Leadership in the NHS
Jon Rouse
The NHS Long Term Plan was released in January with a clear thread leading from the ‘Five Year Forward View’ toward more place based, integrated care. There is an acknowledgement within the plan that workforce challenges are some of the biggest issues facing the NHS in the coming years and that ‘how’ we deliver services in the future will need to be significantly transformed.
With this in mind the leadership of not only our health and care services becomes key if we are to deliver the quality, access, prevention and cost outcomes we are seeking. Here in Greater Manchester we are going one step further to look at leadership across our wider public services.
Leadership begins with clarity of vision and in Greater Manchester we have this clarity through the strategies supporting the devolution of health and care and the wider system. With the support of the Mayor of Greater Manchester, Andy Burnham, the region has taken this a stage further with the development of a Greater Manchester model of public service delivery. The model focusses on organising resources – people and budgets – around neighbourhoods of 30,000-50,000 residents. It looks at remaking the connection between health and other public services which has been lost down the years and is aligned to 6 key features, including leadership and accountability. This vision enables Greater Manchester to be clear as to the kind of leadership we are looking to foster and promote.
Through the region’s ground-breaking Leaders in GM programme, together with the work of the North West Leadership Academy and Greater Manchester Health and Social Care Partnership we have begun to describe what a good public service leader looks like and through that we can begin to design development and talent pipelines that work across our public services and meet the future strategy of a more integrated public service system.
The Secretary of State has spoken regularly about the need for the NHS to develop more porous borders and enable talented people to enter the organisation more easily and this is certainly an expressed intention here in Greater Manchester.
Clinical leadership has been at the forefront of conversations on leadership in the health service since the changes in health and care saw the development of clinical commissioning groups. Here in Greater Manchester we have been keen to develop our clinicians in an environment which is increasingly looking to a matrix style of management to deliver our services. As we have looked to develop local care organisations across our ten localities with neighbourhoods of 30-50,000 residents, so we have looked to our primary care colleagues for leadership of these areas. We have strengthened our clinical networks and this has seen senior clinicians take on key leadership roles for areas which not only cover acute care but reach out into prevention, community care and the opportunities of system working.
This has required our clinicians to begin to broaden their horizons to not only consider the clinical evidence base for the delivery of services but to look at where opportunities to work with other sectors might lie and how workforce reform, commissioning and service transformation can enable us to do something different within Greater Manchester.
For both our clinicians now and those of you emerging in the future it will be important to develop an adaptive leadership style. Being adaptive will enable you to manage how you work within networks of distributed leadership and how as clinicians you can land the ground-breaking ideas and innovations which will help us deliver a first class health and care service in the twenty first century. At a recent clinical summit our clinicians reported confidence in compassionate leadership but felt they needed more support when thinking about system leadership.
Ultimately in Greater Manchester we cannot adopt one leadership programme which will attract, recruit, retain and promote our future leaders. We need to respect the differences across our public services and understand that a variety of leadership styles may be required for the different tasks. We can however use the grand vision of Greater Manchester to provide the principles of leadership to which people can identify. Principles such as a commitment to prevention, system working, inclusion, strengths-based approaches and workforce reform are ones that people from across our public service can relate to and makes sense of within their role – including our clinicians who will continue to be a valued part of future leadership across our system in Greater Manchester.
Jon Rouse is the Chief Officer of the Greater Manchester Health and Social Care Partnership
Greater Manchester Health and Social Care (GMHSC) Partnership is the body made up of the NHS bodies, councils and voluntary, community and social enterprise organisations in the region, which is overseeing devolution. In April 2016 we took responsibility for the £6 billion Greater Manchester health and social care budget. The Partnership comprises the local authority and NHS organisations in Greater Manchester, representatives from primary care, NHS England, the voluntary, community and social enterprise sector, Healthwatch, Greater Manchester Police and Fire and Rescue Service.