1. Developing as a medical leader The leadership of small things.. Saleem Farook Associate Postgraduate Dean North Western Deanery

2. Aims Why ? – the importance of developing as medical leaders What – we mean when we say medical leadership? How we should do it?

3. Background.. The times we live in... Services at full stretch Limited resources High expectations from the public Climate of continual change  Service reconfigurations  NHS reforms

4. The Charismatic leaders

5. Charismatic leaders “Charisma is a tricky thing..... Used wisely, it's a blessing; indulged, it can be a curse...Charismatic visionaries lead people ahead - and sometimes astray.” Fortune, January 15, 1996

6. Defining leadership.. Multitude of definitions Various qualities Different styles of leadership Vast literature

7. Shared (diffused) leadership Shared vision and a common cause Organisational effectiveness Team leadership Personal sense of achievement High readiness for change High concern & engagement

8. What is happening in the NHS? Hamilton, J. et al. Engaging Doctors: can doctors influence organisational performance? NHS Institute for innovation and improvement. 2008 Growing evidence of link between medical engagement and organisational performance

9. Aspiring to excellence “..greater attention is paid to management and leadership skills, regardless of the specialism. An acknowledgement of the leadership role of medicine...” - Prof. John. Tooke, 2008,

10. General Medical Council “ all practising doctors are responsible for use of resources... Doctors have responsibility to their patients, employers....This means doctors are both managers and are managed.” Management for doctors, 2006

11. Leadership or Management?

12. ManagerLeader Administers Maintains Focuses on systems Relies on control Does things right Innovates Develops Focuses on people Inspires trust Does the right thing Hollingsworth, M. J. The British Journal of Administrative Management. 1999

13. Leadership or Management? “..management and leadership are being seen as inextricably linked. It is one thing for a leader to propound a grand vision, but this is redundant unless the vision is managed so it becomes real achievement” Dearlove, D. Reinventing leadership. 2001

14. But where do we start?...

15. Medical Leadership Competency Framework AOMRC & NHS Institute for innovation and improvement. Enhancing engagement in medical leadership project. 2008.

16. Medical Leadership Competency Framework – Personal Qualities Self awareness Self management Self development Acting with integrity

17. Medical Leadership Competency Framework – Working with Others Developing networks Building relationships Encouraging contributions Working with teams

18. Medical Leadership Competency Framework – Managing Services Planning Managing resources Managing people Managing performance

19. Medical Leadership Competency Framework – Improving Services Ensuring patient safety Critically evaluating Encouraging improvement and innovation Facilitating transformation

20. Medical Leadership Competency Framework – Setting Direction Identifying the context for change Applying knowledge Making decisions Evaluating Impact

21. Medical Leadership Competency Framework UndergraduatePost-Specialist CertificationPostgraduate

22. A framework for leadership training in medicine Acknowledgement that ALL doctors require management and leadership competences to be effective practitioners; SOME take on service leadership roles AOMRC & NHS Institute for innovation and improvement. Enhancing engagement in medical leadership project. 2008.

23. This GMC guidance comes into effect on 12 March 2012..

24. So how do we develop as medical leaders?... Is attending a training course enough? If not, why not?

25. Back to basics.. The Kolb’s learning cycle Concrete Experience Reflective Observation Abstract Conceptualisation Active Experimentation

26. Copyright ©2003 BMJ Publishing Group Ltd. Carr, S Postgrad Med J 2003;79:622-626 Back to basics.. A simplified Kolb’s learning cycle

27. Back to basics.. An even more simplified Kolb’s learning cycle DO STUDY/ REFLECT ACT PLAN

28. Developing as a leader - Do Utilise opportunities at the clinical workplace But...Is simply “doing something” enough?

29. Developing as a leader– Reflect/ Study Reflective PRACTICE Knowledge of what is required Learning the theory Attending a course/ conference

30. Developing as a leader - Plan Linking with reflective practice/ study sessions Setting SMART objectives Incorporating learning needs into Personal Development Plans

31. Developing as a leader - Act Deliberate Practice Evidence of practice through portfolio Assessment and appraisal Seek and receive feedback

32. The importance of feedback Perform Feedback Reflect Study & Plan Feedback drives learning Assessment drives learning Improving Assessment. AoMRC. 2009.

33. How could leadership skills be acquired in clinical practice? It is the small things that matter..

34. Leadership Activities – examples.. Clinical Audit  Implementing recommendations to improve service Clinical Care Pathway  Working with colleagues Clinical incident analysis  Get involved in feedback and learning Managing clinical risk and patient safety programmes

35. Leadership Activities Often it is the small things that make a big difference... Often it is the smaller skills that achieve the big things...

40. Summary – Developing as a medical leader Awareness of the need Knowledge of the framework Utilising opportunities that exist within clinical practice One small step…