowledge of population health and how to improve it.

[1] Ghate, D., Lewis, J., Welbourn, D. (2013) Exceptional Leadership in Exceptional Times: Synthesis paper. The Virtual Staff College. Retrieved from:

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