Healthcare delivery and patient circumstances are constantly changing today, and leaders have to continue to learn new abilities and skills to keep up. There is now an increasing need for leaders to be equipped with the knowledge and skills to respond to different challenges such as how to lead across different levels of healthcare in a timely, cost-effective and seamless manner, giving prevention as much priority as treatment and considering how different healthcare systems can be better integrated across diverse primary, secondary and tertiary providers.
This brings up the key question of how can leaders then create and foster an environment in which they, and the people they manage, are constantly learning?
Dr. Ravi Trehan who moved to the UAE two years back after spending 15 years working in the National Health Service (NHS) UK, held a number of leadership positions throughout his career, but his move motivated him to take up this challenge seriously and professionally. At present, he is a Consultant Orthopaedic Surgeon at Mafraq Hospital, Abu Dhabi. He is also associated with the University of Sharjah as Adjunct Assistant Professor, College of Medicine, as it is his passion to spread knowledge and train juniors.
He shared: “In my opinion, a healthcare leader should be skilful and knowledgeable in his field, an active listener, with an ability to respond and adapt as per the situation, empathetic towards patients and staff, with significant short-term and long-term set goals and vision for the organisation.”
The regional healthcare sector is one of the most dynamic industries, facing unique leadership challenges around the rapid expansion and digital transformation of the sector, while continuing to meet international standards, and the need for public and private sector collaboration to meet the needs of a young and growing population with a range of chronic lifestyle diseases. Today’s healthcare leader has to clearly and regularly identify challenges that the industry faces and be equipped with the skills and knowledge that the team needs to overcome these challenges.
In an interview with Arab Health Magazine, Dr. Stephen Brookes QPM, Programme Director, MSc in International Healthcare Leadership (IHL), The University of Manchester - Middle East Centre, in Dubai, discussed the challenges plaguing the healthcare industry and its leaders.
He said: “One of the biggest leadership challenges that I have seen around the world is inequality and no matter how well off a nation is, there are still huge pockets of inequality in healthcare. And certainly, in developing countries, this is a big issue.”
Another challenge Brookes cited was making prevention a priority, as much as treatment. “Research has shown that for every pound invested in prevention, you can get a seven-pound return. This is clearly illustrated by the significant drop in diabetes in the region and that has been possible because of the focus on preventative strategies rather than treating the illnesses,” he highlighted.
Other hurdles include bringing primary, secondary and tertiary healthcare together; along with bringing private, public and hybrid systems together in terms of focusing on putting patients at the heart of what healthcare leaders do. He stressed that it doesn’t matter if care comes from the private or public sector, the patient has to be at the core of that system, which also has to be financially stable.
“For example, the preventative agenda, according to me, works best in Bahrain. It is a small, compact state and its Ministry of Health believes in prevention.
“To what extent the private sector puts a priority on prevention as the public sector does is yet to be seen. Ultimately, it’s about the public value and having a collective vision in terms of what you want your healthcare system to be,” he added.
Brookes heads the MSc in International Healthcare Leadership (IHL) that was launched in Dubai by The University of Manchester – Middle East Centre in September last year with 20 students and this year the university has received applications for more than 25 students, attracting participants from the UAE, Saudi Arabia, Kuwait, and Lebanon, among others. The university is launching this programme in Manchester, UK, in March next year and also runs it in Singapore. The programme has also recently received university approval to recruit in Shanghai and Hong Kong and is looking to expand further in the Middle East region.
Brookes said: “One of the questions I have encountered is that why does the programme have the word “international” in it? I believe that it is important to address this as there is so much out there to learn and the world is becoming smaller due to improved communication.
“One of the strengths of this programme is that we are targeting professionals and don’t call them students but programme participants. Here they learn as much from each other as they do from the programme and the programme, that is us, learns from them. We are very keen to encourage the sharing of good practice and that’s why the international element is a critical part of that.”
He highlighted that the programme has four golden threads: internationalisation; leading through networks, you don’t just lead within your own team or department, you lead outside of organisations; encouraging creativity and innovation within appropriate boundaries of risk, but not being risk-averse, and putting the patient at the heart of everything. The design of the programme and assessments are based on these principles.
Although the content taught is the same in all the centres, each cohort has different face-to-face workshops that are tailored to that region. For example, one of the workshops in Singapore was about the ‘development of plans of preparedness and the collective leadership challenges’, where the participants had to role play and present back in terms of what their case would be and a work-based assignment was to go back to their organisation and look at the prepared case if there was one. One of the other activities participants did in their final workshop was ‘negotiation around an emerging pandemic’.
The programme has been divided into two segments – the online module that uses cutting-edge e-learning with expertise from the University of Manchester. The second part is face-to-face workshops, as the personal interaction between tutors and participants is integral and the only requirement of people joining is that they need to come to Dubai twice a year for five days, for these residential workshops.
Brookes explained: “In effect, we are bringing the study to them, but they still get the same quality of learning and degree as they would when they would have chosen to study at a university. This is what blended learning is all about. The principle is that the learning needs to show its impact in the workplace while ticking academic boxes.”
The course is accredited by Manchester Business School – Association to Advance Collegiate Schools of Business (AACSB International), Association of MBAs (AMBA), the European Quality Improvement System (EQUIS) and Dubai’s Knowledge and Human Development Authority (KHDA).
Expanding Skill Set
Anyone who is remotely connected to healthcare can be eligible for admission, Brookes enlightened, as the course is looking to bring together clinician and non-clinician leaders or aspiring leaders. The participants should have an accepted first degree, two years’ experience in healthcare leadership or management roles, and a good command of the English language proven with an International English Language Testing System (IETLS) test.
He said: “In Dubai, we have a pharmacist, a biogeneticist, and even an engineer who wants to get more engagement in healthcare. He told me that being on this programme helped him achieve a new position and he is now working in San Francisco in the biomedical field.
“As programme director, I do have the discretion to accept students who might not have a first degree but have a 10-year or more work experience in healthcare and more importantly a passion for healthcare. We don’t just get just clinicians starting their careers, but also have consultants on-board. The beauty of the programme is that its growing thanks to word of mouth and is creating international networks around the world.”
Being a skilled healthcare leader means being aware of the fact that everything within the purview of the leadership role is about people. A course such as this teaches participants skills that give them the confidence to be a leader. It offers a wider perspective of healthcare, along with insight, greater intellectual awareness, improved communication skills and strategic problem solving, which leadership is all about. It aims to equip leaders and managers with the latest knowledge and global healthcare best practice and helps facilitate experienced managers to transfer their skills into the healthcare economy.
After looking for the right course for the past few years, Dr. Trehan thought that the MSc in IHL had all the essential components mandatory to develop himself as an effective leader. He found the course content relevant to his current position, and has learned new but tried and tested methods, to work within a team, form a new group and lead from the front.
“I have learned a lot about quality and service improvements methods through their “action learning” approach and put those into practice at my hospital. My quality department and CMO were impressed and agreed to make relevant changes. This course is much more than a degree on paper; it helps to evolve a leader from within,” he added.
Leading the Way
Prevention takes time, is difficult to measure, so often it gets ignored and that’s why public value as a concept versus performance review is much more important because most leaders tend to dismiss things that cannot be measured. Generally, leadership development is dealt with in a different silo to leadership practice and for it to be effective these two have to be part of the same cycle. Leadership development should be carried out, practiced, the impact should be observed, reflected on, and then improved. This requires a collective sense of leadership development with a commitment from senior leaders of the organisation.
“The concept of a virtual leader is emerging — a leader cannot be in all places, all the time, and neither should they be. The leadership should focus on the collective and has to move away from the individual focus. A three-letter word that gets in the way of leadership is ego. You have to leave ego outside the door and replace it with value-based leadership and I think incorporating technology smartly into practice has the potential to do that,” Brookes concluded.
After spending almost 20 years with NHS, Dr. Feroza Dawood, Consultant Obstetrician and Gynaecologist, moved to the UAE in 2016, in order to broaden her clinical experience. She shared: “I believe that a healthcare leader should have a vision of the way forward and strive to deliver high-quality clinical services in any setting. A healthcare leader should possess qualities of self-awareness, self-confidence, resilience, determination, and self-reflection in order to be an effective leader and manager. A leader should also be able to inspire a shared purpose and influence, motivate and engage their teams.”
Having held many managerial and administrative roles, Dr. Dawood applied for the MSc in IHL degree as she wanted to enhance her existing managerial experience with a formal structured course.
“Moving to the UAE exposed me to an entirely different healthcare system as there is a conglomeration of government and private healthcare and this is very different from the NHS. The course has enlightened my understanding of cultural and organisational diversity and more explicitly, has provided the knowledge of how to adapt to change.
“I have also gleaned a wealth of information about quality improvement strategies and the course has equipped me with imparting information of formal strategy improvement models. So far, a crucial learning experience has been about self-reflection and gaining a more profound understanding of my personality, my strengths and weaknesses, self-improvement and application of these at work and personally,” she added.