Medical engagement | The King's Fund | eHealth - Social Business in Health |
by John Clark  and Vijaya Nath July 10th
Incl. Report download
What is good medical engagement? In those organisations where it exists, how has good medical engagement been created and sustained? These questions are at the heart of this report, which builds on earlier work from The King’s Fund on medical leadership.

This report is based on case studies of four NHS trusts with acknowledged high levels of medical engagement. It aims to help other organisations that are seeking to create cultures in which doctors want to engage more in the management, leadership and improvement of services. Based on interviews with a range of executives, senior and junior doctors, the report presents key features of each of the four trusts. Its final analytical section highlights common themes and includes a checklist to allow organisations and individuals to assess how far medical engagement is being sought and developed.

Key Findings

  • Medical engagement needs to be part of an overall organisational approach, from board to ward, and needs time to evolve. It is a journey that requires doctors to be motivated and to assume greater engagement with and responsibility for improving the quality of patient care in partnership with clinical and non-clinical colleagues and with input from patients.
  • The four trusts studied have all enjoyed long-term stable leadership, creating a firm foundation for cultural change. Senior leaders have shown total commitment to medical engagement and leadership.
  • All four trusts have clear strategies based on quality running throughout the organisations. The distinguishing feature is that these strategies form a way of working for the organisation – they are not isolated programmes.
  • Each trust has embraced a strong medical leadership structure with doctors in leadership roles at divisional and departmental levels, supported by managers. Despite making great progress, none claims to have a completely embedded medical engagement culture. 
  • Each trust puts considerable effort and resources into selecting senior staff including consultants, and none takes the stance that clinical expertise is sufficient.
  • Well-developed appraisal and revalidation processes exist in all four trusts. Talent management and leadership development are taken seriously, through education and training, and learning from other organisations.

Policy into practice implications

  • Medical engagement should be an integral part of the culture of all health care organisations and should be a priority for NHS boards and leaders.
  • It requires investment in development and training and also in governance arrangements to support the culture.