Leadership in the AHP’s – what is getting in the way of our ability to act?

There is little doubt that the environment in which the Health and Social Care system functions is becoming increasingly challenging and complex with demands on services far exceeding the resources available to provide. The significant changes in medical care have lead to increased survival rates, thus people are living longer with complex health and social care needs. This shift in public health is forcing organisations to evolve and transform. This creates an environment that is complex, variable, rapidly changing and extremely challenging to navigate for service providers and users alike.

For many years, Allied Health Professionals (AHP’s) have been working autonomously with service-users, families and carers to enable and support self-management, optimising  available assets and linking systems for maximum benefit. Having practised as an Occupational Therapist for over 20 years, and having had the privilege of working with a wide range of AHP’s, I am acutely aware of the significant benefits they bring to the Health and Social Care systems. It would therefore seem sensible to suggest that given the rapidly shifting, complexity of health and social care, the AHP’s should be considered a key part of the solution to the challenges which we are all facing.

In such uncertain times, the current view of leadership is that conventional hierarchical approaches are outdated, inflexible and slow to respond in this rapidly changing environment. A more updated approach includes collaboration, distribution and compassion which are recognised as positive activities and behaviours that support a more agile and responsive leadership approach. This approach is supported by the many policy drivers, beginning with the Christie Commission, the 2020 Workforce Vision, the Health and Social Care Delivery Plan and the National Clinical Strategy for Scotland.

Over the last few years, in recognition of this shift in thinking around leadership, a vast array of resources have emerged within the public sector including; Project Lift, The Kings Fund Collective Leadership  and Workforce Scotland. Additionally and more specifically in relation to the Health and Social Care sector and the AHP’s; NHS Education for Scotland (NES) AHP Career Development Framework, Realistic Medicine, the Active and Independent Living Programme and Ready to Act. All of which acknowledge the importance of leadership and the need for a more distributed, collective and compassionate approach.

This was the basis of my research undertaken for my MBA at the University of Strathclyde where I sought to explore and understand the lived experiences of leadership at all levels from a range of AHP’s. My hypotheses which drove this research stemmed from the shift in leadership theory, the strong steer from policy drivers and the vast range of leadership resources available in Scotland, however noting in practice these did not appear to translate into reality within the Allied Health Professions.

The findings from my research were enlightening and I am extremely grateful to every one of the 254 respondents who were so open and honest in their views providing rich data from which to draw conclusions and make recommendations. The findings and conclusions were categorised into four distinct areas.

• Research Demographic – outlines the experience, professional groups, grade, gender and other employment details of the respondents and was ultimately perceived as being a representative sample.
• Professional Issues – outlines the governance, line management, supervision, support and engagement of the respondents. Predominantly the findings were positive however concerns were raised about;
  1. professional governance structures
  2. AHP leadership at the most senior levels of the organisations
  3. the ability to influence decision making and enact change
  4. varying levels of supervision and support
• Continued Professional Development – recognised of the importance of supervision and a strong relationship with line managers as key contributors to leadership development and resilience. It explored the leadership opportunities available to AHP’s which appeared varied and widespread however concerns were raised around;
  1. opportunity for experiential learning
  2. lack of clarity of the leadership approaches within the existing culture
  3. lack of clarity of leadership pathway/s in the AHP’s
• Leadership in Practice – highlighted the key enablers and disablers to leadership
  1. Enablers to Leadership – included the importance of feeling valued as an individual, particularly as part of a team and the strong relationship/s with peers and in particular line manager. It was also noted that a growth mind-set of the team was crucial in determining individual ability and development
  2. Disablers to Leadership – included a lack of clarity of the leadership approaches and pathways, and limited awareness and availability of leadership resources

From these findings and conclusions, five recommendations are presented for consideration;

• To focus on Leadership Programmes/Resources/Pathways
  1. Maintain and develop access at all levels
  2. Develop consistent concept of leadership at all level
  3. Develop opportunities for experiential learning
• To progress a culture shift from traditional to more collective leadership approaches – requires a consistent message from our most senior leaders of enablement and autonomy
• To support the value of teamwork
  1. Enable and empower teams to review their performance and current ways of working with more innovative and alternative approaches
  2. Assist in removing barriers (perceived, imposed or real) to these new methods
• To strengthen workforce support and leadership and align with governance structures
• To provide strong senior leadership to empower AHP’s to be at the heart of the transformational shift in culture between health and social care providers and users

As AHP’s we are a key component of the transformational shift required to meet the current and future needs of our service users given our strong focus on self-supported management and empowerment. As a group we need to ensure that we are included at every level of organisational change and strategy-making to ensure that our value widely considered and included from the off-set.

If you would like to know more about my research or explore the findings or recommendations in more depth, please do not hesitate to get in touch via Twitter @hannahcairns7 or email me at: hannahcairns7@gmail.com

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