Clinical leadership needed.

Greater clinical leadership will be introduced into the public health system, if the recommendations of a ministerial task group on clinical leadership are enacted.

A report commissioned by Health Minister Tony Ryall and called "In Good Hands" provides guidelines on how doctors and nurses can be re-engaged in the running of frontline health services--"a more participatory and less top down approach for district health board (DHB) doctors, nurses and other health staff", Ryall explained. "Globally, clinical leadership is recognised as a fundamental driver of a better health service."

The task group of six was chaired by Association of Salaried Medical Specialists president Jeff Brown and included one nurse--Wairarapa DHB director of nursing Helen Pocknall The report notes that clinical networks in primary care have helped develop effective partnerships between managers and clinicians. However, there was poorer engagement with DHB management and governance structures.

The report identifies six principles on which to base the processes for developing clinical governance. These include quality and safety to be the goat of every clinical and administrative decision; clinical leadership embedded at every lever of the system to ensure the best use of resources; and clinical reviews of administrative decisions. Clinicians must be empowered to set the direction for the services they deliver, to make decisions on resources and to make decisions on people, the report states.

Recommendations include quality and safety to top every agenda of every board meeting and board report; assessments of the chief executive to include clinical outcomes and clinical effectiveness; clinicians to be on the executive management team as full participants in all decision making; and DHBs to provide on-the-job training to support clinical leadership all levels.