Learning to lead - New framework for doctors
Doctors can play a vital role in managing health services. The GMC has been working alongside the Joint Academy of Medical Royal Colleges and the NHS Institute for Innovation and Improvement, on a new project which aims to enhance engagement in medical leadership. Medical Advisors Dr Veronica Wilkie and Professor Sean Hilton explain.
High-quality healthcare places huge demands on societies for resources, driven by scientific advances, as well as cultural and political expectations. More than ever, doctors are finding that they not only need to manage their patients but they need to be part of the management and leadership of the system within which they work. To ensure society’s expectations and needs are met, all doctors need to be actively engaged in the management and leadership of health services.
The UK-wide Medical Leadership Competency Framework, led by the Academy of Medical Royal Colleges (AoMRC) and the NHS Institute for Innovation and Improvement (NHS Institute), is a response to the changing role of doctors in the 21st century. It is based on the principle of shared leadership i.e. that leadership occurs at every level and is not the sole responsibility of individuals at the top of their organisation. The Framework applies at all stages in a doctor’s training and career, although the emphasis and level of competency required will vary according to stage of career.
With its publication Management for Doctors, part of its core guidance on good medical practice, the GMC recognises the key role doctors play in management and leadership of the health service. The GMC has also been supportive of the development of a Medical Leadership Competency Framework.
‘A Framework such as this is long overdue. It will help doctors in all areas of their professional practice and assist them in developing management and leadership skills to complement their clinical competences.’ Sir Graeme Catto.
Development of the Framework has taken a highly inclusive approach, involving wide consultation with doctors at all stages of their career, as well as people involved in education and health service managers across the UK. The Steering Group, chaired by Dr Patricia Hamilton, President, Royal College of Paediatrics and Child Health, includes representatives from the AoMRC, NHS Institute, NHS Confederation, NHS Employers, Conference of Postgraduate Medical Education Deans, Medical Schools Council, Department of Health and British Medical Association.
Reference groups were established to represent stages of a doctor’s career: undergraduate, postgraduate and post-specialist certification. Input from the reference groups, and other focus groups, and testing the Framework in several medical education and service communities across the UK, have helped position the leadership competences within the reality of working in healthcare in the UK today.
‘As a Medical Director, I see the Framework as a practical tool that provides a clear means of identifying management and leadership learning opportunities for doctors…Mersey Care NHS Trust has been running a leadership development scheme for specialist registrars for over two years, in the form of an action learning set, facilitated by the Medical Director. The Framework fits very well with such a practical approach, providing the substrate for discussion, and focusing on the key skills that require assessment and further development.’
Dr David Fearnley, Mersey Care NHS Trust
The project team is working with the GMC to incorporate the Framework principles into Tomorrow’s Doctors – which sets out the standards, knowledge, skill and behaviours expected of new doctors – and with the AoMRC to develop postgraduate curricula for scrutiny by the Postgraduate Medical Education and Training Board. With an increasing recognition that medical leadership and engagement is essential to ensure the NHS provides high quality services, the Framework is a timely guide.
An online version of the Medical Leadership Competency Framework is available at www.institute.nhs.uk/mlcf. Visit www.institute.nhs.uk/medicalleadership for information on other project activities.
The Framework has been used as part of a special study module at Warwick Medical School. Feedback from students demonstrated that they understood leadership was relevant to them and that they needed to develop leadership skills right from day one as a doctor: ‘Leadership is important for all doctors and medical students; it’s making sure you are doing the right thing, for the right reasons to get the right outcome.’ (Steph Horne, 3rd year medical student).
Dr Neil Johnson, Module Leader at Warwick, says that he thinks: ‘this is a direct result of using the Framework to ensure that the course concentrated specifically on those aspects of leadership relevant in their early years as a doctor’.