Alumni story / Leading from the frontline

Clinicians use leadership skills every day, often without realising. When guiding junior doctors on a ward round, generating treatment plans with members of the multidisciplinary team or advising a patient on the best interventions, doctors are leading. They just need to be given the opportunity to apply these skills to the improvement agenda.

I’m a gastroenterology and general medicine registrar rotating through Kent and South London with two years left of my speciality training and, like most doctors, I never set out with leadership aspirations. However, I have started to appreciate how the combination of clinical knowledge, day-to-day experience of a hospital’s operational systems, and an understanding of how to engage colleagues to develop sustainable changes can be a powerful driver for improvement – both for patient care and for staff members’ working lives.

I chose to study the HFMA qualification in healthcare business and finance as I felt I needed a greater knowledge of healthcare economics and business principles to make my day-to-day leadership more effective and to assist progression into a formal leadership role in the future. The modules have given me a deeper understanding of the many factors involved in providing high quality and cost-effective care, which complemented the learning from my secondment to NHS Improvement’s Medical Directorate last year as part of the National Medical Director’s Clinical Fellowship Scheme.  

As a clinician, the areas of content I have studied through the qualification have been new. I have found it fascinating to understand how money flows through the system and how integrated care works. The qualification has highlighted why financial considerations do indeed need to be at the forefront of decisions made by clinicians. For one of my HFMA assignments, I had to propose a redesign of a healthcare system, so I decided to look at liver disease in Kent and Medway NHS and Social Care Partnership. Effective integration of services across primary, secondary, mental and public healthcare is particularly crucial for these patients. Using this knowledge of new care models, I recommended innovative ways to reduce alcoholism and obesity through patients’ healthcare journeys, which would help to reduce acute demand and the future burden of chronic illness. I was subsequently awarded the HFMA Academy’s first ever distinction, which I am very proud of.

Delving deeply into the world of integrated care was very interesting. I was able to draw on pathway and funding examples from Sustainability and Transformation Partnerships and Integrated Care Systems around the NHS. This strategic understanding of the health service will become increasingly relevant in the coming years, so it’s great to have this foundation of knowledge to draw upon. However, it is a shame so few other junior doctors have even heard of an STP, for example, let alone appreciate the benefits of this type of system approach, or the pros and cons of current payment systems.

Subsequent modules relating to value-based healthcare and international system comparison has helped inform my current practice. I have started to challenge myself to make sure that everything I do adds value to the patient. I now believe I am not only in a better position to lead, but also in a better position to deliver higher quality patient-centred care.