All health professionals - not just doctors - need to embrace clinical leadership if Lord Darzi's vision for the NHS is to be realised. Roland Petchey explains allied health professionals' role in driving change

Almost 70,000 allied health professionals are employed in the English NHS and many more work outside the service.

Like other health professionals, they are being required to work more flexibly, promote change and develop extended roles that cross professional and organisational boundaries. One of the most important of these roles is clinical leadership, and their engagement in this area has been identified as a priority by chief health professions officer Karen Middleton.

There are a number of reasons for this increasing focus on leadership in relation to professions that have historically had limited involvement with it. For example, the recent NHS Alliance report Clinical Leadership for NHS Commissioning argues that significant improvements in patient care will only occur when all frontline clinicians - and not just doctors - are fully engaged with commissioning services that meet patients' needs. This can only be achieved if clinical leadership encompasses the entire clinical workforce at both operational and strategic levels.

Neglected workforce

Developing leadership capacity poses particular problems for allied health professionals as they lag behind medicine and nursing in their involvement in management.

Despite being a key component of the healthcare workforce, they generally receive far less attention than other professions. Part of the explanation for this is that there are relatively few allied health professionals.

They are also held back by the fact that a diverse range of jobs fall under the allied health profession umbrella. They include physiotherapists (who number around 20,000), speech and language therapists (just under 7,000) and arts therapists (700). These differences in size are linked with significant variations in professional organisation, power, status and public visibility, all of which are relevant to their opportunities for involvement in management.

These groups also vary in terms of the extent to which their professional ethos, education and practice approximate the biomedical paradigm, ranging from radiographers and physiotherapists at one extreme to arts therapists at the other.

This fragmentation is reinforced by traditional patterns of education and training, which mean allied health professionals have very little exposure to each other or to opportunities to learn with and from each other.

Building on strengths

If this is the bad news, there is also good news for allied health professionals. They already possess a range of skills and experience, which they can build on as they move into positions of leadership.

As the chief health professions officer's team points out, allied health professionals' clinical work requires an analytical, holistic and collaborative approach, as well as qualities including emotional intelligence and strong communication, negotiation and motivational skills, which are vital for effective leadership.

Many of them also routinely work across a range of professional, organisational and sectoral boundaries, such as social care, education and housing. This gives them an understanding of a variety of organisational cultures and the flexibility of thinking needed to manage across them.

At City University, we are committed to working with the allied health professional leaders of tomorrow on turning these professional skills into tools for effective management and leadership, and to creating opportunities for them to learn together.

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