Multidisciplinary professional leadership makes for a sustainable health and care system

The evidence is clear that if we want to improve outcomes for local populations, we need to embrace leadership at all levels of an integrated care system (ICS). NHS England’s guidance on effective clinical and care professional leadership (CCPL) supports this and sets out five core principles describing what ‘good’ looks like. Since its publication in 2021, ICSs have been designing and implementing frameworks that set out their vision for CCPL and its ambition to support integrated care.

A new tool from the NHS Confederation shares how three systems are working towards embedding these principles, making small and big changes –  from developing a cross-sector leadership programme in Surrey Heartlands, to creating new spaces for collaboration in Leicester, Leicestershire, and Rutland, to committing to developing the talent pipeline in Norfolk and Waveney – that reflect a more diverse, inclusive and holistic model.

It is of course all work in progress, and it is about much more than just including clinicians. The vision is for communities and a range of organisations to work across boundaries, together, developing new ways of working and delivering integrated services. It takes time and perseverance to ensure there is the right culture and practical arrangements and resources to bring people together.

For place-based partnerships and neighbourhood care models to thrive, clinical and care leaders will need to be supported to embrace and lead population health management approaches for their communities, focusing on prevention and proactive care for those most at risk and building teams of teams to co-ordinate care around local needs.

Over time, this might support a change in accountability and leadership, shifting from a focus on clinical settings or care pathways to clinical and care professional leaders taking responsibility for care of population groups using approaches like population segmentation to guide the development of new population-based care models.

CCPL is perhaps most powerful as an enabler for integrated care. For example, in other parts of the country progress is being made to help primary and secondary care work more closely, with some systems developing thinking and new models that embrace on-the-ground expertise and leadership from all parts of the system. The aim is to improve outcomes, reduce waiting times and optimise use of resource. The opportunity for health and care professionals to innovate, collaborate and apply their expertise to find solutions is integral to success.

The Leicester, Leicestershire, and Rutland Chronic Kidney Disease Integrated Care Delivery Project (LUCID) is a data-driven, preventative partnership between primary and secondary care. With over 1,400 virtual consultations performed, leading to early interventions to reduce cardiovascular and dialysis risk, LUCID is a leading NHS example of locally-driven, proactive and personalised care being delivered, underpinned by a sense of shared ownership between primary and secondary care and a culture of improvement and safety for people to learn, experiment and collaborate on shared objectives. LUCID has undergone external evaluation and been shown to be cost effective with estimated savings of £2.75 for every £1 invested. The LUCID approach is being adapted in other ICSs, and developed within Leicester, Leicestershire and Rutland ICS for other long-term conditions.

Gloucestershire ICS is also making progress in this area and has recently published the Gloucestershire Interface Prescribing guidance which sets out the framework for healthcare organisations in Gloucestershire to improve the efficiency and effectiveness of working arrangements between primary, community and secondary care to manage and prescribe medicines. This model, which was developed with all system partners as part of the ICS Medicines Optimisation Committee (IMOC), will aim to ensure that patients receive high quality care and make best use of clinical time and NHS resources.

Across health and care we need to redefine our perception of leadership and its potential.  It is not a knight on a white horse, a job title or a deeply medicalised model, but something that can be found in everyone regardless of their role or background. It is about creating space for listening, dialogue, collaboration, risk-taking and trust which will ultimately improve outcomes and experiences across health and care.

You can learn more about each CCPL principle, what they mean and why it is so crucial that we act now by listening to the five-part Clinical and Care Professional Leadership Lowdown podcast. The NHS Confederation also has a suite of resources designed to build understanding around the value of CCPL and to support systems to consider how they are embedding the health and care voice into decision-making, and developing their leadership.

Head and shoulders photo of Jane Lovatt - Physio and Associate Director for Multi-Professional Improvement and Engagement

Jane is a physiotherapist who began her career working in the community before progressing on to service management, clinical governance and quality, with a career highlight leading on Covid testing across Surrey during the pandemic. Her diverse career has spanned the NHS, Local Authority, the Clinical Commissioning Group, and now Surrey Heartlands Health and Care Partnership (Integrated Care System). In her current role as Associate Director for Multi-professional Improvement and Engagement, she focusses on health and care professional leadership and improvement. She is passionate about wellbeing, leadership and improvement.

Head and shoulders photo of Sir David Pearson - System Transformation Advisor

David is a System Transformation Advisor on the integration of health and social care for NHS England. He is also a Senior Intervenor for the NHS in situations where people with a learning Disability and Autism are in segregated settings on a long-term basis. He is the Chair of the Advisory Board for the social care research programme in England.

He was the Director of Adult Social Care and Health for 14 years and the Deputy Chief Executive for Nottinghamshire County Council, elected the President of the Association of Directors of Adult Social Services in 2014/15, and he was the Chair of the Nottingham and Nottinghamshire Integrated Health and Care System between 2016 and 2021.

In 2017, he was appointed as an independent advisor to the Government on the Social Care Green Paper in England. In June 2020 David was asked to lead the Government Taskforce on COVID 19 in the social care sector. In January and February of 2022, he chaired another Government Taskforce on the delivery and take up of vaccine boosters in social care. He was the Co- Chair of a Commission on the future of housing with care and support conducted by SCIE.

David was appointed to the Expert Panel of the Parliamentary Health and Social Care Select Committee in November 2022.

David was awarded a CBE in 2016 for services to adult social care and a Knighthood in the 2021 New Year’s Honours for services to health and social care integration.