Overcoming the Challenges Facing Medical Leadership and Medical Engagement
Published on 1 December 2022
High quality medical leadership and high levels of medical engagement are thought to be major drivers of effective healthcare systems.
Professor Graeme Martin’s research led to debate in the Scottish Parliament on hospital consultant’s experience of work, shape British Medical Association (BMA) policy on medical engagement, and the development and use of a medical identity diagnostic ‘toolkit’ for assessing suitability for medical leadership positions and the quality of medical engagement with their employers
Governments and NHS have sought to involve the medical profession in the leadership of the NHS by promoting doctors into medical leadership positions. However, a research team led by Martin into consultants’ experience of work in NHS Scotland showed, inter alia., that while doctors wanted to see more consultants in medical leadership positions, becoming a medical leader appealed only to a minority of senior doctors. Moreover, a significant majority of consultants distrusted the competence and motives of those applying for such posts. The study also showed the extent of disengagement and disidentification of many consultants from their employers and their medical leaders because they lacked voice in decision-making.
This work has its origins in a decade long programme of research and knowledge exchange with doctors conducted by Martin and his colleagues, including a major report for the British Medical Association in Scotland in 2015. The research has also been used to develop a novel medical identity self-assessment toolkit for doctors who seek to advance their careers by becoming clinical leaders by comparing key feature of their personal and professional identities with consultant colleagues and the identity profiles of prototypical medical leaders.
The findings of the report for the BMA were presented in the Scottish Parliament to an audience of politicians and senior doctors and reported extensively in the national press, TV and radio. The research was also discussed extensively in a Scottish Parliament debate on health as evidence of major challenges facing NHS Scotland.
The BMA in Scotland used the report’s findings as the basis for a policy paper entitled: ‘Re-engaging the consultant workforce: the role of local advisory structures’ and to make recommendations for re-invigorating or creating local area medical advisory committees. The research also featured prominently in the BMA’s Manifesto Briefing for the Scottish Parliament elections in 2016 to evidence the need for local committees to provide senior doctors with greater voice on how services were best provided and prioritized.
Using data and theory developed from the research, Martin created a novel medical identity self-assessment toolkit for doctors who seek to advance their careers by becoming clinical leaders by comparing key feature of their personal and professional identities with consultant colleagues and the identity profiles of prototypical medical leaders. The toolkit has been used to help the Medical Directorates of two healthcare organizations in Scotland and England understand identity conflicts and significantly impact on medical engagement and medical leadership.
A further impact of his research was Martin’s appointment by the Cabinet Secretary for Health as a Non-Executive Board Member for NHS Tayside, and his appointment as Vice Chair of the Board. This appointment has led to him working closely with the Medical and HR Directorates in NHS Tayside to further develop leadership, culture change and workforce strategy in the Board, which have been recognised formally by the Chief Executive, the HR Director of NHS Tayside and the Cabinet Secretary for Health in 2022-3.