Clinical Leadership: Bridging the divide

This is the story of a cohort of junior doctors who believe that if clinicians take leadership roles within health systems, results will be better for patients and work will be more stimulating for clinicians. In doing this, they are challenging traditional career paths and hierarchies. Each of them wants to share their expertise with others and to support others to become a leader.

This book sets out pointers for those who want to become clinical leaders. It seeks to inspire clinicians and managers from all disciplines to consider what clinical leadership could mean for them, their organisations and their patients.

Being a leader means being brave enough to stand up for what you believe. That is what each of the authors has done by offering their personal perspective in each chapter. Of course, this book is not complete, and some points covered are controversial. But leadership itself is never perfect or certain, and rarely is it uncontroversial. Leadership is rather about pursuing a direction which excites and which makes a difference, and taking others with you on the journey.

We have called this book 'Bridging the Divide'. As a group of junior doctors, we have tried to reach out across hierarchies, specialties and traditional boundaries. Almost invariably, we have found ourselves welcomed on the other side. This book encourages other aspiring leaders to be bold enough to cross the boundaries that divide `us and them' to deploy readers' knowledge and skills toward leading changes which will transformational the NHS.

After an introduction which discusses what we mean by clinical leadership, the book is split into three parts. Part 1 gives an overview of the political and economic history of healthcare, to better understand the origins of the current NHS setup and to provide an insight into the workings of the Department of Health.

The book then shifts gear in Part 2 to explore the range of individual skills and behaviours required for effective clinical leadership, followed in Part 3 by a discussion of the practical ways in which these can be developed and deployed. The final chapter brings together the strands to focus on what clinical leadership really means for healthcare professionals and why there is good reason to believe that we are entering a `golden era' for clinical leadership in the NHS.

This book is not just for doctors, but there is a particular focus on doctors and medical leadership. In part, this reflects the backgrounds of the authors as doctors. But also it is because doctors, in the main, are the frontline decision makers in healthcare. Often without realising it, doctors shape how resources are spent and the direction healthcare takes. Doctors are disproportionately powerful as instigators of or resistors of change.

Nonetheless, this book is relevant to all those who are passionate about what improving healthcare: clinicians of all disciplines and professional backgrounds, healthcare managers, policy leaders and academics. The purpose of the UK's NHS is to deliver great care to patients. Clinical leadership is not an end in itself; rather, it is an important enabler of organising healthcare to deliver higher quality, more efficiently. We hope that patients will also find light shed on many of the conundrums of the health service throughout this book.

The `Prepare to Lead' scheme began in 2007 as a pilot for six Fellows from
the Department of Biosurgery and Surgical Technology at Imperial College,
London.

The programme aims to develop leadership knowledge, skills and behaviours in junior doctors, and to do so alongside their clinical training.

In 2008, NHS London supported 18 new recruits to join three of the original participants in the `Prepare to Lead' mentoring scheme, and in 2009 a further 26 junior doctors were successfully matched with mentors. The authors of this book are from the 2008 `Prepare to Lead' cohort.

Each trainee was allocated a mentor, a senior NHS manager and leader: from an NHS Trust, a PCT, the Department of Health or another arms-length body to the NHS. Mentors come from both clinical and non-clinical backgrounds. A number of chapters are co-authored between mentor and mentee.

This book is unique in that it is written by junior doctors who are all
passionate to develop as leaders, in combination with senior leaders who have extensive experience of leadership.

This book is unique in that it is written by junior doctors who are all

passionate to develop as leaders, in combination with senior leaders who have extensive experience of leadership.

In 2008, NHS London set up a mentoring scheme, `Prepare to Lead', which paired 24 junior doctors with senior leaders within the health service in London (with both clinical and other backgrounds). Prepare to Lead aimed to equip the junior doctors with the skills and sense of purpose needed to become successful organizational and system leaders. Each of the 24 participants has co-authored a chapter, with several chapters being co-authored between mentor and mentee.

We are delighted that in 2009 `Prepare to Lead' recruited its second cohort of mentors and mentees and shows every sign of being an ongoing resource to improve the NHS.