Career progression within the NHS has traditionally been based on technical and academic ability at the expense of the so-called 'softer' attributes, such as emotional intelligence.
As a result, good clinical leaders have not always been identified, nurtured and developed by the system, but have emerged due to a mixture of their own ability, self-motivation, luck and patronage.
This has led to significant variation in the standards of clinical leadership within and between different NHS organisations and has had an impact on the standard of care provided to patients. The inquiries and resulting reports into clinical negligence at Bristol, Alder Hey and Maidstone and Tunbridge Wells all highlighted organisational deficiencies in clinical leadership.
In order to develop effective clinical leaders, the NHS and stakeholder organisations must place professional and personal development of clinical staff at the centre of their priorities. Clinical leaders are unlikely to emerge without creating an environment in which their skills have been nurtured and valued.
There is considerable debate in the literature as to whether leaders are born or whether they can be made. While Kotter argues that leadership consists of a series of definable skills that can and should be taught,1 others have suggested that there must be a prerequisite level of innate natural leadership ability.