Lord Darzi's review singles out Kaiser Permanente in the US as an example of an organisation with strong clinical leadership and says the NHS can learn from its 'practitioner, partner, leader' model. Permanente Federation director John Cochran explains

Our patients encounter the healthcare system in multiple ways: physically, socially, psychologically and financially. As doctors, we must accept broad accountability on behalf of our patients by embodying the roles of healer, leader and partner.

The doctor as healer not only provides excellent clinical care and service, but does so while being mindful of the vulnerability, uncertainty and pain patients are experiencing in addition to their physical symptoms.

The doctor as partner takes responsibility for leading the healthcare team and all the professionals involved in the patient's care. This means not only providing great leadership and clear expectations for that team, but also supporting team members in their careers and lives.

The doctor as leader accepts areas of accountability in healthcare to ensure we work in a system that is safe, equitable, accessible and affordable. This is a commitment to being the kind of leader who always brings the patient's view into conversations, whether in the areas of therapy, system design, healthcare delivery or health policy. Medical leadership is crucial to improving the quality and cost of healthcare.

Developing leaders

Leadership development is essential for clinicians, who may be primarily chosen for leadership positions based on clinical respect. Thus, a systematic approach is needed to develop management skills such as communication, performance management and conflict management. This approach should combine formal training and skill-building opportunities with monitoring and feedback provided by a respected mentor.

We encourage all clinicians to participate in and contribute to activities that enhance our group practice. Professional development is a core component of this and we have built a culture dedicated to life-long learning. We offer comprehensive leadership development programmes for clinicians throughout their careers.

Since we started our physician development programmes more than 20 years ago, we have experienced many benefits. Perhaps the most significant accomplishment is the change we have seen in our clinicians' mindset. They now embrace the idea that their leadership affects the health of the patient and the health of the system. Only when we accept that we are more than providers of clinical care to our patients will we transform healthcare.