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How to develop your PCN leadership skills

3 March 2023

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Stepping up to be a GP leader is no easy task. How can you hone your leadership abilities without it requiring a lot of time and money? Dr Rupa Joshi shares her advice 

PCN clinical directors (CDs) have had a steep learning curve – and for many GPs it has been their first time in a leadership role.  As more work has shifted to PCNs, it has required local leaders to integrate with partner organisations and embark on health inequalities projects. An expanding PCN workforce has meant that we are often overwhelmed with supervision responsibilities, and finances have also increased in complexity. 

Against this background, developing leadership skills is vital. The good news is that leadership development doesn’t have to involve expensive programmes and courses. 

Here’s how to make it a continuous process and part of your routine working life: 

Understand what good leadership looks like  

Our emerging clinical leaders are using their GP skills to listen to concerns, be democratic, develop trust and negotiate. Many are taking time to build relationships, adopt and spread best practice, network, and improve care. PCN CDs are learning to understand the strengths of their teams and engage and influence partnership organisations, while putting patient and PCN staff needs at the centre of their decisions.  

A leader ensures that individuals/ teams feel appreciated and that they know and understand their team’s values, motives and behaviours and align priorities to these. Leadership is increasingly about using soft skills, such as good communication, listening to concerns and recognising the efforts of everyone. It is also essential to develop a vision and business plan, set targets and priorities, and understand resources and needs.  

See leadership as a continuous learning process 

Learn from every project and meeting, reflecting on ‘what went well’ or questioning what could be ‘even better if’ by using a quality improvement lens. Focus on building trust and on developing relationships. Always be yourself, open, honest and be vulnerable. 

I use a ‘Before Action Review’ (BAR) template that helps me to prepare for important meetings. A BAR is a way of assessing the knowledge and experience that exists before embarking on a new activity, project or event. It can help identify potential challenges and risks by drawing on lessons learned from past experiences. It could include the following questions:  

  • What are we setting out to achieve? 
  • What can be learned from similar situations and past projects from elsewhere? 
  • What will help deliver success? 
  • What are the actions we need to take to avoid problems and apply good practice?

After a meeting talk to your team and evaluate using the model, ‘what went well, even better if.’ Did the meeting align with your overall shared purpose and goals? Was the meeting solution-focused? Think about the pinch points, what the pressures are and whether these were addressed. Also, are you using collaborative solutions? Remember you are stronger together.  

As part of practising personal reflection, I also like to set monthly goals and priorities and review these, checking whether the goals were achieved and what can be learned from the processes and experiences of trying to meet them. 

Perfect the art of running effective meetings 

Always have your vision and goals at the forefront of any meeting. Ensure you have a good chair acting as facilitator, that there’s opportunity for all to get their voices heard, there’s a clear decision making process in place and good clear notes are taken and documented. Don’t have an agenda with more than eight items on it. Practise storytelling to get your point of view across. Use a ‘hook’ and stick to three to five main points. You will need to repeat messages as people are very busy.

Find out how people want their information presented to them, for example, do they prefer face to face contact or email?   

Read up on leadership   

There are some great books available and I recommend:

  • The Leadership Hike – Shaping Primary Care Together by Amar Rughani and Joanne Bircher
  • Compassionate Leadership by Michael A West
  • The 7 habits of highly effective people by Stephen Covey
  • How Women Rise by Sally Helgesen and Marshall Goldsmith
  • Patrick Lencioni’s The Five Dysfunctions of a Team.  

Also, take a look at Brené Brown’s blogs and TED talks from Simon Sinek, author of Start with Why. The NHS Confederation’s website also features useful material on leadership, as well details about networks. 

Find a mentor  

A mentor is an experienced and trusted advisor who provides guidance. A mentor shows positive behaviours. Ask if you can do some shadowing, use them for peer support and for talking through difficult conversations to help you gain new perspectives. Experienced managers can also provide excellent insight.  You can find a mentor and more information about mentoring at the Faculty of Medical Leadership and Management.  

Use coaching

This is goal-based support for your own personal development. Coaching helps individuals find the answers to their own questions and unlock their potential. Coaches can be found through the local NHS leadership academies or sessions booked via the NHS Looking after you too programme. 

Play to your strengths, don’t focus on your weaknesses 

Use your ‘tribe’, speak to like-minded people. Get advice and use them as a sounding board. 

Take on new challenges 

Every challenge is an opportunity to learn and grow as a leader. Some may feel uncomfortable and completely out of their comfort zone. Ask for help and guidance from your support network and use their expertise. Learn from social media, adopt and learning, not just what went well, but what didn’t go well, exploring why and what you might do differently next time.  

Develop soft skills  

Listen with fascination, don’t interrupt, reflect, use appreciative enquiry, be curious, ask questions, learn from expertise. Use soft skills in all meetings and interactions, and be authentic. You will always learn something from every conversation or meeting if you listen, not just talk.   

Key summary tips for leadership development  

  • Use your support network – find your ‘tribe’ using local clinical director networks or the NHS Confederation PCN Network. 
  • Create harmony in your team – build emotional bonds and mobilise people towards a shared vision. 
  • Apply your learning and experience from each previous role/project when taking on a new role or challenge.
  •  Make time for your team and utilise and nurture their individual skills and insights.
  • Communicate and listen to patients and staff with curiosity and fascination to gain a better understanding of your PCN’s priorities.  
  • Don’t be disheartened by laggards, engage your innovators and early adopters and motivate and mobilise to engage others. 
  • Make use of resources offered by NHS England through the Time for Care programme.   

Dr  Rupa Joshi is a GP and PCN Joint Clinical Director at Wokingham North, as well as a qualified coach.  She also sits on the PCN Network Board at the NHS Confederation.