Comment

• A question of leadership

Case study

• Working together to improve diabetes services

Publication

• Better team working for a safer hospital

Current work

• Leadership schemes

News

• Leading lights celebrate Foundation focus

A question of leadership

Jan Walmsley, Assistant Director, The Health Foundation

Leadership in the NHS has never been more important. The recent outbreak of C. Difficile at Maidstone and Tunbridge Wells NHS Trust has been laid firmly at the door of poor leadership, not least by Health Minister Lord Ara Darzi, who in evidence to the House of Commons Health Select Committee, said that “the right leadership” at hospital level was vital to ensuring that a culture of safety applied to everyone who worked there.

At The Health Foundation, we are trialling ways to develop a culture of leadership across the NHS in order to make sustainable improvements in patient safety. Central to this culture has been shared leadership, where everyone takes responsibility for safety, knows what is happening, what their role is and how they contribute to change.

The four hospitals involved in the first phase of our Safer Patients Initiative have all reduced the number of medical mistakes occurring in their organisations, including the number of cases of MRSA and C. Difficile. They have done this using ward level safety briefings and senior team walk rounds to improve hand hygiene compliance and to promote a safety culture. The culture of shared leadership has been critical to this.

Shared leadership is based on the principle that teams work together more effectively if all team members assert their individual leadership qualities. This approach is well established in other industries. Our Shared Leadership for Change scheme, which has recently finished, tested this concept in the healthcare setting with the aim of creating lasting improvements in the care of people with diabetes.

The evaluation of this scheme indicates that teams have made achievements on a wide range of fronts, both prior to and during the scheme. Some of the improvements the teams made include: improving systems for tracking and monitoring patients; moving routine care from secondary to primary care, resulting in shorter waiting list times at hospitals; setting up a screening project with local employers; and establishing a patient education project in local community pharmacies.

These are significant and important achievements for the teams and, most importantly, represent an improvement in diabetes care for patients. Prior to the initiative, all the teams had found it difficult to take their ideas forward. Shared Leadership for Change addressed this problem and helped the teams overcome their barriers. There is strong evidence that the teams are now working better together, undertaking changes to practices and procedures, implementing strategy, and becoming more effective. This kind of multi-disciplinary teamwork is a key element in delivering high quality patient care.

There has also been a considerable amount of learning which team members have been able to take into other contexts. This kind of cascading of improved practices into the wider health service is a valuable part of what the initiative has achieved.

Several respondents considered the initiative to be of sufficient value to replicate in other areas of healthcare. As the Maidstone and Tunbridge Wells affair shows, the NHS is long overdue for a strong shot of leadership. NHS Trusts, Strategic Health Authorities and the Department of Health should all examine the Safer Patients Initiative and Shared Leadership for Change scheme for lessons on how to implement good leadership throughout the health service.

Respond to author

Case study

Working together to improve diabetes services

The development of leaders in healthcare is widely recognised as being integral to improving the quality of care for patients. However, all team members need to be involved if lasting improvements are to be made.

Publication

Better team working for a safer hospital

One in ten patients admitted to hospitals in developed countries suffer harm as a result of medical errors. This briefing looks at how The Health Foundation’s Safer Patients Initiative has improved patient safety using the concept of shared leadership.

Current work

Leadership schemes

We believe that effective, skilled leaders lie at the heart of lasting improvements to healthcare. We offer high-quality leadership development opportunities – free of charge – to healthcare professionals from a wide range of organisational and professional backgrounds.

News

Leading lights celebrate Foundation focus

Twelve UK healthcare professionals committed to changing patient services for the better have been given a helping hand by The Health Foundation. These leaders of the future have been chosen as the latest winners of the prestigious Leaders for Change scheme.