CHAPTER 15 - The role of the clinical director

Summary

Key points

1. ✓ Effective communication is a key role for the clinical director.

2. ✓ Leadership is about developing teams, managing teams, monitoring progress and acknowledging success.

3. ✓ Sell the RCOG standards for gynaecology enthusiastically and with conviction.

4. ✓ Be prepared to carry out developmental work, such as team building, if required.

5. ✓ Identify lead for all the standards.

6. ✓ Provide support in terms of time and personnel appropriate for achieving implementation.

7. ✓ Develop reporting framework and agreement from lead consultants.

8. ✓ Monitor progress regularly throughout the year.

9. ✓ Produce an annual report and circulate this widely.

Introduction

There are understandable anxieties that this document becomes another quick read and is then consigned to that dusty pile of papers in the corner of the office never to see the light of day again.

Clinical directors may feel a reluctance to tackle standards for gynaecology, as implementation will require additional work within a climate of fatigue and burnout following years of Department of Health-driven targets and implementation of national service frameworks, National Institute for Health and Clinical Excellence guidance, Clinical Negligence Scheme for Trusts/NHS Litigation Authority (CNST/NHSLA) standards, NHS Quality improvement standards reviews in Scotland, cancer peer reviews, Human Fertilisation and Embryology Authority visits, Colposcopy Quality Assurance Review Centre visits and on and on.

A cursory glance at the Standards for Gynaecology document may leave the impression that there is not much work to be done. A more detailed read exposes deficiencies in services. In our department, gynaecology guidelines and patient information has lagged behind obstetrics. I suspect that this has occurred because there have not been the incentives that litigation concerns and CNST/NHSLA work has brought to bear on obstetric practice.

Clinical directors should view the Standards for Gynaecology as the opportunity to convince the RCOG that we, not the College Tutors or the Regional Advisers, are the key to raising standards in obstetrics and gynaecology. Furthermore, the document also gives us an unprecedented opportunity to identify gaps in our service provision and to develop an informed business case for seeking additional funding from the strategic health authorities.