... to doctors
All doctors go into medicine because they want to make a difference to patient care. Education and training often emphasizes our role as clinicians in providing effective, compassionate and safe interventions in our patient encounters. However, GMC Outcomes for Graduates (2016) emphasise our wider responsibilities, many of which need leadership skills outside the realm of our clinical competencies: to lead, to work in partnership with colleagues, to understand and improve health care systems, to work with complexity and uncertainty and to accept shared accountability and to work with others to change systems when it is necessary for the benefit of patients.
The leadership skills needed for this are now taught from early on in but need honing and developing throughout a doctor’s career.
The Medical Leadership Competency Framework (PDF) is built on the concept of shared leadership where leadership is not restricted to people who hold designated leadership roles and where there is a shared sense of responsibility for the success of the organisation and its services. Acts of leadership can come from anyone in the organisation, as appropriate at different times, and are focused on the achievement of the group rather than of an individual. Therefore shared leadership actively supports effective teamwork.
The Framework sets out five domains and within each domain there are four elements. To deliver appropriate, safe and effective services, it is essential that any doctor is competent in each of the five domains
1. Demonstrating Personal Qualities
1.1 Developing self awareness
1.2 Managing yourself
1.3 Continuing personal development
1.4 Acting with integrity
2. Working with Others
2.1 Developing networks
2.2 Building and maintaining relationships
2.3 Encouraging contribution
2.4 Working within teams
3. Managing Services
3.2 Managing resources
3.3 Managing people
3.4 Managing performance
4. Improving Services
4.1 Ensuring patient safety
4.2 Critically evaluating
4.3 Encouraging improvement and innovation
4.4 Facilitating transformation
5. Setting Direction
5.1 Identifying the contexts for change
5.2 Applying knowledge and evidence
5.3 Making decisions
5.4 Evaluating impact
... to psychiatrists
The development of leadership skills is particularly relevant to psychiatrists and is emphasized in their training. They need to be comfortable working in challenging and complex situations. Their patients (and their carers) often have problems which are disabling and disenfranchising and they need to utilize relational and interpersonal skills as tools to navigate challenges. Much of what they do depends on their ability to work in large multidisciplinary teams and to operate within ever changing legal, commissioning and political frameworks. The landscape in which they work is dependent on understanding communities, working alongside primary care, acute services, social care and the non-statutory sector.