Reflections on clinical leadership

Alongside my clinical work as an ophthalmologist I have held various leadership roles, currently a national one with responsibility for appraiser training in Scotland. My first contact with the HSMC was participating in the Nye Bevan Programme. This gave me exposure to learning with people from a wide range of backgrounds, regularly taking me out of my comfort zone while feeling fully supported. How often do we ask ourselves ‘What is it like to be at the receiving end of me?’ The diversity of the group challenged my thinking and gave me many opportunities to reflect on my impact on others. And it helped me work out what holding myself and others to account really means in practice.

During the year I spent on the programme I recognised that I needed to be more aware of my emotions and what triggered them. Opening up to them and having better self-awareness gave me more confidence in being able to handle difficult situations and not avoid them. It has made me act in a more authentic way and has helped me react better to unexpected or challenging feedback. In many situations I am more aware of my default reactions, more able to make a conscious choice to react in a different way. I have become much better at really listening to people who have a very different outlook to me, have different values. And I have valued occasions when this has led to better decision making for me.

In the increasingly complex health and social care context how do I see clinical leadership now? We all need to work much more closely together within and between different teams, keep the patient/client at the centre of our decision making. This is only possible if we start with self-care and make looking after ourselves and each other a priority. While the system is under so much pressure it can seem counter-intuitive to make space to slow down and listen, to give everyone a voice. And as an increasingly senior leader we need to be mindful of the power differences – real or perceived. Are we really hearing what we need to hear? Are we holding each other to account in a compassionate way? People work much better together if they feel heard and valued, feel they belong. The tone clinical leaders set and how they role model what they value has a strong influence on the culture we are working in.

Reflecting on what this means for developing clinical leadership at all levels in my mind it needs to be centred around relationships. Bringing people with different experiences together and making space for listening and exploring different perspectives and how we can use them to strengthen our working relationships. Involving patients/clients more in this to understand what it looks like from their point of view and what their priorities and suggestions for improvements are. Everyone has a contribution to make and by celebrating diversity and listening with an open mind and being willing to try different ways of working we can improve the situation for all of us. None of this is easy and achieving it will not take away the pressures we are all under at present. It can help us be more compassionate with patients and each other and this has been shown to improve patient experience and outcomes. The programmes HSMC and the NHS Leadership Academy are collaborating on are a great example of taking this approach to leadership development with direct application in the working life of the participants. Let us celebrate that in this anniversary year.