Defining leadership

When I was in the air training corps, I was tasked with leading a team of nine other cadets on a competition weekend against other teams in the region. We had no expectations of winning, yet out of forty teams, ours ranked third. Although I attribute most of our success to being part of a high performing team, I realised that leadership and the ability to make decisions in time pressured situations was also key to our success. As pharmacy professionals, we are the leaders of medicines optimisation in relation to patient care, but what does leadership mean?

In his book, Other People’s Shoes, Ken Jarrold CBE defines leadership as “showing the way – showing what to do next”, which differs from management which he defines as the responsibility for the use of resources. A manager may not be a leader unless they can show the way. We shouldn’t expect all managers to lead, but managers shouldn’t prevent those who can show the way from doing so. From my limited experience, this is where the potential for leadership is stymied. Leadership can be demonstrated by people at all levels, regardless of seniority, and the most effective teams are ones where leaders are allowed to lead, with support from managers. If anything, there is a symbiotic relationship between great leaders and great managers, which when fostered, creates a formidable partnership.

Unfortunately, pharmacists are not taught to be leaders, but instead taught to be managers, and in my opinion are expected to become followers to the will of those above. Good leadership shows teams how to deliver the best patient care through a values-based approach. Evidence by Francis, Berwick and Keogh supports this, and further research by Michael West demonstrates the link between good leadership and improving patient care.

The NHS Long Term Plan focuses on changing the way we work to deliver effective and efficient patient care. Primary care networks (PCN) is one approach proposed by the chief pharmaceutical officer, Keith Ridge, to increase collaboration in primary care by delivering a population-based model of care, i.e. looking at the individual as part of a larger community, while still keeping the personalised aspect. For PCNs to work, ensuring collaboration and integration across multiple services is important to help patients get the care they need, when they need it. An opportunity therefore exists for community and general practice pharmacy to get involved and work alongside others in a PCN. As such, there will be a requirement to ‘show the way’ for patient centred care through such transformative times.

To support community pharmacy, NHS England in collaboration with HEE, CPPE and the NHS Leadership Academy has funded 1,200 places via the Pharmacy Integration Fund (PhIF) to undertake the Mary Seacole Programme. The programme is one of the highly sought after, flagship programmes offered by the NHS Leadership Academy to those working in the NHS and has been specifically adapted for pharmacy professionals so that they can take their learning back to the workplace. The programme is funded for those who work at least 40% of their working week in community pharmacy and is open to both pharmacists and pharmacy technicians. The course offers a fantastic opportunity to learn new skills which can help further your career by developing the necessary leadership skills to become a pharmacy pioneer and navigate the complex healthcare and commissioning environment.

As part of the NHS Graduate Management Training Scheme, on the policy and strategy stream, we complete half of the Elizabeth Garrett Anderson Programme (PG Certificate in Healthcare Leadership) which has similarities to the Mary Seacole Programme. This is also provided by the NHS Leadership Academy. As part of the programme, we learn different models such as the Kolb-Frohman model for carrying out organisational change. It sounds very by-the-book, but learning these models helps the individual to develop their personal approach to changing a system. Other topics include human factors and ergonomics, a relatively new scientific discipline. It looks into the causes of errors happening, using examples from different industries and of the human elements which cause them. Understanding this is vital for designing effective, integrated pathways in healthcare, and as part of the larger agenda of moving away from a blame culture to a culture of learning. Human factors brings together elements from many disciplines, to explore how and why things go wrong, e.g. a patient being given an unnecessary knee operation. Despite all the checks and balances, situations like this do still occur, and in human factors you learn how to drill down and find the true root cause of errors. From my own perspective, I have used my understanding of human factors in an investigation I worked on. The change in mindset made me look beyond the surface to evaluate situations at a deeper level resulting in discoveries on how to improve both the system and design.

In conclusion, leadership is the skill of bringing staff, teams, clinicians and organisations together cohesively to work towards a common vision. Sustainability and transformation partnerships (STPs) and integrated care systems (ICS) are developing across England with PCNs starting to evolve within each ICS. Leadership by pharmacy professionals working within a PCN, including community pharmacy, will become of greater importance in demonstrating the role they play in improving quality of care with a focus on patient centred care.