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Enhance: Contextual leadership in a nutshell Dr Claire Edwin South West Foundation School Support Fellow Alumni National Medical Director’s Clinical Fellow 2021/22 notLeadership in the NHS • To deliver the best, safe care, improve patient outcomes and experience of their care – effective team working, often across disciplinary and organisational boundaries is essential ‘We are a team - first and foremost, we are one huge, diverse and growing team, united by a desire to provide the very best care. We learn from each other, support each other and take time to celebrate successes.’ NHS People Promise, 2021Failures in leadershipLack of diversity in NHS leadershipWe keep saying the same thing…. 2008, Darzi 2013Berwick Review 2024, DarziLeadership (development) comes up again and again…. 2015 2022 2018 Why is leadership important for foundation doctors? At the beginning of your career, you are in the ideal position to start thinking about: • What shapes patient care and health care services? • How does leadership have an impact on patient safety and patient experience of their care? • How can you be involved in designing and implementing improvements in your current and future roles?Who makes decisions? 1. NHS Oversight: The Secretary of State for Health and SocialCare oversees the NHS, setting mandates and allocating finances 2. DHSC Role: develops health policies and allocates funds to NHS organisations, including NHS England and Health Education England 3. NHS England: Manages the allocation of funds to NHS Trusts primary care, and Integrated Care Boards, ensuring efficient healthcare delivery across the country 4. Integrated Care Boards: Local bodies responsible for planning and commissioning healthcare services tailored to regional needs 5. NICE: Provides evidence-based guidance and evaluates treatments to ensure high-quality, cost-effective healthcare services• https://www.kingsfund.org.uk/insight-and-analysis/animations/how-does- nhs-england-work A practitioner , a partner , a leader • Key part of doctors professional work • Requirement in GMCs Good Medical Practice • All doctors workin systems and within organisations • Doctors have direct and far-reaching outcomesn patient experience and • professionalroader than any other health • running of the organisation and futureive directions https://www.leadershipacademy.nhs.uk/wp-content/uploads/2012/11/NHSLeadership-Leadership-Framework-Medical-Leadership-Competency-Framework-3rd-ed.pdf Developing Leadership Competencies: ‘learning by doing’ Good news! It isn’t all theory • According to the 70-20-10 rule, leaders learn and grow from 3 types of experience, following a ratio of: • 70% challenging experiences and assignments (QIPs, clinical work, working groups/committees) • 20% developmental relationships (supervisors, mentoring and coaching) • 10% coursework and training (some theory) • The underlying assumption of the 70-20-10 rule is that leadership can be learned — that leaders are made, not born https://702010institute.com/702010-model/ Please download and install the Slido app on all computers you use What is the difference between a manager and a leader? ⓘ Start presenting to display the poll results on this slide. Not all leaders are managers….all managers are not leaders Leadership Management • Vision, big picture, strategies, non- technical/people skills, educational and • Technical competencies and know how, organisational expertise, innovation/change vision/strategy, stability, standards, • Development of practical wisdom in self and processes, procedures othersWho are leaders?YOU!Contextual Leadership Styles •Directive or hierarchical useful in high stakes situations where quick decisions need to be made, for example in a crash team • Collaborative or shared useful where joint problem solving is important, such as in a multi- disciplinary care planning discussion •Influencing important in teams, particularly for empowering colleagues to raise concerns or improvement ideas Compassionate leadership ‘Compassionate leadership involves a focus on relationships through careful listening to, understanding, empathising with and supporting other people, enabling those we lead to feel valued, respected and cared for, so they can reach their potential and do their best work.’ Professor Michael West, 2021 • According to the King’s Fund, ‘collective, inclusive and compassionate leadership is increasingly essential to deliver high quality care and cultural change.’ https://www.kingsfund.org.uk/insight-and-analysis/long-reads/what-is-compassionate-leadership Compassionate Leadership • Compassionate leadership is especially important since the pandemic • This can look like: • Recognising successes • Self-care and wellbeing • Supporting others https://www.kingsfund.org.uk/insight-and-analysis/long-reads/what-is-compassionate-leadershipBrené Brown- Dare to Lead • Defines leadership broadly, without any association to role, title, seniority, or relationship • Defines a leader as anyone who takes responsibility for finding the potential in people and processes, and who has the courage to develop that potential • Everyone in an organisation can provide leadership, and that leadership can involve developing and nurturing, technologies, procedures, source code, documentation, relationships, and culture, in addition to people. Leadership Lessons fromDancing Guy – The First Follower https://www.youtube.com/watch?v=Z61W5d2ePpw Another form of leadership? Civility Saves Lives • https://www.youtube.com/watch?v=4RUIhjwCDO0 • I would really encourage you to watch this video clip. Its 15 minutes and illuminating. https://www.civilitysaveslives.com/ What next? • Peer support and mentoring is essential for your leadership development: • A culture of support, coaching and mentoring within your team is invaluable • You should be able to access this sort of support from your supervisor(s) • You can also work with your peer group to support each other or identify a mentor who you admire and could learn from • There are mentoring schemes available through other professional networks i.e. royal colleges, FMLM, NHS Leadership Academy • S.M.A.R.T . goals for your leadership development • By establishing your strengths and identifying any gaps to close, you can create some SMART actions for your professional development action plan. https://www.gmc-uk.org/-/media/documents/good-medical-practice---english-20200128_pdf-51527435.pdfEvidencing Contextual Leadership domain for theenhance programme • Workbook tasks found on the learning hub • In person or online teaching with reflection • Self – directed experiences e.g. local opportunities, conferences, away days or external courses with reflection ((i.e. REAL form) • Reflectivepieces (no need to be longer than 300 words), future practice you have learnt and how it may shape your • Complete the Contextual leadership module: self-assessment matrix, and Contextual leadership module: evidence of engagement • PODCASTS Resources GMC: Leadership & Management of all doctors Perry J, Mobley F, Brubaker M. Most doctors Have Little or No Management Training and That’s a Problem. West et al. The link between the Management of People & Patient Mortality in Acute Hospitals Int J HR Mgt 2002 13:8 1299-1310 Talks: Brown, B. The power of vulnerability. Edmonston, A. How to turna groupof strangers intoa team. Lencioni, P.. The 5 Dysfunctions of a Team.This presentation was created using content from the National enhance programme workbooks National enhance programme contextual leadership module workbook and Dr Tabitha Campbell’s and North Devon Generalism Team: Foundation Contextual Leadership Workbook.