Many years ago, I was advised by an eminent professor that if enough people all wanted something to happen at the same time it always happened. As far as the events of men rather than nature are concerned, this has proved to be a truth.
Had I had been smart enough to call this theory the the “tipping point” and write a book about it, perhaps I would be relaxing now in my villa overlooking the sea while twittering to my public.
The clamour within healthcare for more doctors to participate in leading health service change is reaching that moment of balance. The heavyweights lined up behind this now include organisations such as the Academy of Royal Colleges, the British Medical Association (trust me on this!), the great and the good at the Department of Health, namely Ara, David and Bruce (there’s a song in there somewhere) and an army of increasingly confident clinicians, young and old, who recognise that the pen is at least as mighty as the stethoscope.
As a marker of the level of interest shown by doctors, the British Medical Journal debated last month the role of doctors in leading health service change. The proposition translates as ‘Are they doing enough?’ The BMJ believes the issue is important. Emails I have received concerning the BMJ articles from New Zealand and a three day conference by SIMM (the Italian equivalent of the British Association of Medical Mangers) indicate that clinicians worldwide are joining a mainstream movement. The point is that this is an issue whose time has come. It will not go away.
NHS leadership movement
Fortunately, in the weeks and months ahead there is a vehicle to nail it to the zeitgeist. The NHS leadership council was launched a few weeks ago. It is, of course, to promote leadership in general and not exclusively clinical leadership. Promoting clinical leadership is a key ambition which I have been asked to lead. My sense is that the timing is right. It arrives at a point when the NHS is moving forwards from the “push” of performance to the more enlightened “pull” of patient quality and safety. Managers and clinicians at last feel at ease on the subject material if not yet the language. Aligned ambition across professional and managerial groups is the only way to deliver for the future.
Although there have been the usual PowerPoint pictures and endless paperwork filling briefcases and hard drives, essentially, and herein lies the difference from former initiatives, it is not fundamentally about structure or policy. Even in its infancy, it feels like a movement. It has more than the ministerial thumbprint upon it. It has heart and soul, it is about people and what they need to deliver the most complex and important public service at the most complex and important time since the inception of the NHS. That important emotional commitment is there.
I have seen leadership initiatives come and go since resource management sparked an interest in clinical managers in the late 1980s. None has felt as likely to succeed. There is a plan and the money to back it. If it is about belief, it has the momentum. If it needs a burning platform, then smell the smoke. We have most certainly reached the tipping point.