How doctors are using their management degree in the pandemic
Associate Professor, Cass Business School
Life does not get much better for academics when students apply their learning at work. But it is truly humbling when they are using their management education to save patients’ lives in the battle against coronavirus.
At Cass Business School we run a leadership and management master’s degree exclusively designed for medical doctors (Executive Master’s in Medical Leadership). The degree grew out of our research showing that hospitals perform better on average when they are led by doctors. But being a great clinician alone is not sufficient. Doctors also need the right leadership development, which until recently has been unavailable. With the formation of the Faculty of Medical Leadership and Management (FMLM), courses like ours, and importantly, access to Apprenticeship Levy funds, things are starting to change.
How are our frontline students using their learning? Apart from supporting each other through their course network, two areas dominate: leadership and change management.
Sanjiv Sharma, Medical Director at Great Ormond Street Hospital for Children, says the pandemic has tested the UK healthcare system like never before. He believes it is entirely appropriate that medical leaders have been at the centre of the response. “We have all seen good and bad examples of leadership over the past few weeks. Clinically led decision-making will need to continue when we switch services back to a new ‘steady state’ in potentially resource limited, covid-19 affected environments.”
With the help of leadership development professional Natasha Maw, we built in techniques such as personalised coaching and action learning. These were particularly helpful to Consultant Forensic Psychiatrist Adrian Cree when, at the start of the pandemic, he went through promotion from Medical Director to Group Medical Director at the Priory. “The coaching and action learning provided a safe space for me to be challenged, to reflect and work through important issues. Improved communication skills, problem solving, resilience, implementing change, and leadership style also helped me to hit the floor running in a way I don’t think would have been possible.”
Our research shows that being a competent leader effects employee morale and consequently their productivity. Intensive care doctor, Hanieh Asadi highlights the leadership skills she believes are needed now as “open and honest communication, to practice active listening, provide clarity around roles, lead by example, empower people, and realise the importance of non-verbal communication.”
In the months prior to the onset of the pandemic Hsien Chew, Head of Medical Services, Joint Ventures, HCA Healthcare UK, had already “put into place several interventions learned from the course to build my teams, including coaching, action learning groups and frontline ownership”, which he believes built trust and good will “and a necessary ballast against the impending anxiety, particularly during the choppy first wave of the pandemic”. Valuable to his mental health now, was to have “developed understanding about my own strengths and weaknesses, and to be able to share experiences with other members of my cohort with whom I have a rare, professional honesty.”
The strain across organisations and regions has been compounded by the acute emotional distress of caring for high volumes of critically ill patients coupled with high mortality rates, no family to support patients, and the difficulty of communicating through the barrier of hot and restrictive personal protective equipment. To cope with this, Nick Prince, Consultant Paediatric Intensivist at St Georges Hospital, has immersed his team in the theory of emotional intelligence where they are consciously practising techniques to encourage empathy and self-awareness.
While the coronavirus has been all consuming, Russell Durkin, Consultant in Emergency Medicine at the Royal Free Hospital, believes it has also revitalised the NHS. “Covid-19 has been the greatest example of change management that the NHS has seen since its formation. Barriers to change have been rapidly removed; organisations or departments have remodelled almost overnight; new ways for working have been trialled and tested; inter-disciplinary specialty collaboration has emerged effortlessly.”
Coronavirus has also brought about rapid change within primary and secondary care. Kirsty Gillgrass, GP and Clinical Director, in charge of Covid at Sheffield Clinical Commissioning Group, believes that a sound knowledge of transformational change theory has helped her develop new teams and structures. As clinical lead in Gold Command she has had to oversee new ways of working for the city, ensuring emergency care continues and deciding which services can be safely paused.
Change has been dramatic in the private sector also. Kate Oakland, Head of Digestive Diseases, Surgery and Anaesthetics, HCA Healthcare UK, has used theories of decision-making studied in multiple healthcare contexts to help her prioritise time-critical surgery, link up with NHS hospitals to free essential acute care beds, and coordinate the dispatch of ventilators to NHS Nightingale. “Without my master’s training I would have been less equipped to deal with the uncertainty and self-doubt we all faced”.
A large patient backlog is now a major worry for the medical profession. At the start of the pandemic the Royal College of Ophthalmologists issued guidance to cease all elective activity nationally. Ophthalmology departments have the highest number of outpatients in the NHS, accounting for nine million appointments a year. Bansri Lakhani, Ophthalmology Resident at Nottingham University Hospitals, used her learning to design, cost, and gain Board approval to implement a glaucoma virtual clinic to substantially increase outpatient capacity.
How have doctors reacted to the possibility that they may not gain a formal master’s award as part of their Apprenticeship Levy education? Over their years of training, doctors personally contribute thousands of pounds to postgraduate study and clinical exams. Accessing funds for their continuing professional development has been largely absent until the opportunities made possible by the Apprenticeship Levy.
Doctors are the frontline decision makers now and this is likely to last. More than ever they need high quality, tailored management education.
The degree for doctors Executive Master’s in Medical Leadership
Cass Medical Leaders Network is a LinkedIn group to support all doctors and medical leaders during coronavirus (sign up here to join group or copy link: https://www.linkedin.com/groups/8917789/).
A version of this article appeared in the Financial Times on 20 May 2020