The NHS needs strong leaders to bring it through its planned historic transformation. And if estimates of the size of the financial problems in the health service are accurate, it seems like there’s only going to be a short window of opportunity to get leadership right.
Pioneering new ways of thinking, promoting new cultures and kick-starting innovation requires people with influence to act differently and inspire staff working in the frontline to deliver new, quality and cost-effective services. This is a challenge that applies equally to those working in community pharmacy as it does to the rest of the health service.
Clare Price-Dowd, senior programme lead for professional leadership programmes at the NHS Leadership Academy, says that modern leaders need very special skills. She speaks to P3 about leadership and the work of the Academy, set up two years ago to play its part in accelerating change across a modernising health service.
‘You have to be brave to lead in the NHS these days, but not everyone allows themselves to fail. Therefore they don’t make those leadership decisions that might or might not be successful. But unless they try they will never know. We call it a leadership omission. For example, a healthcare manager could make a difference by setting up a new service, but does not, because they are frightened of commissioning the wrong thing, so they don’t commission anything,’ she explains.
Leadership is an important skill that can certainly be learned or refreshed, she says. ‘Are leaders born or are they made? We think it’s a bit of both. There are skills and models and tools that we can help people use, that empower them and will make them better leaders.’
The Leadership Academy’s programmes aim to help people to lead differently. ‘We expect people to be able to lead more effectively by having a better knowledge base, be empowered to be more challenging, to be brave and be able to make change.’ Leadership starts with understanding yourself and changing how you approach things. ‘It’s about being willing to change yourself,’ she says.
‘We’re trying to develop leaders who are nnovative, think differently and who try new approaches. There are all sorts of things that people can do in their own leadership practice to be better and more innovative leaders.
‘In the past there’s been very much an emphasis on teaching people management rather than leadership. Now there is a great emphasis on really compassionate, caring delivery of healthcare. We’ve seen that in some of the problems we’ve had in the health service; lack of leadership has always been flagged up as one of the contributing factors.
‘There’s been a lot of research that says that good leadership has a direct correlation with lower mortality rates, happier staff, less sickness and absence and generally better clinical outcomes and a better patient experience. So having an emphasis on being a good leader, a leader who can challenge, who can bring about change, working with other people, but also understanding themselves and the impact that they have, is really coming to the fore,’ says Dr Price-Dowd.
The NHS Leadership Academy programmes, launched last September, are tailored to the challenges of the health service, she says. This offers participants a unique opportunity. ‘Why would you send someone on a leadership programme that wasn’t based on their daily work? I think that’s been one of the issues with leadership programmes before – they’ve taken people away, given them skills, but not got them leading in an applied way – and that’s what we’ve tried to change.’
In fact, in one assessment, the performance of participants on the Academy’s postgraduate certificate was better when benchmarked against those on the same university’s MBA course, she says.
Community pharmacist Jonathan Mason of NHS England has recently been selected to join the NHS Executive fast-track programme for senior clinicians and business leaders. He started the 10 month course, which includes international study, in June.
He told P3: ‘Good leadership within the NHS, and more widely within health and care services, is vital if patients and the public are to receive the highest possible quality of care, and if healthcare services are to deliver optimal public value. Every pharmacist has the potential to be a leader within their own services, and for the communities they serve. Enhancing leadership skills will help pharmacists to provide better services for patients and communities.’
The NHS Leadership Academy would like more pharmacists to take part in its programmes. ‘We only have 12 pharmacists on the academic programme at the moment, but we would really like more. We could fill every cohort with doctors and nurses, but what we really want is a more diverse mix,’ says Dr Price-Dowd. Pharmacists are among several groups that are under-represented. However, she acknowledges that the more formal programmes may be most suitable for pharmacists working in larger organisations who can be more easily released from their day-to-day roles to study the more formal courses that the Academy offers. ‘It’s very difficult to study and learn and work. It’s not a programme to enter into lightly. Especially the masters, where you are looking at a one- to two-year commitment alongside a full-time job. But it can be incredibly rewarding.’
Pharmacists currently enrolled include those from Boots, Sainsbury’s and a pharmacist who works in a young offenders institution. Funding may be available to pharmacists directly involved in CCG commissioned services, and employers are also able to purchase places if required. ‘We have pharmacists on the three programmes that I manage – the Nye Bevan programme for executives, the Elizabeth Garrett Anderson programme for middle managers aspiring to senior and the Mary Seacole programme for front-line staff.
She is particularly interested in community pharmacists because of the unique commercial skills they can bring to a mixed group of learners – skills that she says are ‘greatly acking in the NHS’. ‘It’s very much a two-way thing. The NHS is looking to be more commercial and pharmacists have those skills that are not as apparent in other parts of the sector. The great thing is to get together and learn as part of a wide multi-professional group.’
While there may be few pharmacists who can be readily released from the pharmacy, one leadership programme in particular is directly accessible to anyone, including pharmacists, online and free of charge. She suggests that this could be a good place to start.
It may be that people find themselves in a very senior leadership position, but have not yet had any leadership training, she suggests.
‘We have a range of programmes that start with a completely online programme (the Edward Jenner Programme – Leadership Foundations), that anybody nationally and internationally worldwide can sign up to do. It’s self-directed; you do it in your own time.
Then there’s the postgraduate certificate (the Mary Seacole Programme – Leading Care I), a full masters in healthcare leadership (the Elizabeth Garrett Anderson Programme – Leading Care II) and an executive programme (the Nye Bevan Programme). The programmes are each named after key figures in healthcare.
The Edward Jenner programme is being redeveloped and relaunched, she says, because the current version, though still useful, was aimed at clinical staff. We are looking to have a generic clinical and non-clinical route available, and you are completely free do it in your own time with no charge.This is available now, if you can get past the clinical focus, online through our website.’ “We’re trying to bring in leaders who are innovative, think differently and who try new approaches”
The relaunched version will be available by the end of the year. The open access programme is already being used by around 16,000 people worldwide.
Another resource available is an online leadership self-assessment tool. ‘There are a number of questions, you rate yourself and it gives you personalised feedback.
‘There are lots of leadership assessment tools available, but we use one that’s been developed specifically with healthcare in mind. Your findings can form the basis of your personal development plan,’ says Ms Price-Dowd.
Taking up any opportunity to learn is a good idea, she suggests. ‘Leadership programmes will help you look at how your behaviours affect the culture and the climate you develop behind you, and how your team may or may not function because of your leadership style.’
‘We’re trying to establish the largest business school in this country, and we will achieve that. We’ve fantastic support from NHS England and the NHS generally. Last year we had 700 per cent over-subscription for the programmes.’ www.leadershipacademy.nhs.uk