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We need “change agents” and effective leaders

By Chijioke Agomo

During this period of health reform in the NHS and change in the pharmacy profession, pharmacists have the potential to further develop their roles as effective leaders and change agents

Chijioke Agomo community pharmacist, London

 

The Advanced and Consultant Level Competency Framework and the Pharmacist with Special Interests Framework have been planned around several functions, one of which is professional leadership. The pharmacy profession will need to develop influential leaders who are able to grab opportunities so it can stay at the vanguard of patient care.

The leadership skills called for are different from management skills (see Panel below). Therefore, managers will still be required to sustain service delivery in pharmacy and senior pharmacists will need to evolve from being good managers to being effective leaders.

Panel: Leadership versus management

Leadership:

  • Based on influence and sharing
  • An informal role
  • An achieved position
  • Part of every healthcare professional’s responsibility
  • Requires initiative
  • Requires independent thinking

Management:

  • Based on authority and influence
  • A formally designated role
  • An assigned position
  • Usually responsible for budgets, and hiring and firing people
  • Can be improved by the use of effective leadership skills

From Barr J, Dowding L. Leadership in Health Care. London: Sage; 2008.

Defining leadership

Although there are several definitions of leadership, it is still considered to be an elusive concept and a discipline that is still evolving. One definition of leadership is that it is an influential relationship among leaders and followers who intend real changes and outcomes that reflect their shared purpose. Effective leaders enable people to move in the same direction, toward the same destination and at the same speed, not because they have been forced to, but because they want to.

Several leadership tools have been developed to measure the styles, abilities and skills of leaders, some of which include the leadership and followership test, the strengths, weaknesses, opportunities and threats analysis, and the Myers-Biggs Type Indicator, which identifies ways in which individuals vary in assembling and assessing information for problem-solving and decision-making.

Pharmacists could use these leadership tools either on their own or in combination to identify their various leadership styles.

Leaders and other practitioners are now increasingly expected to be reflective practitioners through the maintenance of a professional portfolio. To be able to do this effectively, they will also need to operate a model of reflection that is clear, usable, effective and robust for the proposed purpose.

A frequently used model is one that uses a sequence of questions that permit one to work through an experience, learn by it and re-evaluate it later. Not only has reflection been acknowledged as a brilliant process by newly emerging leaders to learn, three main kinds of reflection have been illustrated:

  • technical (based on scientific method and rationale)
  • practical (leads to interpretation, description and explanation of human interaction)
  • emancipatory (leads to transformative action)

Looking at leadership as a collection of personal characteristics or traits, the notion is made that some people possess specific leadership qualities, while others do not. However, leadership qualities and skills are not just inborn, but can be developed.

New leadership

The term “new leadership” is a concept that is related to the new roles and expectations that are driving healthcare professionals into a more prominent position. There are specific skills needed in new leadership, including self-mastery, strategic visioning, continual learning, creating partnerships and team facilitating. Newer concepts of leadership that involve facilitating change, creating a learning environment, sharing vision and shaping cultural values are important in the complexity of working life.

This is probably the reason why these skills form the main cores of the Advanced and Consultant Level Competency Framework and the Pharmacist with Special Interests Framework.

Change agents

A “change agent” has been defined as a person who facilitates planned change or innovation. These agents can support those who are in a leadership role. There are four main ways that a person can operate as a change agent. They include being

  • a catalyst
  • a solution-giver
  • a process-helper
  • a resource-linker

Catalyst

As a catalyst, the change agent helps to overcome apathy, to push and pressure the team to be less contented and to begin working on its serious problems. The role of a catalyst is vital since most people do not like change and, therefore, like keeping things the way they are, even when outsiders know that change is necessary.

For example, the previous dual role of the Royal Pharmaceutical Society was argued to be slowing the advancement of pharmacy practice in Britain, yet some people object to the separation of its regulatory and professional leadership roles.

Change agents do not necessarily have the solution to problems, but they are usually dissatisfied with things the way they are. By making their dissatisfaction known and by disturbing the status quo, they therefore energise the problem-solving process, and hence get things happening.

Solution-givers

Effective solution-givers have to know when and how to offer solutions, and they need to know enough about the problem in order to provide a solution.

Process-helper and resource-linker

The change agent as process-helper deals with how change comes about in individuals and organisations. The change agent as a resource-linker involves effective problem solving through bringing together needs and resources.


The four primary change agent roles are not mutually exclusive and one can be an effective change agent either as an insider or an outsider (eg, a locum pharmacist can sometimes be the change agent that sparks change within a pharmacy team).

Conclusion

At this time of change in the NHS and in pharmacy, pharmacists have the opportunity to develop their role as effective leaders and change agents in line with their personal developmental objectives.

Citation: The Pharmaceutical Journal URI: 11068840

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