Health Services Research Centre

The Professionalization and Practice of Medical Leadership Project Synopsis

What is medical leadership? Throughout the NHS’ history, there have been numerous attempts to involve and engage the medical profession in management and leadership concerns, notably around service planning, delivery and finance. Even more so, over the past decade there have been concerted attempts and movements towards bringing the medical profession more formally into the management and leadership arena, notably with the creation of the Medical Leadership Competency Framework (Academy of Medical Royal Colleges and NHS Institute for Improvement and Innovation, 2010) and the subsequent creation of the Faculty of Medical Leadership and Management (FMLM) in 2010/11, who themselves have introduced medical leadership standards and fellowship of the faculty and have done much to legitimise the concept of medical leadership. In addition, postgraduate degree level awards in medical leadership, with a focus on skills and behaviours related to personal development (self-as-medical-leader) and the management of change and innovation are other formal moves towards establishing the concept of medical leadership as an entity.

Attempts to formalise medical leadership in such a way could be conceived of as a project of professionalization, with a purpose to serve distinctive organizational, social and ideological objectives within different societies. In the first place, professionalization projects began as a means to legitimise the role of the medical profession as the foremost profession in health care, establishing the means for self-administration, self-recruitment and self-governing behaviour. Such acts, according to Reed (1996: 583) led to the liberal professions, of which medicine is a part, becoming the “…dominant occupational mode and organizational form for institutionalizing the provision and evaluation of expert services in modern capitalist societies.” In latter years, with the growth of market ideologies (such as New Public Management) and concerns over deprofessionalization, professionalism has faced challenges and disruptions to its traditional form and one response has been further professionalization projects through adopting more hybrid professional roles, in the form of medical leadership and management roles, which help to protect and maintain professionalism’s foundations.

Another way of understanding what constitutes medical leadership is in its practice. With its origins in audit and risk management (the practice of discussing mortality and morbidity to learn from episodes of care that went well or not), the practice of medical leadership is now often seen in cases of discrete service or quality improvement (SI/QI) projects and a 2017 symposium hosted by the FMLM, NHS Leadership Academy and Health Education England on medical leadership in the undergraduate curriculum showcased many projects of this type. Moreover, two studies of medical leadership at the same level of the undergraduate curriculum (Varkey et al., 2009; Quince et al., 2014) discussed a preference for learning about medical leadership in the contextual environment of clinical practice.

This provides a rationale for considering medical leadership through a practice lens and to further determine what medical leadership, as an entity, is, practice theory allows for some light to be shed on the everyday, embedded actions and practices of actors. Practices can be considered as more than describing what people do, as such they are “…meaning-making, identity-forming and order-producing activities” (Nicolini, 2012: 7). Moreover, Dreyfus’ (1991) notion of practice as implying an individual’s social and historical relation to the world, means that practice is rooted in its common usage, creating the rules and meanings for customs and institutions. Practice theory focusses on the dynamics between practices, agents and the routines and processes they negotiate and (re)produce and can therefore help in determining what constitutes medical leadership. If the actions of the FMLM and others to bring medical leadership out from the dark and into the light are to be understood better, recognising, acknowledging and understanding the very practices that constitute medical leadership may be helpful if medical leadership is seen to be a mainstream rather than a fringe or ‘add-on’ activity.

Events that form part of this project include:

19 April 2018

Health Politics and Policy Network Spring Event, Birmingham
The Professionalization & Practice of Medical Leadership: Current Debates, Future Issues – An Introduction to the Research Agenda

Presentation  


27 September 2018

Faculty of Medical Leadership and Management
What next for medical leaders? Current debates and future issues in the professionalisation of medical leadership

Webinar: focus on the practice of medical leadership

25 October 2018

Faculty of Medical Leadership and Management
What next for medical leaders? Current debates and future issues in the professionalisation of medical leadership

Webinar: focus on the professionalization of medical leadership

15 November 2018

Leaders in Healthcare, Birmingham
What next for medical leaders? Current debates and future issues in the professionalization and practice of medical leadership

LiH A3 What Next For Medical Leaders panel session_nov18_final.pdf

6 December 2018

Health Services Research Centre, Manchester
Professionalization and Practice of Medical Leadership Symposium 

This one-day symposium aims to bring together academics and practitioners to present and discuss current research and practice relevant to medical leadership. Hosted by the Health Services Research Centre at The University of Manchester, the symposium forms part of a wider research project, which aims to:

  1. Advance knowledge and understanding of medical leadership;
  2. Explore the emerging concept of medical leadership;
  3. Gain a better understanding of its impact on the medical profession, relating to role, identity, training and its relevance to the socio-political context of the English National Health Service.   


Programme

Final Abstract Booklet

Symposium Presentations

January/February
2019 - exact date TBD
Academic Research Panel, Birmingham
Professionalization and Practice of Medical Leadership
 Seminar