The importance of clinical leadership in service redesign : Experience in three English National Health Service Hospitals
International Journal of Leadership in Public Services
ISSN: 1747-9886
Article publication date: 5 August 2014
Abstract
Purpose
The way change occurred at a strategic level and in four clinical services in three hospitals was examined. The purpose of this paper is to report how the hospitals designed and delivered change at organisational and clinical service level to improve services for patients, and the role of clinical leadership in this process.
Design/methodology/approach
A comparative case study involving semi-structured interviews was undertaken. These involved a range of senior managers in 2009 (n=77), 2011 (n=21) and 2012 (n=29). Interviews with staff involved directly in service delivery were also carried out in 2011 (n=92). The interviews were recorded digitally, transcribed verbatim, and analysed thematically using the Framework Method.
Findings
The value of, and approach taken to clinical leadership varied across the hospitals and over time. This was affected by the culture and priorities of the organisation. Some strategies for developing clinical leadership were developed, however they were limited. It was expected that capable clinical leaders would emerge, and be supported. Effective clinical leadership during organisational and service change required direct executive or managerial support and relied on clinical “champions”.
Originality/value
The paper demonstrates that despite the importance of clinical leadership being widely recognized in policy and research, there were no established programmes in place at the hospitals that were studied to support it. Rather there was a reliance on clinical staff coming forward to take on leadership roles as part of organizational efforts to bring about change.
Keywords
Acknowledgements
This research was funded by the National Institute for Health Research (NIHR) Birmingham and Black Country Collaborations for Leadership in Applied Health research and Care (CLAHRC BBC). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Citation
Mulla, A., Hewison, A. and Shapiro, J. (2014), "The importance of clinical leadership in service redesign : Experience in three English National Health Service Hospitals", International Journal of Leadership in Public Services, Vol. 10 No. 3, pp. 126-141. https://doi.org/10.1108/IJLPS-03-2014-0001
Publisher
:Emerald Group Publishing Limited
Copyright © 2014, Emerald Group Publishing Limited