Clinical leadership

Psychiatrists bring an important perspective to the leadership of an organisation.

This includes their expertise regarding the prevention, cause and treatment of mental and physical illness; their understanding of healthcare systems; their familiarity with evaluating complex information and evidence while managing uncertainty; and their links with external partners and stakeholders. Importantly, psychiatrists will often have experience from working within an organisation over many years. This ‘institutional knowledge’ can be vital to ensure an organisation is aware of its past when planning the future.

Due to the nature of delivery of healthcare interventions, particularly for mental health conditions, psychiatrists work in teams that bring together members from other professions. In that position, psychiatrists are likely to be the most senior members trained in the diagnosis and treatment of mental disorders and therefore have a key role in the clinical leadership of treatments these teams deliver.

Through the continuous personal development framework psychiatrists remain up to date with the evidence-based treatments that should be provided. They should play a key role in leading service and quality improvement locally, regionally and nationally, ensuring the efficient and targeted use of limited resources. Organisations need to work actively on medical engagement, internal decision-making and job-planning processes to ensure that psychiatrists are able to provide input into regional and national bodies, including local commissioning groups, the Royal College of Psychiatrists, universities and the NHS. Support for this work comes from the General Medical Council, chief medical officers and the national Departments of Health.

Psychiatrists typically work in multidisciplinary teams. They provide senior clinical leadership and expertise which should optimise the performance of the team, helping to ensure that the care needs and safety of patients are appropriately met. This leadership may be expressed in formal roles but also experienced more informally via the psychiatrist’s actions, integrity, values, credibility and consistency. Working in teams can be both rewarding and stressful and psychiatrists will often play an important role in supporting and promoting a positive culture.

Psychiatrists are often uniquely positioned to help identify and resolve complex problems and support staff through change.

Psychiatrists will also lead and manage teams in a way that supports the development of a culture of continuous improvement and learning. Again, this may occur in a variety of ways and at different levels within the organisation. Psychiatrists should promote reflection and review of standards, performance and policies. Participation in clinical audit and quality improvement systems will be important. Psychiatrists should offer expertise in the evaluation and management of risk and patient safety and should contribute to the review of near misses, adverse events and critical incidents. They should help promote standards in information governance systems, confidentiality and privacy. This may include:

• ensuring that the voice of patients and carers is captured and listened to
• facilitating regular time and space for team reflection
• monitoring quality and performance of the service through tracking key measures over time
• involving a wide range of stakeholders and data/information in helping the team identify their key improvement priorities
• utilising the quality improvement approach to think systemically about complex problems, developing potential change ideas and testing these in practice using the organisation’s quality improvement framework
• deploying resources to identified and agreed quality improvement projects and supporting staff in finding space and time for quality improvement
• supporting team members in developing an appropriate level of skill in quality improvement
• empowering the team to resolve local issues on a daily basis using the tools and methods of quality improvement without staff having to seek permission
• promoting awareness and understanding of quality improvement, and sharing learning and successes from quality improvement work
• taking a lead role as mental health experts in their local communities and work with primary care and local authorities, the third sector, patient/carer groups and employers to improve public mental health and reduce stigma.