Raj Kumar

Raj Kumar

In this month’s column for HSJ, Debby Gould from NHS London talks about how the Clinical Leaders Network is helping her to work collaboratively with other midwifery departments, helping to improve maternity services. NHS London has decided to use the CLN initially to focus on these services, supporting clinicians to achieve the vision of Healthcare for London.




As head of midwifery at University College London Hospitals foundation trust, I want women and their families to enjoy the best possible service. To achieve this, they need us to step outside of our comfort zones and make a real difference to working practices.

Service commitment is a set of minimum standards relating to positive attitudes and behaviours

The Healthcare Commission has reported that many women felt they were not treated with privacy and respect across NHS maternity services. In the wider NHS, we hear people say they do not have trust and confidence in doctors — that they are not given information in a way that they can understand, or that they are not listened to. I believe that the Clinical Leaders Network will help deliver the changes necessary to move away from a target driven NHS towards a service driven by values.

At UCLH, service commitment is a set of minimum standards relating to positive attitudes and behaviours that are essential to a high quality service. These are sometimes difficult to quantify — and, as a clinician, delivering them is not something you can do by yourself. You need to work together with colleagues to inspire a sense of a values driven service to encourage everyone to aspire to the highest standard of care. The network has the power to bring this about. It has allowed me to share understanding of issues with consultants, managers and heads of midwifery.

Leadership and self-awareness

One area where the network can make a great contribution to personal growth is in developing self-awareness. This is an important skill for any leader, but is something that can be overlooked as people take on more senior roles. Now, the network’s competency framework has been developed by a national team in partnership with strategic health authority project managers and clinical leads. It uses a combination of psychological tools to define important competencies necessary for successful performance in a number of leadership roles. The CLN has enabled us to look at our leadership styles and access resources and mentors to help us improve our emotional intelligence — something that is vital to spreading the positive attitudes and behaviours that will ultimately improve standards of care.

I recall a conversation about the difficulty that many maternity services were experiencing in getting women to book early for maternity care. It emerged that people were working on the same problem in many different ways — by using extra resources to work through the backlog, making GPs and midwives aware of the importance of early booking and helping women to understand the importance too. As well as a process problem, there needed to be an emotional engagement from everyone in this key change. By sharing our experiences, we were able to learn from what others were doing and combine our efforts to a greater effect.

This is the benefit of the action learning used in the network — it is an excellent learning environment. A departure from the traditional top down managerial culture, its methods may take some getting used to for people whose previous experience is of more didactic approaches. But its ability to foster personal and organisational growth is very exciting.

Overall, the Clinical Leaders Network has been a very positive experience, for me personally and, I believe, the NHS. The challenge will be giving clinical leaders space to make the most of the network within their busy diaries. They have to be allowed to prioritise the network, such is its potential for effecting service reform.

For more information about the Clinical Leaders Network, or to get involved, visit www.cln.nhs.uk or contact cln@nhs.net