Clinical leadership is central to service planning, delivery, evaluation and improvement. To deliver sustainable high-quality healthcare it is vital that doctors, by virtue of their training, determine resource requirements and allocation to ensure resources are used efficiently and efficaciously. While at present societal determinants dictate that policy-makers and government ultimately govern this, as a profession, we must not revoke our responsibility for it. With increasing economic pressures and an overwhelming increase in the demand for healthcare, it has never been more important for doctors to uphold their professional values and highlight to policy-makers, based on clinical evidence, what is needed and where priorities must lie, to ensure that equitable healthcare of the highest possible standard is delivered to patients, who deserve no less.
Historically, this has been challenged within the UK by recurrent governmental reforms of the healthcare system. The lack of direction in service delivery resulting from this, compounded by a series of high-profile healthcare tragedies across the country, not excluding mental health, has challenged one of the principles that lies at the heart of every doctor's practice, ‘to do no harm’ (Department of Health, 2012; Francis, 2013; Keogh, 2013). It could be argued that both the lay and the professional perception of healthcare professionals and the healthcare service as a whole has worsened, and that the trust placed in professionals to look after patients, indeed, to provide even the very basics of care, has been irreparably damaged.
It is clear that questions as to our professionalism must be answered and that we must now, more than ever, demonstrate that, as doctors, we value patients as being at the centre of healthcare delivery and strive for the highest quality of healthcare in everything we do, by upholding and developing our leadership responsibilities.
The Charter on Medical Professionalism, published simultaneously in the UK and USA in 2002, was an attempt to restore the profession's reputation. The Charter outlines values, behaviours and relationships that underpin the essential components of professionalism through what it terms the fundamentals which doctors must uphold and the commitments they must have (Medical Professionalism Project, 2002).