Public Health Leadership in Primary Care Practice: Everybody’s Business? (original) (raw)
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International Journal of Health Planning and Management, 2014
The paper revisits the theme of clinical leadership in UK countries, following an earlier (2009) review. It examines the competency-based approach; considers the emerging voices of clinical leaders; explores the results of evaluation research studies; identifies learning from intra-UK and international comparisons and considers the issue of leader development versus leadership development. It concludes that there is little conceptual clarity; that there continues to be a major disconnect between clinicians and managers; that different approaches to developing clinical leaders are emerging in different parts of the UK and that the major challenge remains to develop leadership, rather than leaders.
A critical account of the rise and spread of ‘leadership’: the case of UK healthcare
This paper considers the rise of ‘leadership’ in discourses relating to the British health service, and the application of the term to increasingly heterogeneous actors. Analysing interviews with NHS chief executives from the late 1990s, and key policy documents published since, the authors highlight how leadership has become a term of choice among policymakers, with positive cultural valences which previously predominant terms such as ‘management’ now lack. They note in particular how leadership is increasingly conferred not only on those in positions of formal power but on frontline clinicians, patients and even the public, and how not just the implementation but the design of policy is now constructed as being led by these groups. Such constructions of the distribution of power in the health service, however, contradict the picture drawn by academic work. The authors suggest, therefore, that part of the purpose of leadership discourse is to align the subjectivities of health-service stakeholders with policy intentions, making their implementation not just everyone’s responsibility, but part of everyone’s sense of self. Given the realities of organizational life for many of the subjects of leadership discourse, however, the extent to which leadership retains its current positive associations and ubiquity remains to be seen.
Leadership development in the English National Health Service: A counter narrative to inform policy
Objectives: To examine the current approach to leadership development in the English National Health Service (NHS) and consider its implications for nursing. To stimulate debate about the nature of leadership development in a range of health care settings. Background: Good leadership is central to the provision of high quality nursing care. This has focussed attention on the leadership development of nurses and other health care staff. It has been a key policy concern in the English NHS of late and fostered the growth of leadership development programmes founded on competency based approaches. Design: This is a policy review informed by the concept of episteme. Data sources: Relevant policy documents and related literature. Review methods: Using Foucault’s concept of episteme, leadership development policy is examined in context and a ‘counter narrative’ developed to demonstrate that current approaches are rooted in competency based accounts which constitute a limited, yet dominant narrative. Conclusion: Leadership takes many forms and varies hugely according to task and context. Acknowledging this in the form of a counter narrative offers a contribution to more constructive policy development in the English NHS and more widely. A more nuanced debate about leadership development and greater diversity in the provision of development programmes and activities is required. Leadership development has been advocated as being crucial to the advancement of nursing. Detailed analysis of its nature and function is essential if it is to meet the needs of nurse leaders.
BMJ, 2011
The overarching task of the NHS is not that complicated; it provides healthcare to the population in a fair manner (with perhaps a nod towards health improvement). It only becomes complex when the number of variables that influence this aim are considered: a politically ...
Barriers to doctors successfully delivering leadership in the NHS
Future Hospital Journal, 2016
Leadership will be essential to deliver the changes outlined in the Five year forward view and to ensure that the effi ciencies identifi ed in the Carter Review are delivered. To achieve the scale of savings outlined in these papers, while maintaining the quality and safety of care, all NHS staff will need to be involved in and to take the lead in identifying wasteful practice and procurement and, more importantly, to become the agents of change and architects of innovative and high-quality practice. However, many barriers exist to successful leadership by doctors in the NHS. In this article we present qualitative data from interviews with senior NHS leaders identifying several real-word barriers that need action to maximise the success of the medical profession in leading these changes.
Scandinavian journal of primary health care, 2017
To explore general practitioners' (GPs) views on leadership roles and leadership challenges in general practice and primary health care. We conducted focus groups (FGs) with 17 GPs. Norwegian primary health care. 17 GPs who attended a 5 d course on leadership in primary health care. Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. KEY POINTS Little is known...
Journal of the Royal Society of Medicine, 2014
Clinicians are being asked to play a major role leading the NHS. While much is written on about clinical leadership, little research in the medical literature has examined perceptions of the term or mapped the perceived attributes required for success. To capture the views of senior UK healthcare leaders regarding their perception of the term `clinical leadership' and the cultural backdrop in which it is being espoused. UK Healthcare sector PARTICIPANTS: Senior UK Healthcare leaders METHODS: Twenty senior healthcare leaders including a former Health Minister, NHS Executives, NHS Strategic Health Authority, PCT and Acute Trust chief executives and medical directors, Medical Deans and other key actors in the UK medical leadership arena were interviewed between 2010 and 2011 using a semi-structured interview technique. Using grounded theory, themes were identified and subsequently analysed in an attempt to answer the broad questions posed. Not applicable for a qualitative research ...