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Tomorrow’s leaders today

Peter Lees, chief executive and medical director at the Faculty of Medical Leadership and Management (FMLM), Dr Alex Till, national medical director’s clinical fellow at FMLM, and Tim Swanwick, senior clinical adviser and postgraduate Dean at Health Education England (HEE), discuss how to embed leadership and management within medical education.

“But what is striking when you look at the pool of potential NHS leaders of the future is just how few have a clinical background… it is time for urgent action to broaden and deepen the pool of people willing and able to step into NHS management roles.” Jeremy Hunt, secretary of state for health, 2016 

In life, we have windows of opportunity – opportunities for change and opportunities to make a difference. The undergraduate years are one such window and last month, three organisations working in collaboration – HEE, the NHS Leadership Academy and the FMLM – hosted the start of a national conversation about how to embed leadership and management within medical education. Clinical leadership is at the forefront of the agenda for our NHS with increasing recognition of its contribution to high-quality care, not just from politicians, but from across the service, the healthcare professions, the Department of Health, arm’s-length bodies and regulators. 

Harnessing the energy of over 100 passionate clinicians, medical educators and students, we aimed to share best practice and understand how we can better develop ‘Tomorrow’s Leaders Today’ through leadership and management training in the undergraduate medical curriculum. While there is no easy answer, the message was clear: leadership and management training should be built in, not bolted on. It is time medical schools, trusts, health boards and national organisations worked collaboratively to ensure medical leadership and management is explicitly integrated with incremental development into every undergraduate’s education. 

We welcomed in particular the voice of Colin Melville, director of education and standards at the GMC. He highlighted that the revision of Outcomes for Graduates, which sets out the knowledge, skills and behaviours expected of the newly minted UK medical graduate, will be founded upon the same principles as their recently launched Generic Professional Capabilities Framework for postgraduate medical education. This includes the domains of ‘leadership and team working’ and ‘patient safety and quality improvement’. Given the continuum between undergraduate and postgraduate curricula, there was much hope within the room that when consultation opens later in 2017, leadership and team working will be seen as a core domain, respected in equal measure along with professional values, skills and knowledge. Complementing FMLM’s Leadership and Management Standards for Medical Professionals with this approach, these documents by the GMC should help affirm the latest thinking that while caring for our patients is paramount, so too is caring for the organisations, systems and populations we work within – that’s what being a good doctor, a good leader, is all about. 

This is undoubtedly a welcome and huge step forward, but we have been here before with attempts to integrate Medical Leadership Competency Framework into curricula. What was missing was the ‘how?’ We must learn from our mistakes and consider a more holistic view of what we need in order to succeed in not just developing, but delivering a broader and deeper pool of the next generation of clinical leaders. 

We are still digesting our learning, but three key themes have emerged: 

• We need to identify untapped leadership opportunities which lurk unrecognised within the system. Whether in universities, on clinical attachments, or in the wide array of extra-curricular activities our undergraduates excel at, there are multiple opportunities in which to lead, reflect and learn – leadership development is not a one-size-fits-all methodology. We must embrace a vertical leadership approach, by providing experiences and helping each other make sense of the colliding perspectives we encounter as we grow together
• Leadership and management development should be for all, not just a selected few. But we do need opportunities for those with a particular interest or aptitude to thrive. Undergraduates are privileged to be able to follow their interests in a wide variety of student-selected aspects of their training – yet leadership opportunities and opportunities to gain a deeper understanding of the organisations and systems that they work within are limited. Progress is being made through expanding programmes such as intercalated degrees, as offered by the University of Birmingham, or student-selected components, as offered by the University of Glasgow. So there are many great examples to learn from, we just need to continue to expand these across our four nations 

• We need a strategic vision for medical leadership with a career structure that supports tomorrow’s leaders. Students have not just called for greater integration of leadership and management within the undergraduate curriculum, but for wider development of opportunities within the Foundation Programme and an offer to progress beyond that. 

It’s only the start of a conversation, but we agree with the health secretary: we do need to broaden and deepen the pool of people willing and able to step into NHS management roles, and this must start at the earliest of stages. At every level, we have strong, potential leaders lying dormant, it is time they are mobilised and the FMLM is here to help.

FOR MORE INFORMATION

W: www.fmlm.ac.uk