The Care Quality Commission’s State of Care 2014/15 reports that three quarters of hospitals and one third of GP services inspected so far had problems with safety. If you listen carefully you will be able to hear the general public’s alarm being drowned out by the wall of groans of doctors up and down the country. Is this another crisis to be heaped upon an already demoralised workforce?
It would be easy to adopt Henry Kissinger’s glib comment: “There cannot be a crisis next week. My schedule is already full,” and carry on regardless. You may be familiar with some colleagues who will take on the ‘head in the sand’ approach or others who will shake their heads in the belief that we are facing a hopeless future.
Yet within the report there is real cause for optimism. Of 123 services that were re-inspected within a year of the original rating, 50% demonstrated measurable improvements.
Kissinger’s quote was made with his tongue firmly in his cheek. An alternative quote, which may sum up the attitude of the people who were involved in making these significant differences comes from another US politician, Rahm Emanuel, Mayor of Chicago: “You never let a good crisis go to waste. And what I mean by that is that it’s an opportunity to do things you could not do before.”
A crisis can lead to realisation that change is required; create focus and initiate momentum. A crisis can prove to be a powerful catalyst. However if the energy created is neither harnessed or channeled then, as with any catalytic reaction, an initial burst of noise, heat and light will result in not much of anything changing long term.
The CQC report identifies one of the three key factors which play a critical part in quality improvement to be ‘Engaged leaders building a shared ownership of quality and safety’.
If leadership is the key, then who are the leaders?
During a workshop at a recent conference that I attended a junior doctor asked the group “At what stage of her career should I start to consider developing my leadership skills”. In response, a senior doctor sagely advised her to concentrate on her clinical development and then to start thinking about leadership when reaching consultant level. This may be a common opinion – but how appropriate is that viewpoint?
The NHS Leadership Academy Framework states that ‘The Leadership Framework is based on the concept that leadership is not restricted to people who hold designated management and traditional leadership roles, but in fact is most successful whenever there is a shared responsibility for the success of the organisation, services or care being provided.’
In other words acts of leadership can come from anyone in the organisation. As a model it emphasises the responsibility of all staff in demonstrating appropriate behaviours, in seeking to contribute to the leadership process, to developing and empowering the leadership capacity of colleagues. Where tasks are complex and highly interdependent this idea of shared or distributed leadership is recognised to be more effective than simplistic linear hierarchy.
With this is mind it is better to start developing leadership skills as early as possible. They need to be nurtured and grown over time and with experience. Senior doctors can support juniors through mentoring and enabling with delegation, encouragement the offering opportunities. This may mean a change in style of leadership for these senior doctors. As a direct result this may include the need to change and redevelop their own leadership skills.
Leadership is a multifaceted collection of human behavioural skills which both deserve and require proactive, life-long developmental focus.
Oxford Medical Training is the UK’s leading provider of high quality career development for doctors of all levels. We specialise in advancing leadership, management, communication, interview and teaching skills in the medical environment through our courses, distance learning and one to one bespoke services.
