Every doctor is a leader: six traits of effective everyday leadership
Charlie Massey's remarks at ConfedExpo, 14 June 2023.
Introduction
I’m really pleased to be joined by my colleagues Sue, Aneka, Chris and Tarryn to talk about the importance of clinical leadership and how it must be embedded in everyday medical practice.
I’ll hand over to them shortly but wanted to start by laying out why this is such a priority for us at the GMC.
Why leadership matters to patient care
I know that the concept of leadership can seem somewhat remote to doctors on the ground. And in a service that’s overstretched, there may be a temptation to deprioritise something that is seen as a ‘softer’ skill to focus efforts on meeting patient demand.
But this is a false economy. It is exactly in these moments of acute stress that leadership and professionalism matter more than ever. Because compassion, clear communication and strong teamwork are the foundations of good patient care.
All the evidence shows that when core leadership values are neglected, patient care suffers. And the impact on doctors is profound. Our own data demonstrate a clear link between the risk of burnout and the presence of visible leadership. In research we published in 2021, doctors with a high risk of burnout were more likely to disagree that clinical leaders were readily available, compared to doctors with a very low risk of burnout.
Therefore, I would argue that good professional behaviours act as a form of protection in terms of doctors’ wellbeing, which in turn supports the delivery of good care.
Research carried out for us by Professor Michael West and the late Dame Denise Coia made this clear.
It highlighted that doctor with high levels of burnout had between 45% and 63% higher odds of making a major medical error, compared with those who had low levels.
Indeed, this is reinforced by research we published in 2021, in which over two-thirds of doctors told us that workload pressure was a barrier to patient care.
The evidence is clear that there is a causal connection between professional behaviours and good patient outcomes. And that is the reason why promoting leadership is a core priority for the GMC.
Every doctor is a leader
The link between good culture and good care is one that needs to be embedded and emphasised throughout a clinician’s career.
Doctors don’t become leaders when they hit a certain level of seniority. Leadership is not the same as management – it’s about the way a doctor conducts themselves, and relates to those around them, every day. It’s a question of behaviours, rather than hierarchy or formal responsibilities. So, doctors are leaders from the earliest moments of their careers. Because the need to communicate clearly, exert judgement and reflect and learn apply at every stage of practice.
After all, who is better placed to lead change than the young doctor who’s just come out of medical school, seeing things for the first time? That fresh perspective is priceless and can be as transformational as the delivery of any formal organisational responsibility.
So whether it’s being bold in putting forward a new approach, or just having the presence of mind to speak up when something’s not right, every doctor has a duty to lead, and delivering on that duty is central to delivering first-class care.
Embodying these behaviours is all the more critical as standard models of care continue to evolve. In an age of multidisciplinary teams, working well alongside other professionals is an essential part of the toolkit of today’s doctor – not an optional extra, but rather an integral part of their practice.
Why leadership matters to workforce planning.
But for those behaviours to be centre stage, doctors and other healthcare professionals need to work in environments that support them. Indeed, inclusive, supportive environments are not only instrumental in the delivery of first-class patient care, but also in the retention of the workforce.
We know that being part of a supportive team and having a strong sense of belonging leads to higher satisfaction, lower risk of burnout and better patient safety – improving organisational performance overall.
Our own evidence shows the role wellbeing issues play in driving doctors out the service – our Completing the picture survey pinpoints dissatisfaction and burnout as two of the main reasons for doctors leaving UK practice.
New research we’ll publish shortly highlights how wellbeing issues are creating a vicious cycle of doctors voting with their feet, compounding workload pressures for those they leave behind.
We need to create virtuous cycles, cultures which make healthcare professionals feel valued, and which enable us to retain the workforce we so desperately need.
That’s why we believe compassionate clinical leadership is so fundamental, not only to doctors’ wellbeing, not only to patient care, but also to the future of the health service.
The role of leadership in the new Good medical practice
It’s this understanding that has led us to formalise the value of leadership through the updated version of Good medical practice, the professional standards all doctors must follow.
And I’d like to take the opportunity here to thank Confed’s Joan Saddler for her contributions to our advisory forum on the revised standards.
The new Good medical practice, which we’ll publish later in the summer, will strengthen the focus on professional behaviours, stressing their role in creating respectful, fair and supportive workplaces – workplaces that empower medical professionals to deliver high quality care.
The revised standards will also include a more explicit focus on leadership. And they’ll emphasise the role of doctors in shaping the culture of the organisations in which they work.
During the consultation process, we’ve seen widespread agreement around the need to champion leadership and supportive workplace cultures. There is now recognition that these values are material both to patient care and staff satisfaction – the question is how to make them a reality.
Because, despite their importance, we know that the concepts of professionalism and leadership may seem at one removed from the realities of everyday practice.
That’s why we need you – system leaders – to help make leadership feel meaningful on the ground.
The role of employers
A core part of this is the environment in which a doctor works. Employers have an essential role in creating and cultivating supportive, inclusive cultures that allow doctors and other healthcare professionals to thrive. Without this foundation, talk of leadership and compassion will ring hollow. At the most basic level, we, as leaders, have to practise what we preach – setting the tone through our own behaviours.
Then there’s the practical part employers have to play in recognising and developing leadership – from offering shadowing opportunities, to encouraging and enabling doctors to step into formal leadership roles. Mentorship is central here too, with an accessible, well established network giving hands-on support to build confidence and skills.
As Aneka and Sue will lay out, we need employers to play an active part. Rather than leadership being perceived as a well-meaning but distant concept, it needs, more consistently, to become a vivid, tangible way of operating. Celebrating and recognising those leaders who embody what good looks like is essential to making leadership feel real, and demonstrating the benefits both to doctors and those in their care.
Conclusion
In short, well supported doctors, who feel included and valued, deliver better care than those who feel isolated or marginalised. And they’re more likely to remain in UK practice, to the good of colleagues and patients alike.
That’s why embedding the power and importance of leadership is crucial not only to patient outcomes, but also staff satisfaction and therefore retention.
The revised Good medical practice is a formal recognition of this – emphasising the fundamental role of strong clinical leadership, both in good patient outcomes and the future of the healthcare workforce.
So it’s in all our interests to get this right. I look forward to working with you to ensure we do.
I’m now going to hand over to Aneka and Sue, who will take you through the leadership principles in a little more detail.
Thank you.
