You are here:

• Home
• Publications
• GMCtoday archive
• Views from outside the GMC
• Leading on leadership

All the latest news and views from GMC

Features: Leading on leadership

25 March 2009

Pippa Gough and Abigail Masterson, Assistant Directors in Clinical Quality at the Health Foundation look at leadership roles in today's clinical environments.

The governments in all four parts of the UK are investing heavily in clinical leadership development in order to improve the quality of services. But what does leadership for improvement look like and how should it be developed?

Traditional conceptualisations of leadership were based on the model of a single ‘heroic’ leader who took responsibility for ‘driving’ the service forward and acted as a central focus for everyone else’s collaborative effort. In this model the leader has to be all-knowing and take the blame when the master plan fails.

However, successful service improvement is likely to require all those involved in a service to make an active contribution and accept responsibility for delivering the improvement rather than leaving it all to one single leader. Instead, the leader’s role is to explore what needs to be done and to facilitate a process which motivates people to agree and work out how to do these things. The leadership process is ‘co-created’. It becomes one of enabling the ‘community’ of staff, service users, carers and other agencies to contribute to planning and implementing the improvement, and to work skillfully through differences to develop solutions.

The role of today’s clinical leader, therefore, is not to produce all the answers but to provide and hold the space that enables groups, teams, organisations and communities to find their own way forward and their own solutions to problems as they arise; to ‘co-produce’ the improvements required. The leader asks the hard questions, promotes and maintains dialogue, and provides support.

A plethora of leadership programmes is emerging but the best way of learning to be such a new-style leader remains elusive. The available literature and our own experiences suggest that work based leadership schemes are the most effective and that action learning in multidisciplinary groups can also be particularly valuable.

Organisational support is vitally important for those individuals and teams aspiring to lead change, and for those who are already modelling improvement attitudes and behaviours.