What makes a good medical leader in tough times? Introducing the '4C' leadership model

Stock image. iStock.com/ Bevan Goldswain

By Professor Rich Withnall

A pressing challenge facing all NHS organisations is to nurture cultures that ensure the delivery of continuously improving, high-quality, safe and compassionate healthcare.

Leadership is the most influential factor in shaping organisational culture, and so ensuring the necessary leadership behaviours, strategies and qualities are developed is fundamental.

Current NHS conditions make good leadership even more important. Demand in primary and secondary care is huge; 6.3 million patients are waiting for more than 7.5 million treatments, and 75,000 people have been waiting more than 65 weeks.¹

While the fact that people are expected to live 13 years longer now than when the NHS was established in 1948 is a triumph of medicine and public health, an ageing population brings more chronic disease, polymorbidity and polypharmacy. Alongside improved diagnoses of cancer, ADHD and mental health, the NHS needs more capacity to treat these extra patients. Extra patient throughput and capacity increase costs, but this year’s fiscal climate is already grim. For example, in the first 4 months of this financial year, the 42 integrated care systems in England recorded a collective deficit of £2 billion, compared with a planned £2.2 billion deficit by the end of the 2024/25 financial year, HSJ reported.