Leadership is needed at all levels of the NHS at times of budget constraints and reorganisations. So why do physios fight shy of the concept? In the first of our new series, Daloni Carlisle investigates
Educational helpMany PCTs and trusts run leadership programmes for staff, and the NHS Confederation, the King’s Fund and the Health Foundation operate national schemes. But how many physiotherapists are involved? Is leadership regarded as really only for doctors and nurses? ‘I think as a group we are reticent,’ says Karen Middleton, chief health professions officer for England and a chartered physiotherapist, who represents 12 allied health professions.
New groundThis could be something to do with being autonomous practitioners, she feels. ‘Nurses, whether they are going into the acute sector or community, have to work around doctors,’ she says. ‘AHPs are autonomous and work independently. I think, and I include myself here, that we do not develop the softer political skills of influencing and working with others to get where you want to,’ But she has no doubts about the need for AHPs to become leaders in clinical and management spheres. ‘We do bring something different to the table,’ she says. ‘No other clinical groups work at the interface [between home and hospital] like we do, and that is where the productivity gains are to be made.’ ‘We are going through one of the most significant periods of change and difficulty that we have ever seen in health and social care. We need people who are able to innovate and to enable,’ she says. Doing their best for patients requires physios to overcome their resistance to anything labelled leadership, she says. And the results can be impressive. Of the 428 AHPs who took part in the Leadership Challenge she organised last year, 196 were physios. And the six strong winning team included five physios.
Rise to the challengeKaren Middleton hopes to secure funding for Leadership Challenge 2010 and is fighting for physios to be able to apply for senior stratategic posts. She sees structural barriers to physios, and other AHPs, taking on leadership roles. The move towards multiprofessional teams in healthcare means physios may no longer be managed by physios. Karen Middleton does not have a problem with this but is annoyed by job descriptions for team managers, and directors of patient care, which specify a nurse for the role. It is up to all AHPs to challenge these, she says. ‘I want them applying for these jobs’ she urges. Then, she adds, ‘If they do not get them it would not be because they are not allowed to apply, but because they are not good enough.’
Potential of new rolesJackie Anderson, head of physio at King’s College hospital, agrees that physios have not fulfilled their leadership potential. ‘People are so are so clinically trained that they do not recognise they have leadership skills,’ she says. ‘If I say to say to someone they have the potential to be a leader they are reticent. They do not see it as an integral part of their role.’ She welcomes new roles such as consultants. ‘Consultant roles are leaders,’she says. ‘They are go-getters taking services forward.’ But she is concerned that physios are not fulfilling their leadership potential at local level. Provider units may now have a band 7 physio with no managerial responsibility as the most senior physio. ‘No managerial responsibility, no influence,’she says. And, some PCTs are cutting clinical lead jobs, leaving the band 7 physios in provider units with no one to turn to for a professional lead, she points out. It is common, and mistaken, to think of clinical and leadership roles being entirely separate. Training and experience give physios a range of skills applicable to several domains. The desire to do your best for patients that drew you into the profession in the first place is the best possible starting point for considering a leadership role. Taking on greater management responsibilitymay change your day to day acitivities and shift relationships with colleagues. But the objective of more efficient services and better care for individuals remains constant. Time, perhaps, to see what opportunities are out there, investigate the training available and step forward. FL
What is the essence of leadership?
- Ann Green, chair of CSP Council : ‘Leadership is about getting the support of others and trying to enable them to make things happen.’
- Claire Marshall , head of physio services at Heatherwood and Wexham Park hospitals trust, Slough, and the physio member of the National Leadership Council, established last year to implement the Darzi review: ‘Vision and motivating people to come along with you.’
- Jackie Anderson, chair of the Association of Chartered Physiotherapists in Management: ‘You can be a leader without Being a manager but you would be a pretty poor manager without leadership skills.’
- Karen Middleton, chief health professions leader: ‘Maximising potential and enabling others to develop and do better.’
- Grasp any leadership development opportunities with both hands
- Read the leadership material produced by the NHS Institute for Innovation and Improvement
- Develop your leadership skills through involvement with the CSP, such as standing for council or taking an honorary officer’s role in a special interest group
- Find a mentor
- Look at any transferable skills in your home life such as chairing the PTA or school governorship
- Don’t be afraid to manage other professions
- Challenge job descriptions that unnecessarily require a registered nurse, then apply for them
- Moving to multiprofessional management
- Building confidence
- Leadership at every level
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