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Walpole S, Popat A, Blakey EP, Holden E, Whittaker B, Saggu R, Fennell-Wells A, Armit K, Hothi D. Health and social care professional standards need to be updated to advance leadership and action for environmental sustainability and planetary health. BMJ Lead 2024:leader-2023-000889. [PMID: 38233120 DOI: 10.1136/leader-2023-000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Human health is inextricably linked to planetary health. The desire to nurture and protect both concurrently requires the mitigation of healthcare-associated environmental harms and global initiatives that support sustainable lifestyles. Health leadership is important to bring adequate attention and action to address planetary health challenges. Health professionals are central to this endeavour, but the will and energy of a few will not be adequate to address this urgent challenge. STUDY We present an appraisal of the current UK health professional standards, frameworks and curricula to identify content related to planetary health and environmental sustainability. RESULTS No current UK health professional standard provides statements and competencies to guide practising and trainee health professionals to focus on and advance the sustainability agenda within their clinical practice and across wider healthcare systems. CONCLUSION Update of health professional standards is needed to ensure that health professionals in every specialty are supported and encouraged to lead the implementation of environmentally sustainable practices within the health sector and advocate for planetary health.
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Affiliation(s)
- Sarah Walpole
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
| | - Aneka Popat
- General Medical Council, London, UK
- Occupational Health, London North West University Healthcare NHS Trust, London, UK
| | | | - Eleanor Holden
- Medical Physics and Clinical Engineering, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Office of the Chief Scientific Officer, NHS England, London, UK
- Medical Physics, The Harley Street Clinic, HCA, London, UK
| | - Ben Whittaker
- Centre for Sustainable Healthcare, Oxford, UK
- Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Ravijyot Saggu
- Central London Community Healthcare NHS Trust, London, UK
| | | | - Kirsten Armit
- Faculty of Medical Leadership and Management, London, UK
| | - Daljit Hothi
- Faculty of Medical Leadership and Management, London, UK
- Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Millar KR, James C, Headon H, Afzal A, Lipton J, Armit K, McKimm J. Generic professional capabilities hub: developing leadership and management skills in trainees. BMJ Lead 2023:leader-2023-000872. [PMID: 37918905 DOI: 10.1136/leader-2023-000872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
High quality leadership is key to delivering high standards of patient care. For many reasons, doctors in training are not currently well represented in leadership positions and struggle to access opportunities to develop these skills. As a key cohort within the medical workforce, using existing present opportunities within clinical training programmes would allow them to engage in leadership development and support them to lead on projects within their trusts and make sustainable changes within their own organisation.Within our anaesthetic department, we designed the Generic Professional Capabilities Hub (GPC hub)-a framework that aims to address some of the barriers to engagement in clinical leadership. Involvement in the GPC hub can be at three different levels, which allows for flexibility around other training needs. Currently, there are seven workstreams within the framework, with trainees being involved through symposia attendance, leading on projects linked to the hub or becoming a trainee workstream lead. We share our learning from setting up this framework, the benefits it brings to trainees and departments, initial evaluation results and our next steps which include regional roll out to four other anaesthetic departments.
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Affiliation(s)
| | | | | | - Azka Afzal
- Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Joseph Lipton
- Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Kirsten Armit
- Faculty of Medical Leadership and Management, London, UK
| | - Judy McKimm
- Swansea University Medical School, Swansea, UK
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Jones L, Armit K, Haynes A, Lees P. Role of medical leaders in integrated care systems: what can be learnt from previous research? leader 2022:leader-2022-000655. [DOI: 10.1136/leader-2022-000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/25/2022] [Indexed: 11/03/2022]
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McKimm J, Lees P, Armit K, Mills C. Evaluating the impact of a national strategic leader development programme for UK doctors: myth-busting, mind-changing, mood-enhancing. leader 2021; 6:199-205. [DOI: 10.1136/leader-2021-000464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 10/03/2021] [Indexed: 11/04/2022]
Abstract
BackgroundThe drive towards engaging UK doctors in clinical leadership and management has involved many initiatives at various levels.MethodsThis paper reports on the findings of an in-depth evaluation of a national medical leadership programme for doctors in the late stages of specialty or general practitioner (GP) training or have just become consultants or GPs.ResultsThe evaluation clearly demonstrates the impact of this programme and the benefits for the individuals and organisations involved, particularly around stimulating a shift in mood and a major mindset shift in what medical leadership is (and is not) and what they can achieve as medical leaders. The programme structure and activities allowed participants to learn from a range of senior decision-makers about policy and strategic developments and processes. However, the evaluation also highlighted that some pervasive myths still exist around medical leadership and management which, if not addressed, will hamper efforts to fully engage doctors in taking on strategic leadership roles.ConclusionClinical leadership programmes are valuable, but must be carefully managed to extract the full value from them.
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Lees P, Armit K. Promoting and learning from leadership research: 10 years on. leader 2021; 6:4-5. [DOI: 10.1136/leader-2021-000498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/24/2021] [Indexed: 11/03/2022]
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Lees P, Armit K. UK approach to embedding medical leadership: progress and challenges. leader 2020. [DOI: 10.1136/leader-2020-000220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BackgroundThe drive towards engaging UK doctors in clinical leadership and management has involved a number of initiatives at various levels, including specific fellowships for doctors in training which enable them to take a year out of programme to work with senior leaders on service improvement or policy development projects.ObjectivesThis paper reports on the findings of an impact evaluation of a national Fellowship Scheme for doctors in training. The evaluation aimed to determine: What were the key success factors and areas for improvement of the Scheme? How did the Fellows experience the Scheme and how has this influenced their subsequent engagement, behaviours and thinking about healthcare leadership and management? What was the perceived impact of the Scheme?ParticipantsSix cohorts of Fellows and key stakeholders were involved in the evaluation .ResultsThe evaluation has clearly demonstrated the impact of this long-standing national Fellowship Scheme and the huge benefits for the individuals and organisations involved. For the Fellows, a national scheme such as this provides a unique experience, allowing them to learn first-hand from a range of senior decision-makers and engage in policy and strategic developments and processes.ConclusionsThis evaluation has demonstrated the wide impact of the Scheme but has also highlighted that more evaluations are needed of the wide range of fellowship schemes on offer to evidence broader impact, and raised issues around some of the difficulties these Fellows encounter on their return to practice in using their new skills to engage in service and healthcare improvement initiatives.
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Abstract
OBJECTIVE This article aims to outline the historical development of medical leadership in the United Kingdom (UK), present recent advances, and discuss professional development and future prospects. CONCLUSIONS With increasing involvement of medical professionals in top managerial roles in the UK over the last 30 years, leadership development initiatives have been growing steadily and there is increasing recognition of the need for leadership and management skills for doctors. Such skills can help to greatly improve patient care as well as enhance organisational effectiveness and productivity. The central involvement of professional bodies such as the UK Faculty of Medical Leadership and Management, and the establishment of medical fellowship schemes, have provided a solid foundation for a new generation of aspiring medical leaders but there is still a long way to go to achieve a higher degree of professionalism for clinical leadership in the UK. The evidence base is weak such that integrated efforts by clinicians and management academics have much to offer in achieving the vision of socially responsible, clinically relevant and research informed medical leadership training.
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Affiliation(s)
- Yiannis Kyratsis
- Lecturer, Health Management and Leadership, School of Health Sciences, City University London, London, UK
| | - Kirsten Armit
- Chief Operating Officer, Faculty of Medical Leadership and Management, London, UK
| | - Azra Zyada
- Senior Research and Development Fellow, Cass Business School, City University London, London, UK
| | - Peter Lees
- Chief Executive and Medical Director, Faculty of Medical Leadership and Management, London, UK
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Stringfellow TD, Rohrer RM, Loewenthal L, Gorrard-Smith C, Sheriff IHN, Armit K, Lees PD, Spurgeon PC. Defining the structure of undergraduate medical leadership and management teaching and assessment in the UK. Med Teach 2015; 37:747-754. [PMID: 25301039 DOI: 10.3109/0142159x.2014.971723] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Medical leadership and management (MLM) skills are essential in preventing failings of healthcare; it is unknown how these attitudes can be developed during undergraduate medical education. This paper aims to quantify interest in MLM and recommends preferred methods of teaching and assessment at UK medical schools. Two questionnaires were developed, one sent to all UK medical school faculties, to assess executed and planned curriculum changes, and the other sent to medical students nationally to assess their preferences for teaching and assessment. Forty-eight percent of UK medical schools and 260 individual student responses were recorded. Student responses represented 60% of UK medical schools. 65% of schools valued or highly valued the importance of teaching MLM topics, compared with 93.2% of students. Students' favoured teaching methods were seminars or lectures (89.4%) and audit and quality improvement (QI) projects (77.8%). Medical schools preferred portfolio entries (55%) and presentations (35%) as assessment methods, whilst simulation exercises (76%) and audit reports (61%) were preferred by students. Preferred methods encompass experiential learning or simulation and a greater emphasis should be placed on encouraging student audit and QI projects. The curriculum changes necessary could be achieved via further integration into future editions of Tomorrow's Doctors.
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Affiliation(s)
| | | | | | | | | | | | - Peter D Lees
- e Faculty of Medical Leadership and Management , UK
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Abstract
OBJECTIVES To investigate the experiences of doctors who become chief executives of NHS organizations, with the aim of understanding their career paths and the facilitators and barriers encountered along the way. DESIGN Twenty-two medical chief executives were identified and of these 20 were interviewed. In addition two former medical chief executives were interviewed. Information was collected about the age at which they became chief executives, the number of chief executive posts held, the training they received, and the opportunities, challenges and risks they experienced. SETTING All NHS organizations in the United Kingdom in 2009. RESULTS The age of medical chief executives on first appointment ranged from 36 to 64 years, the average being 48 years. The majority of those interviewed were either in their first chief executive post or had stepped down having held only one such post. The training and development accessed en route to becoming chief executives was highly variable. Interviewees were positive about the opportunity to bring about organizational and service improvement on a bigger scale than is possible in clinical work. At the same time, they emphasized the insecurities associated with being a chief executive. Doctors who become chief executives experience a change in their professional identity and the role of leaders occupying hybrid positions is not well recognized. CONCLUSIONS Doctors who become chief executives are self-styled 'keen amateurs' and there is a need to provide more structured support to enable them to become skilled professionals. The new faculty of medical leadership and management could have an important role in this process.
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Affiliation(s)
- Chris Ham
- The King's Fund, 11-13 Cavendish Square, London, UK.
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