Partha Kar: Leadership without accountability benefits no oneBMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l248 (Published 24 January 2019) Cite this as: BMJ 2019;364:l248
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I was intrigued by Partha Kar’s piece on leadership accountability earlier this week. Partha observed that the NHS needs followers as well as leaders. I concur that not everybody aspires to a leadership position. However, in an NHS in which care is delivered by multidisciplinary teams that work within complex systems, those with the inclination to do so should be supported to switch interchangeably between the roles of leader and follower. We need good leadership at all levels of the NHS - it unlocks a multitude of opportunities to improve patient’s experiences and outcomes.
Health systems face wickedly complex challenges; a rapidly aging population, the rise of long-term conditions and co-morbidities, a belated but wide-reaching response of health system redesign, and a relentless drive for increased quality and productivity coupled with accelerating technological advance. All against a background of severe financial constraint. Healthcare isn’t delivered by individuals working in isolation, but by multidisciplinary teams working in complex systems that cross disciplinary and organisational boundaries. Effective clinicians need to understand these systems, and be able to work within - and with - them for the benefit of patients, their loved ones, colleagues and populations. That’s why it’s no longer enough to be a technical expert.
Leadership is no longer an option for clinicians; it is a responsibility.
In addition to the socio-political imperative, there’s growing evidence to support a strong relationship between high quality leadership and an organisation’s culture, and its impact on the quality of care for patients. When we consider the impact of clinicians being strongly engaged in leadership, the picture is equally as encouraging. For example, organisations where doctors have high levels of engagement, performed better on certain measures of performance than others.
The Academy believes that leadership skills are every bit as important as clinical skills, regardless of age or seniority. That’s why we offer programmes and resources for colleagues across the full spectrum. One example is the work we’re doing in collaboration with the Faculty of Medical Leadership and Management, the UK Medical Schools Council and Health Education England to increase leadership and management content within undergraduate curricula. Undergraduate students tell us they agree with the importance placed on leadership, and the need to start learning about it at an early stage in their career.
An abiding question for everyone working in health and social care is ‘what is my impact on others and how can I enhance this to enrich the lives of others?’ Creating the environment in which such discourse and practice flourishes is a leadership task. Everyone has a potential contribution. The question is not if the opportunities to improve exist, but if we choose to take them.
Competing interests: No competing interests