For the last decade or so I have been working mainly on leadership development in the NHS.
Much of that work has been done in NHS Trusts and organisations like NHS England, and Clinical Commissioning Groups. Recently I have been working more with GPs, GP Federations, Primary Care Networks and other community health and development workers.
Working in secondary care
- Primary care and care in the community are sometimes looked down upon. They are treated, by some, as a ‘second class’ part of the health service. It’s not ‘proper nursing/doctoring’ unless it is in a hospital, apparently. This is occasionally stated explicitly. But more usually it is implicit in what gets discussed, invested in and shown on the TV.
- The way that secondary and acute care attract the lions share of investment. Even when that runs counter to national strategy which is to strengthen prevention and care closer to home. This is particularly clear at the moment as politicians are queuing up to promise us new hospitals!
- When I work in secondary care I get to work with perhaps a director of Workforce and Transformation or Strategy. Often a Chief Operating Officer as well and other executive and non executive directors. There is a board and a sub-committee structure looking after issues like quality, finance and workforce. There will usually be an Organisation Development Team. Sometimes a training and development team. Often there will be a Leadership Development specialist or two.
- And there may even be some budgets available.
Working in primary care
Contrast this when working in primary care at general practice level.
- There is often precious little specialist experience in leadership development or organisational development and even less resource.
- Instead there are partners, GPs and other health professionals and practice managers trying to run a sustainable business providing excellent health care in a challenging clinical and financial environment. At the same time they are trying to find a pattern of working that is financially and psychologically sustainable.
- And the financial vulnerability, the precariousness, of small or medium sized business often shows up.
- The idea of Leadership Development often seems like a luxury rather than a necessity.
No wonder the workforce data in primary care is so shaky. And while politicians promise thousands of new doctors and shiny kit the challenge lies in retaining the current workforce. This is a leadership challenge. Helping them to find pride and joy in their work. To believe that it offers them a rewarding future.
For 30 years I have been married to Anne. In that time she was a nurse, midwife, health visitor and infant mental health specialist. She told me about her work, often with partner agencies to keep families together and getting by. This too is the work of the NHS and it’s partners. This IS integrated care. Care in the home and the community focussing on people in their life context – not just in a hospital bed or waiting room.
I am excited to work with the GenX GP network in Leeds. It gives us a chance to find hope, pride, sustainability and joy in this very beautiful part of the NHS.
Close to people and their communities.
Increasing access to and effectiveness of leadership development here will help to realise the aspirations of the NHS constitution.