Medical Leadership and Management in the United Kingdom

Objective: This article aims to outline the historical development of medical leadership in the United Kingdom (UK), present recent advances, 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

The Beaker phenomenon and the genomic transformation of northwest Europe

From around 2750 to 2500 bc, Bell Beaker pottery became widespread across western and central Europe, before it disappeared between 2200 and 1800 bc. The forces that propelled its expansion are a matter of long-standing debate, and there is support for both cultural diffusion and migration having a role in this process. Here we present genome-wide data from 400 Neolithic, Copper Age and Bronze Age Europeans, including 226 individuals associated with Beaker-complex artefacts. We detected limited genetic affinity between Beaker-complex-associated individuals from Iberia and central Europe, and thus exclude migration as an important mechanism of spread between these two regions. However, migration had a key role in the further dissemination of the Beaker complex. We document this phenomenon most clearly in Britain, where the spread of the Beaker complex introduced high levels of steppe-related ancestry and was associated with the replacement of approximately 90% of Britain’s gene pool within a few hundred years, continuing the east-to-west expansion that had brought steppe-related ancestry into central and northern Europe over the previous centuries

The genetic history of the Southern Arc: a bridge between West Asia and Europe

By sequencing 727 ancient individuals from the Southern Arc (Anatolia and its neighbors in Southeastern Europe and West Asia) over 10,000 years, we contextualize its Chalcolithic period and Bronze Age (about 5000 to 1000 BCE), when extensive gene flow entangled it with the Eurasian steppe. Two streams of migration transmitted Caucasus and Anatolian/Levantine ancestry northward, and the Yamnaya pastoralists, formed on the steppe, then spread southward into the Balkans and across the Caucasus into Armenia, where they left numerous patrilineal descendants. Anatolia was transformed by intra–West Asian gene flow, with negligible impact of the later Yamnaya migrations. This contrasts with all other regions where Indo-European languages were spoken, suggesting that the homeland of the Indo-Anatolian language family was in West Asia, with only secondary dispersals of non-Anatolian Indo-Europeans from the steppe

Exploring the contextual factors influencing clinical leadership and patient experience

Introduction The NHS has prioritized the leadership development of healthcare professionals as a fundamental strategy for enhancing organizational outcomes and patient care (NHS Institute for Innovation and Improvement, 2011). Consequently, various leadership development programs, frameworks, and models have emerged to support this initiative. Despite the emphasis on patient experience as a quality-of-care indicator, the conceptual and evidential link between leadership development and patient experience has not been systematically investigated yet. Aim and objectives We present preliminary findings from an ongoing Delphi study aiming to investigate clinical staff perceptions regarding the relationship between leadership training and patient experience. Method Twenty participants were purposefully selected from physicians, nurses, physiotherapists, and pharmacists currently employed in the NHS. Recruitment took place through the Faculty of Medical Leadership and Management (FMLM) Clinical Leadership Fellowship program and the MSc Leadership Development Programme at Edge Hill University. Semi-structured interviews were conducted to gather in-depth insights into participants' views on the enablers and barriers to demonstrating clinical leadership. Thematic analysis, as outlined by Braun and Clarke (2006), was employed to identify patterns and themes within the interview data. Ethical approval was obtained from the Edge Hill University Health Research Ethics Committee. Findings Participants identified several enablers and barriers influencing their engagement in clinical leadership. Enablers included a strong commitment to continuous learning and development at both personal and organizational levels, an empowering work environment and organizational culture, possession of positive leadership traits and skills, participation in formal leadership training, organizational dedication to patient-centredness, and the ability to lead oneself. Conversely, participants reported barriers such as resistance to change and innovation, a limited focus on patient outcomes in leadership training, a lack of authority to challenge poor behaviours, limited opportunities for engaging in leadership activities, and a fear of repercussions for speaking up. Discussion These initial findings provide a foundational understanding of the complexities surrounding clinical leadership in the NHS and its impact on patient experiences. The identified enablers and barriers may serve as impetus for refining existing leadership programs and developing targeted interventions to address systemic challenges, so as to improve the experiences of patients. Furthermore, the identified contextual factors underscore the necessity of fostering an empowering environment that enhances clinical leadership effectiveness, aligning with the NHS's commitment to continuous improvement in patient care. We hope to provide additional insights that deepen our understanding of the complex relationship between clinical leadership and patient experience as the study advances through the Delphi process

Medical chief executives in the NHS : facilitators and barriers to their career progress

The quality of leadership and management define the difference between excellence and mediocrity and success and failure for all organisations. In my view good leaders inspire others and are able to align them towards a common goal. Good managers, on the other hand, simplify and streamline the way organisations work to achieve the organisational goals and maximise potential. These two are quite different functions. Not all leaders are good managers but most effective managers are also good leaders. In provider organisations the quality of clinical leadership always underpins the difference between exceptional and adequate clinical services which in aggregate determine the overall effectiveness, safety and reputation of every hospital. Similarly, effective clinical leadership in commissioning organisations brings perspective and challenge which in turn drives up clinical quality for the whole health economy. So, good clinical leadership is not an end in itself, it is a means to achieving high performing healthcare systems

Leadership and leadership development in health care: the evidence base

A key challenge facing all NHS organisations is to nurture cultures that ensure the delivery of continuously improving high-quality, safe and compassionate health care. Leadership is the most influential factor in shaping organisational culture and ensuring the necessary leadership behaviours, strategies and qualities are developed is fundamental. But what do we really know about leadership in health care services?The Faculty of Medical Leadership and Management, The King’s Fund and the Center for Creative Leadership share a commitment to evidence-based approaches to developing leadership and collectively initiated a review of the evidence by a team including clinicians, managers, psychologists, practitioners and project managers. This report summarises the evidence emerging from that review

Defining the structure of undergraduate medical leadership and management teaching and assessment in the UK

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