Leadership, management and strategy in context

Purpose and context

The development of leadership skills among our GP learners is a necessity, to improve current healthcare delivery and to bring about positive change.

Many GP learners will become GP partners or hold leadership roles at national, integrated care system (ICS), PCN or practice level. For current GP learners, the Workplace Based Assessment includes mandatory requirements in relation to leadership, and trainees are encouraged to develop their leadership skills incrementally over the training programme and record any other leadership activities undertaken.

Many trainees have engaged with separate leadership programmes, like Next Generation GP, which aims to engage a new generation of leaders in primary care. In addition, Health Education England and the Faculty of Medical Leadership and Management have produced a Developing Medical Leadership toolkit to support the development of regional leadership programmes for GP learners.

Our future GPs will need to be compassionate, collaborate and inclusive leaders, who are advocates for their patients and their profession. As the health and care system adapts to the formation of integrated care systems, the vision of the GPs at the nexus of health and social care is exciting and promises to deliver seamless care for patients.

This vision should be nurtured, to enable GPs to work across organisational and functional boundaries that allow for relationship building and innovation in primary care (Giordano,2011).

We heard...

The value of leadership skills is widely acknowledged, and GPs and trainees want to understand how to develop leadership capabilities while working within the NHS.

In focus groups and retention workshops, we heard trainees express concerns about lacking leadership skills as they progressed towards the end of their training. There is a sense that those concerns are not being addressed, given that early career GPs told the Big GP Consultation (Loftus, et al., 2022) that they do not feel adequately trained for system-based healthcare leadership.

Preparation for many of the practical aspects of leading within a GP practice is viewed as lacking, with trainees highlighting gaps in their learning around understanding and managing budgets, change management and human resource issues.

Leadership skills are also required beyond the GP’s own practice, and there is a desire among trainees to improve their understanding of population health management, how to lead change at scale and how to build relationships with different providers within the system.

Priorities and action

We are developing and piloting two blended learning modules: one focused on leadership, and the other on management and the business of partnership and running a general practice.

The Big GP Consultation outlined key actions to ensure strong GP leadership across the healthcare landscape of the future, including:

• the provision of specific, relevant and ongoing training to GPs to ensure they have the requisite knowledge and skills to lead in their practice and beyond, as a spiral curriculum throughout their careers;
• training in the knowledge and skills to provide clinical supervision of the wider MDT, including other doctors;
• representation of primary care voices and patient voices at all levels of healthcare leadership and management, including the new ICS structure;
• more equitable distribution of resources within practices, PCNs and across primary care.

We support these recommendations, and additionally propose that GP DiTs should be exposed to leadership opportunities during their training, including opportunities to take responsibility for a particular area while in training practice under supervision. These opportunities should instil GP DiTs  with an understanding of resource limitations and advocacy.