Nurturing medical leadership in the NHS

Ara Darzi’s report on the NHS finds much key infrastructure seriously degraded.1 Crucially, it identifies weakness in leadership, management structures, and capacity among the main drivers of deterioration. Senior medical leadership should have a valuable role in tackling these challenges. Growing evidence shows an association between clinical leadership and high performance—for example, in improving operational efficiency, supporting innovation and adoption of technology, and facilitating integration across care systems.23456 But the right opportunities, support, and environment to secure medical leadership locally and nationally in the NHS need to be put in place to deliver the benefits.

Many of the barriers to medical leadership in the NHS are practical. A clinical director with responsibility for a department of more than 400 people typically will be allocated 12 hours a week to manage 70 consultant colleagues. Most of that …