Void at the top
Dentistry’s ability to deliver and sustain effective patient care demands strong leadership
In March, on the eve of International Women’s Day, I attended the first Royal College of Physicians and Surgeons of Glasgow President’s Lecture since the installation of their new President, Dr Jackie Taylor. It was delivered by the Chair of the GMC, Dame Clare Marx, and the subject was Clinical Leaders – your patients need you. Following the lecture, I had the absolute privilege to join 50 other specially invited female guests at a dinner to celebrate the role and achievements of women in healthcare, with a continuing focus on leadership.
So why am I mentioning this? In putting this edition together, with its focus on dentistry from the patient perspective, what struck me more than anything was the importance that good leadership has in the patient experience. Whatever the clinical pathway, and whatever the eventual outcome for the patient, good leadership ensures strong, efficient, effective teams who are able to focus on using their skills and expertise to the benefit of their patients, providing excellent and safe care. Poor leadership, and unfortunately there is much of it out there, negatively impacts teams and patients, as well as the healthcare services, organisations and practices in which it happens.
It’s easy say you are a leader by dint of your role and responsibilities, but being called upon to lead, and being a good leader are two very different things. Leadership is more than a job description, it is the behaviours you exhibit; the way you communicate – the very fact that you do communicate; the way you make your colleagues act and feel, and how you support them to develop, whether you can bring out the very best in them; the confidence and trust you inspire in your patients and the relationships you build with them. Good leaders display, amongst other things, integrity and honesty; creativity and innovation; commitment and passion; and inspire and motivate their colleagues.
It is important to remember, therefore, that this means anyone can behave as a leader, whatever their role. It is very true that in a clinical environment there needs to be a clear chain of leadership, a person in charge who is responsible for the situation and the team. They might be a GDP, a DCP, a surgeon, or someone else entirely, but they are usually where the buck stops in that particular clinical situation. But one of the qualities of a good leader is that they are not afraid to be challenged. No one is infallible, and team members must feel able to show their own leadership, to challenge, to put forward ideas, and to step-up and take responsibility, when necessary and appropriate. After all, there is significant evidence to show that teams who have a dictatorial, micro-managing leader who exhibits no compassion for or faith in their teams, who will not support their team members to grow, develop and take on responsibility, and who might exhibit bullying and undermining behaviour – in the very worst cases – will be dysfunctional, inefficient and ineffective. This is where mistakes can creep in, and where patient safety and care can be compromised.
What about leadership on a national level? Since the collapse of the Northern Ireland Assembly in 2017, there has been ever-growing concern over the stagnation caused by this void in leadership. It has impacted all areas, and dentistry certainly. Issues which pre-dated the crisis have been left to fester and much-needed decisions to drive policy forward have been left un-made. Meanwhile, in the Republic, the long-promised oral health policy remained a promise, even with a leadership structure in place, meaning it was not always clear if this leadership was itself effective. However, in the last couple of months, things have indeed moved forward. In the Republic the oral health policy is finally out, though not without its critics, and in Northern Ireland, well-publicised rulings have allowed officers who never expected to have such significant decision-making powers to take up the mantle of leadership and drive change and movement. It is also heartening that talks to restart a Northern Ireland Executive are under discussion, particularly in light of recent tragic events.
It is important to recognise, however, the critical role of the dental profession in all this. The continued commitment and leadership of the dental professionals and their representatives ensured that the dental voice continued to be heard and listened to. Perhaps, therefore, this shows more than anything that everyone working in dentistry has a role as a leader? Perhaps it is the responsibility of all dental professionals to speak to politicians, the public and colleagues in other areas of healthcare and demonstrate the critical importance or oral health and the dental profession as a whole. It’s a big ask. Particularly in the context of increasing stress, anxiety and disillusionment, but surely true leaders can lead and inspire however bleak the situation appears. They can find the good and magnify it, they can see the opportunities and follow them through, whether this is on a micro level, or on big public platforms. Perhaps.
So that is why I mentioned the RCPSG President’s lecture on leadership. But why was it relevant that it particularly celebrated women leaders? Well, that’s simple. There’s a lot of evidence to suggest that women are better natural leaders than men, and that having them at the top of organisations changes culture and drives positive organisational change. I’ll just leave that there.