RCGP Leadership Capabilities Framework

We’ve created a framework to help GPs develop their leadership skills. It outlines the capabilities needed for leadership in different GP contexts. There are several GP leadership contexts, but we've focused on the most common:

  • GPs in postgraduate training – for doctors training to become a GP
  • practice level leadership – for leading immediate team or practice
  • locality level leadership – for leading services, groups or multiple practices
  • system level leadership - for leading whole organisations or healthcare systems, possibly at a national level

Who is it for?

The framework aims to help GPs with personal development and career progression. Multidisciplinary teams can also use it as a training and development tool.

Using the framework

The framework consists of five key areas, taken from the NHS Medical Leadership Competency Framework

Each area is broken down into smaller elements, showing the capability outcome expected at each career stage.

Demonstrating personal qualities

Developing self-awareness

Leadership context Capability outcome
GPs in postgraduate training
  • Understands and can describe own learning style
  • Begins to understand own values set
Practice level leadership
  • Understands and can describe own teamworking style
Locality level leadership
  • Understands and can describe own leadership style
System level leadership
  • Flexes and adapts own leadership style to situations, concepts, people and problem

Managing yourself

Leadership context Capability outcome
GPs in postgraduate training
  • Understands own best learning style
Practice level leadership
  • Understands how to work effectively in a team
Locality level leadership
  • Develops a wider teamworking skills set
System level leadership
  • Flexes and adapts – grows
  • Develops ways to have a positive impact on others

Continuing personal development

Leadership context Capability outcome
GPs in postgraduate training
  • Understands how to develop own CPD needs during training
  • Responds to feedback
Practice level leadership
  • Commits to own CPD development
  • Actively seeks feedback
Locality level leadership
  • Establishes local CPD support
  • Obtains, analyses and acts on feedback from a wide range of colleagues
System level leadership
  • Changes strategies in light of feedback and reflection, situation or context
  • Career strategy in place
  • Supports innovation

Acting with integrity

Leadership context Capability outcome
GPs in postgraduate training
  • Understands own values and professional values
  • Develops clear understanding of person-centred care
Practice level leadership
  • Develops own values and behaviours in a team setting
  • Promotes and involves others
  • Displays candour
  • Delivers person-centred care
Locality level leadership
  • Draws on and develops local values and behaviours
  • Explores and understands diversity and inclusion
System level leadership
  • Leads with values and demonstrates duty of candour and authenticity
  • Advocates for all in system wide decision making

Working with others

Developing networks

Leadership context Capability outcome
GPs in postgraduate training
  • Participates in multidisciplinary team
  • Listens to the views of others
  • Develops resources
  • Develops practice and peer networks which are relevant to current practice
Practice level leadership
  • Supports team development in practice
  • Understands practice population
  • Develops and shares resources for a population or group
Locality level leadership
  • Attracts and develops local colleagues
  • Understands locality population needs
  • Develops and shares resources for a population
System level leadership
  • Pull in expertise from all parts of the system
  • Understands population needs and health inequalities
  • Understands how all parts of the system work - including commissioners, providers and integrated care systems, for example Sustainability and Transformation Partnership

Building and maintaining relationships

Leadership context Capability outcome
GPs in postgraduate training
  • Participates in learning groups
Practice level leadership
  • Understands population health needs
  • Develops practice learning offer
Locality level leadership
  • Brings colleagues, patients and all groups together
System level leadership
  • Develops a collective leadership approach

Encouraging contribution

Leadership context Capability outcome
GPs in postgraduate training
  • Supports other trainees locally via the training programme or small group teaching
Practice level leadership
  • Works collaboratively with practice groups and local networks
Locality level leadership
  • Actively builds local talent
  • Meaningfully engages expertise and resources
System level leadership
  • Challenges, identifies and develops the next generation of leaders
  • Actively seeks alternative views

Working within teams

Leadership context Capability outcome
GPs in postgraduate training
  • Understands current role and how to be part of a small team
  • Begins to take on care coordination lead roles – including palliative care
  • Understands Quality Outcomes Framework (QoF) where applicable
Practice level leadership
  • Delegates effectively within a team
  • Develops own team working skills
  • Takes on projects such as QoF, Quality Improvement (QI) and Enhanced Services
  • Leads multidisciplinary team meetings
Locality level leadership
  • Builds a consensus on a common vision and purpose
  • Respects views of others
  • Willing to build and lead a team
System level leadership
  • Promotes values-based teamworking
  • Respects and develops inclusion and diversity
  • Promotes team working skills
  • Advocates for others

Managing services

Planning

Leadership context Capability outcome
GPs in postgraduate training
  • Looks at pathways in practice and undertakes a small-scale change management project or Quality Improvement (QI)
Practice level leadership
  • Develops and reviews practice-level policies and procedures
  • Works to understand and gather feedback from patients and local groups, for example Healthwatch
Locality level leadership
  • Uses population health data to develop or change a service to meet local needs
  • Uses QI regularly
System level leadership
  • Takes part in system wide service planning meetings across integrated care systems (ICS)
  • Adopts an advocate role for person centred care and primary medical care

Managing resources

Leadership context Capability outcome
GPs in postgraduate training
  • Identifies the resources needed for individual patient care
Practice level leadership
  • Understands the delivery of safe and effective services for defined populations
  • Understands the importance of delivering services within a budget
Locality level leadership
  • Analyses the available data and makes evidence-based decisions for locality
  • Evaluates the service from a variety of perspectives
  • Is able to understand budgets in different forms - practice budgets, commissioned services and the commissioning budgets
System level leadership
  • Informs service change through input of clinical perspective
  • Ensures care is patient focussed and safe
  • Provides appropriate challenge at various levels
  • Takes part in financial scrutiny
  • Develops clinical colleagues’ awareness of working within a defined budget

Managing people

Leadership context Capability outcome
GPs in postgraduate training
  • Takes guidance and support from others
Practice level leadership
  • Provides support for all in the practice team, including administration, clinical and managerial
Locality level leadership
  • Supports others to develop their roles and careers
  • Develops people in line with the needs of the population, for example frailty
System level leadership
  • Facilitates others to promote, develop and enhance care across networks and populations

Managing performance

Leadership context Capability outcome
GPs in postgraduate training
  • Understands and interprets personal and practice level performance data
Practice level leadership

Reviews the following data:

  • local practice targets
  • GP Patient Survey
  • data from local bodies, such as Clinical Commissioning Groups (CCG), including service spends
Locality level leadership
  • Analyses the available patient data
  • Evaluates the service from a variety of perspectives
  • Addresses performance in a locality, based on local, such as CCG, and public or national data sets
System level leadership
  • Brings patient stories into performance management
  • Able to state and challenge clearly difficult issues

Improving services

Ensuring patient safety

Leadership context Capability outcome
GPs in postgraduate training
  • Recognises, and demonstrates techniques to manage, personal limits
Practice level leadership
  • Identifies practice level safety incidents
  • Develops forums for learning events and Significant Event Analysis (SEA)
  • Develops use of QI methods in practice
Locality level leadership
  • Able to interpret data and develop quality markers that ensure patient safety
  • Uses the available evidence to support up to date processes
  • Improves safety through collaborative working
System level leadership
  • Challenges practice when new evidence supports
  • Monitors and evaluates the effects of change
  • Reports on safety and quality issues

Critically evaluating

Leadership context Capability outcome
GPs in postgraduate training
  • Understands that feedback from staff, patients and colleagues is critical
Practice level leadership
  • Develops ways to gather views
  • Uses local data, for example from Clinical Commissioning Groups (CCGs) and others
  • Uses evidence bases to inform changes to patient care
Locality level leadership
  • Brings together local voices to improve care across a locality or network
  • Speaks up in the appropriate forum
System level leadership
  • Looks at all options across a population
  • Understands information from all sources
  • Interprets information carefully and sensitively to create solutions

Encouraging improvement and innovation

Leadership context Capability outcome
GPs in postgraduate training
  • Understands that changes can always be made to improve care
  • Understands that there are many sources of data, both in-house and nationally collected public data, that can help and encourage changes
  • Understands that innovation and change is wholly welcomed in General Practice
Practice level leadership
  • Thinks about what is going on in own practice and of ways to improve
  • Has an open and critical mind about improvements to patient care
  • Identifies recurring themes from clinical case discussions, discussions with colleagues, in practice learning events and SEA
Locality level leadership
  • Thinks about what is going on in own network or neighbourhood and discusses with colleagues to identify similar themes and issues
  • Agrees, facilitates, encourages and explores with other practices ways to improve care
  • Uses available data from practices, local bodies such as CCG, and other local system partners, for example acute trusts
  • Seeks new ideas
System level leadership
  • Works with all stakeholders to improve care to make it meaningful for patients
  • Represents and supports sensible and pragmatic changes
  • Collaborates effectively
  • Is critical of new developments that may have adverse consequences across organisations
  • Harnesses innovation
  • Encourages and supports others to take projects and innovations forwards

Facilitating transformation

Leadership context Capability outcome
GPs in postgraduate training
  • Puts ideas into practice
  • Participates in the process as an active team member
Practice level leadership
  • Delivers a full QI project
  • Is an active team player
  • Seeks out new ideas
  • Encourages contribution and supports others to take a lead on projects in practice
Locality level leadership
  • Is a team player across practices and organisations
  • Knows how to collect data safely across practices
  • Facilitates projects across locality, network and neighbourhood
System level leadership
  • Encourages cross-collaboration
  • Effective at communicating next steps
  • Creates and encourages opportunities for others
  • Develops strategies in collaboration with the right teams
  • Knows when the time is right

Setting direction

Identifying the contexts for change

Leadership context Capability outcome
GPs in postgraduate training
  • Takes part in opportunities to learn about the healthcare system
  • Takes part in departmental meetings with the local health community
  • Demonstrates an understanding of the healthcare system and the impact of the doctor’s role on patients and their families
  • Complies with the clinical governance requirements of the organisation
  • Attends multi-agency case conferences
Practice level leadership
  • Seeks opportunities to learn about the NHS policy environment, organisation and structures
  • Undertakes analysis to systematically appraise the organisational environment
  • Develops and enacts the clinical governance in a practice
  • Attends and actively contributes to multi-agency meetings and conferences
Locality level leadership
  • Develops clinical governance arrangements across a locality
  • Presents locally and nationally
  • Creates new ideas or solutions
  • Communicates with teams and community
System level leadership
  • Seeks opportunities to learn about the NHS policy environment
  • Responds to policy and direction

Applying knowledge and evidence

Leadership context Capability outcome
GPs in postgraduate training
  • Uses appropriate sources of information, including patients, to support learning
  • Uses and interprets practice performance data and information to debate services within multidisciplinary team meetings
  • Uses audit outcomes to challenge current practice and develop consistent, reliable care
  • Critically analyses information and data
  • Delegates responsibility to colleagues to act as service leads and supports them to innovate
Practice level leadership
  • Critically analyses information and data
  • Uses external references, such as IT-based resources, to support analysis
Locality level leadership
  • Investigates an identified problem in small group work
  • Presents information sensibly to all colleagues, including administrators, managers, clinicians, local bodies such as Clinical Commissioning Groups and neighbourhood colleagues
  • Applies principles and practices of evidence-based medicine
  • Communicates effectively with communities, teams or networks
  • Communicates about patient care improvements
System level leadership
  • Delegates responsibility to colleagues to act as service leads and supports them to innovate

Making decisions

Leadership context Capability outcome
GPs in postgraduate training
  • Takes part in multidisciplinary team meetings and listens to patient experiences during clinical placements to appreciate the organisational context for decisions
  • Makes decisions with trainer to enable a move to independent practice
  • Understands how decisions have taken account of changes in evidence and policy
Practice level leadership
  • Contributes to decisions using evidence about the running of the service as part of a multidisciplinary team
  • Contributes to relevant decisions about workload and arrangements for cover, based on clear and concise information and data
  • Takes part in clinical committee structures within practice
Locality level leadership
  • Takes part in clinical committee structures within the organisation and on localities
  • Determines priorities for a service, incorporating them into departmental and trust business plans
System level leadership
  • Advises management colleagues, providing a clinical perspective on service developments and the implications for patients and care delivery in practice and at locality and system level
  • Inputs in timely and patient-centred way

Evaluating impact

Leadership context Capability outcome
GPs in postgraduate training
  • Takes part in training for committees, for example to review the effectiveness of initiatives
  • Seeks opportunities to determine the impact and effectiveness of service changes
  • Reviews the effectiveness of alternative treatments and approaches during training posts
  • Presents audits and QI in practice posts and in training programmes
Practice level leadership
  • Contributes to the evaluation of services and care within practice
  • Initiates reviews of patients’ care
  • Sets the outcomes based on values and patient-centred care
  • Presents audits and QI within practice
  • Facilitates the introduction of new services, systems and processes
Locality level leadership
  • Participates in organisational service review and planning with healthcare commissioners
  • Facilitates the introduction of new services, systems and processes
  • Identifies good practice and communicates this to a wider audience, for example speaks at meetings
  • Sets outcome-based measures across a network or locality
System level leadership
  • Identifies good practice and communicates this to a wider audience, for example speaks at meetings and conferences, publishes articles and guidelines
  • Commits to outcome-based impact measures
  • Reports clearly, timely and efficiently

Feedback

The framework will inform our future leadership offer, so we welcome your feedback to help us ensure it reflects the rapidly changing leadership landscape.

Email: leadership@rcgp.org.uk

We would like to thank Dr Ali Lea for her contribution to this work.

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