Building effective clinical leadership and engagement is the key to improving services, writes Jackie Kay

The national guidance Fit for the Future, published in April 2007, gave primary care trusts the freedom to determine how professional executive committees should be structured and operated based on local circumstances, while observing a set of guiding principles.

These include:

  • the need to be patient focused and promote the health and wellbeing of communities as well as addressing health inequalities;
  • the need to be drivers of strong clinical leadership and enablers of clinical empowerment;
  • the need to be decision making and firmly part of the governance and accountability framework of the PCT;
  • the need to reflect a range of clinical professions and a wealth of experience.

Following discussion and engagement with our local clinicians through a series of events and workshops, County Durham PCT has developed a new mechanism in place of the traditional committee arrangements to build effective clinical leadership and engagement so that clinicians are influential at all levels in the organisation.

Clinical champions

As part of this drive to redefine clinical engagement, County Durham PCT has successfully recruited 15 visionary, committed clinical champions to work one day per week for the commissioning organisation. The clinical champion post has been developed to:

  • support the trust in developing its vision and strategic direction;
  • enable effective commissioning including the support of practice based commissioning;
  • ensure clinically effective, high quality and safe services are commissioned for our local population;
  • lead clinical communication with partners and stakeholders.

The clinical champions are all active clinicians from a range of professions including: GPs, pharmacists, dentists, nurses and allied health professionals. They each have an individual focus of one of the eight work streams within Lord Darzi’s next stage review report and NHS North East’s Our Vision Our Future.

These clinicians bring their own professional focus and, through their clinical networks, they encourage and lead innovation across professions and settings ensuring high quality, safe services are commissioned for the local population based on best available evidence. They are considered a key group to influence the trust’s five year strategic plan, as well as having direct involvement with clinical pathway and planning groups and service review and redesign mechanisms.

A clinical reference core group is in place that is responsible to the board for ensuring effective clinical engagement and involvement across the organisation and, crucially, with partner organisations. This group comprises a number of the clinical champions together with key executive directors and associate clinical directors of County Durham PCT.  It is pivotal in providing the clinical advisory function to the board with a focus on service innovation, patient safety and quality.

The creativity that such a diverse group of clinicians bring to the table is a real asset to the organisation. Their expertise and experience are invaluable, but so is the point of view they bring, challenging our ideas, supporting clinical engagement and promoting a patient centred perspective.

Such a different and possibly unique approach has brought its challenges. Synergy between the role of clinical champions and that of practice based commissioners has been a healthy and productive dialogue. Discussion and agreement to clearly define the range of clinical involvement required within the complex commissioning cycle is inextricably linked to the world class commissioning assurance framework.

Positive feedback

Evaluation of the role’s impact continues, with much of the story yet to unfold over time. However, feedback and reflections from the post holders, as well as from commissioning teams across the organisation has been very positive.

Clinical champion Jan Connor says: “Throughout my career I have always been passionate about patient care, striving to make the patient experience positive with the best possible outcomes. When the clinical champion’s job was advertised, I felt this was an exciting opportunity to not only progress my own professional development but take an active role in the transformational change for the future. I wanted to be part of it. Being a clinical champion will enable me to apply my clinical expertise to influence and challenge at a strategic level, to contribute to developing and delivering high quality services, which is my passion. I am looking forward to supporting and developing others to drive forward patient centred services across the PCT.”

The appointment of the clinical champions is enabling and strengthening clinical leadership and engagement as part of world class commissioning here in County Durham and Darlington. Clinical champions are new and innovative posts within our organisation and maybe an opportunity is emerging to compare and contrast models for clinical leadership and engagement in other commissioning PCTs.