Time to get serious about distributed leadership: lessons to learn for promoting leadership development for non-consultant career grade doctors in the UK

Abstract

COVID-19 has exposed the National Health Service (NHS) to the greatest challenge in its existence, highlighting the need for nimble, reactive and inclusive leadership. It is set against a backdrop of a workforce recruitment and retention crisis predicted to worsen in coming years. There is a need to do things differently in healthcare, including better diversity and distribution of leadership. We make the case for senior non-consultant doctors, in the UK more usually referred to as specialty and associate specialist or locally employed doctors. These skilled, experienced medics have much to offer yet are frequently overlooked, with little guidance or support from central organisations and medical colleges or within NHS Trusts themselves. In this commentary, we suggest ways this workforce might be better tapped into, to the benefit of patients and healthcare systems, as well as the doctors themselves.

Contemporary perceptions and meanings of ‘the medical model’ amongst NHS mental health inpatient clinicians

“…Interpreted in the context of a large body of research, our findings highlight how important it is for mental health services to create psychologically safe workplaces for clinicians to share knowledge, challenge opinions, and encourage professional growth through interdisciplinary learning and dispersed responsibility amongst professionals who have traditionally been excluded from leadership positions (e.g. Cordoba et al 2021;Kline 2014;West et al 2015). Whilst it is clearly crucial to develop and evaluate new initiatives for distributed leadership and integrating plural (multidisciplinary) perspectives in mental health care, our findings indicate that there are still many barriers to successfully implement such approaches in practice.…”

“…Over time, this has prompted broad calls for initiatives to tackle the education and training of the multidisciplinary public health workforce (see Cordoba et al . 2021; Kline 2014; West et al . 2015).…”

“…The NHS framework has historically been organised around medically dominated hierarches at a clinical level and promoted medics to be elevated into positions of clinical leadership (Read 2015;Till et al 2020). Over time, this has prompted broad calls for initiatives to tackle the education and training of the multidisciplinary public health workforce (see Cordoba et al 2021;Kline 2014;West et al 2015).…”

Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare

“…In contrast, Ability, Motivation, and Opportunity (AMO) theory describes how the interplay between ability, motivation, and opportunity (of a person, a team, or a department) to enact leadership, gives us a measure of an leadership performance and performance-related outcomes [ 11 ]. This enables us to embrace leadership as a distributed and collective process [ 12 ]. In the distributed leadership literature, leadership becomes a shared process across a collective group, where people have common organisational perspectives, goals, and shared actions [ 12 ].…”

“…This enables us to embrace leadership as a distributed and collective process [ 12 ]. In the distributed leadership literature, leadership becomes a shared process across a collective group, where people have common organisational perspectives, goals, and shared actions [ 12 ]. Framing leadership in this way allows us to move away from traditional heroic leadership tropes, to recognise the contribution that groups of people, such as a surgical team, make to leadership processes and practices [ 13 ].…”