“District Health Boards are failing to foster a culture of distributed clinical leadership, despite its demonstrated benefits to the sector,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

ASMS’ latest survey of clinical engagement reveals that more than half of the 1158 respondents (53%) believe their DHB does not encourage distributed clinical leadership by hospital specialists.

There has been little change in this measure since the last survey, in 2015, when 58% said their DHB did not encourage distributed clinical leadership, and that survey showed virtually no improvement on the previous one, in 2013.

The 2019 survey shows that 24% said their DHB encouraged distributed clinical leadership. South Canterbury topped the table for distributed clinical leadership – its specialists were most likely to say the DHB was committed to distributed clinical leadership, followed by Whanganui and Canterbury.

Not a single specialist at Wairarapa DHB believed the DHB was committed to distributed clinical leadership. Southern, Taranaki, and Tairawhiti also ranked in the bottom four.

When asked if they felt able to speak out about patient care quality concerns, less than half of respondents felt able to speak to their Chief Medical Officer, and only a quarter felt able to discuss concerns with their Chief Executive.

“DHBs’ lack of commitment to encouraging extensive clinical leadership represents a lost opportunity to improve the quality and accessibility of patient care and financial performance,” says Powell.

“The lack of confidence of hospital specialists to raise within their DHB quality concerns over the care of patients is downright scary.”



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