New care models provide a unique opportunity to clinical leaders to break barriers of the past and try new solutions to existing challenges. By Samantha Jones and Saira Ghafur

Group of small goldfish following a larger goldfish


The NHS Five Year Forward View set out the challenge facing the NHS and presented a consensus view on what the future health service should look like, focusing on three main areas:

  • prevention and changed relationship with communities;
  • care redesign for “triple integration”; and 
  • putting the NHS on a financially sustainable footing through new investment and new efficiencies.

There is undoubtedly a call to action for all staff across the NHS to get involved and rise to the challenges outlined in the forward view and more so for clinicians to lead the way in helping to innovate and transform services to ensure that our current health system is fit for the future.

The service is struggling to cope with demand; we cannot afford to do more of the same and now is the time to be creative and trial new solutions to existing challenges. Effective clinical leadership can and will help set the direction of change in this process.

At all levels

This leadership needs to be cultivated across all disciplines and at all levels of the health service.

The forward view provided a blueprint for the new models of care and these models present a unique opportunity for health leaders to articulate the needs of the NHS with clarity and ambition.

The HSJ Clinical Leaders have demonstrated and celebrated how clinicians have influenced and shaped key policies at national level to make a significant impact on the running of the NHS. This positive message needs to be seen across the health service and clinicians at all levels can be empowered with leadership capability and skills in order to continue this impact.

‘Skills need to be accompanied by effective leadership’

Strong clinical leadership is associated with better outcomes of care for patients, we know this. Clinical credibility and competency are key; however, these skills need to be accompanied by effective leadership which is crucial to deliver an excellent service in a different way to previously.

The scale of change proposed by the new care models requires leadership capability across the system. Thinking needs to be focussed on population health and creating true integration of the health and social care system that can be sustained for future generations.

Skill development

To accomplish these goals, clinicians will need to be supported in developing skills in service improvement and transformation to ensure we are producing quality services. This will require systems thinking outside of conventional boundaries and ensuring collaborative working.

Nick Timmins’ report for The King’s Fund highlighted that leaders need to be able to work across complex systems and be able to break down organisational barriers in order to achieve success. To really drive change, leaders need to have the capability to be bold in terms of innovative solutions to problems and ensure that they can empower others to do the same.

‘It requires systems thinking outside of conventional boundaries’

During the vanguard workshops (where the 29 vanguards were chosen), it was incredible to see the extraordinary levels of clinical leadership that was clearly fundamental to many of the bids being presented. It is this bold vision; determination and innovation that will truly ensure the care models outlined in the forward view are delivered in practice.

Forming a network

The key values of the new care models care team are based around four principles: clinical engagement, patient involvement, local ownership and national support.

Supporting and developing leadership capability within vanguards will include a community of practice so that vanguards can share ideas and good practice. This is what they have told us they want. 

‘The new care models put clinicians at the centre of health and social care’

Leaders throughout the system will be offered support in development and coaching to enhance their capabilities and a clinical leadership network will allow emerging leaders to be identified and supported to form another layer of expertise within the system. Importantly, we need to work together to capture the enthusiasm of many and ensure ideas, however large or small, ultimately work not just for the vanguards but across the NHS as a whole.

Einstein said: “If you always do what you always did, you will always get what you always got”. Now is the time to change this sentiment and use the opportunity presented in the forward view to truly revolutionise the way healthcare is provided in the NHS.

The new care models put clinicians at the centre of health and social care where they will be well placed to lead innovation and system transformation in order to deliver the best possible care for patients. There is significant support throughout the NHS to back the bold ambitions of the new models of care and it is absolutely an incredibly exciting time to be a clinician within the service.

Samantha Jones is director of new models of care at NHS England and a member of the judging panel for HSJ Clinical Leaders 2015; and Saira Ghafur is clinical fellow to Sir Bruce Keogh at NHS England