The importance of good leadership skills in general practice is not a new issue. The Mid Staffordshire NHS Trust public enquiry called for stronger healthcare leadership and ‘the recognition that healthcare management and leadership is, or should be treated as a profession’.
Research has demonstrated the positive impact good leadership and effective teamwork has on patient outcomes and experience, as well as reducing costs, and is a key focus of training competencies. The CQC recognises that leadership is an essential element of delivering high quality patient care, and assesses this specifically during inspections.
However, despite all of our efforts, I find trainees still sometimes cannot shake that sense of a lack of authority and confidence to challenge bad practice or drive improvement.
Leadership is not just about being in a position of power: it is about working well with others, keeping the patients’ best interests at heart, keeping services working as effectively and efficiently as possible, and driving forward a vision of what better care can look like.
However, working in a world of requirements for quantitative evidence for all of our competencies, how can we truly measure what good medical leadership looks like?
The Faculty of Medical Leadership and Management (FMLM) was established in 2011 to promote the advancement of medical leadership, management and quality improvement at all stages of the medical career, for the benefit of patients. It has now released the Leadership and Management Standards for Medical Professionals, a set of standards by which doctors of all grades can benchmark themselves and be measured by.
It sets out the key competencies of the ‘gold-standard’ medical leader, looking at self-awareness and development, effective teamwork and the importance of being a corporate team player. The faculty makes it clear that these are open to evolution and evaluation, but they are an important first step in giving trainees the confidence to know they have both a duty, and a right, to step up and make a difference.
We have known leadership is an essential skill we need to develop in our trainees. We now know how we can measure progress and benchmark the qualities of a leader. But being such an intangible concept, how can we provide the elusive evidence?
The value of reflection and self-assessment cannot be underestimated. As well as helping tease apart challenging situations you have experienced for your own benefit, the very act itself demonstrates self-awareness and a commitment to development for your supervisors.
Use the FMLM standards to think about how you have demonstrated good leadership qualities and how these could be developed further.
Learn from mentors
Observing how mentors network and lead is a canny way of seeing how others do things differently, and allows you to pick out key skills you can adopt in your own practice. Attend practice meetings, CCG meetings and anything else someone you respect is involved in, and take with you a keen eye for how they act and how others perceive them.
A common adage in corporate life is ‘dress for the job you want, not the job you have’: we should also lead for the job we want, not the training post we have.
Put yourself forward to chair a practice meeting; volunteer to address complaints or serious untoward incidents. If you see a problem in the practice, think how this can be improved upon and constructively present your ideas to your team. Not only will you be developing your confidence and competencies for future leadership decisions, you will be demonstrating a commitment to your team and the organisation as a whole.
We are faced with barriers on an almost daily basis to dissuade us from having the confidence to take on more responsibility for personal and organisational development.
GPs have the privilege to shape the health and wellbeing of entire communities, and with this comes the duty to equip ourselves with the right skills to make a difference. Strong and competent leadership is needed to challenge culture and change things for the better - and we need to look to ourselves to meet this challenge.
The leaders of the future are developing themselves as the leaders of today.
- Dr Emily Phipps wrote this article while she was a clinical fellow at the Care Quality Commission. She is now training as an ACF ST2 Public Health in Thames Valley.