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Thursday 20th October 2016

The future of NHS leadership

24th February 2009

Dr Peter Reader, clinical director of Human Europe and a member of the NHS Alliance national executive committee, examines the future of NHS management in the Health Service Journal.


Over the last ten years I have experienced a voyage of "development and discovery" upon which I have moved from being a GP into a management role. 

I have been lucky to have colleagues who have given me encouragement and support during this voyage. 

When I started out, these supporters were very important in what were harsh surroundings. Political splits between managers and clinicians were at their height in the climate of "post-fundholding fallout".

Although some of the same stigmas are around today, the push forward by managers has found substantial power, helped by the actions of bodies such as the British Association of Medical Managers and the NHS Alliance.

At present, there is evidence of even more action as venerable organisations such as the Royal College of Physicians acknowledge the importance of the roles played by clinicians in leading and managing the NHS.

The report Doctors in Society was published in December 2005 by the Royal College of Physicians and was a significant marker on this journey.

The Academy of Royal Colleges and the NHS Institute for Innovation and Improvement have also jointly published a framework that showed how doctors could receive management skills as part of their education.

Each person in the health service has something to learn about management and "we all have our part to play".

The Department of Health's next stage review "sees clinical leadership as a vital strand of sustainable innovation in the NHS."

When the national leadership council is fully formed it could prove crucially important to drive this innovation forward, although we will have to wait and see the effect it has within the NHS as a whole.

In December last year the Deaprtment of Health launched the practice based commissioning development framework, which sadly "has been rather strangled at birth by a number of factors and so this is a pivotal time and opportunity for primary care trusts and practice based commissioners alike".

Clinical leadership is waiting at the threshold for the next leap forward of "development and prominence" in the health service. The road ahead "may still hang in the balance" and will be determined by how the health service and its decision makers take hold of the chances laid out in front of them.


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