title: What is clinical leadership…and why is it important?
abstract: BACKGROUND
  The 'invitation' for clinicians to participate in leadership practices, previously considered the province of the professional health service manager, is driven by a number of international policy and professional agendas. This article, the first in a short series, considers definitions and theories of clinical leadership and management, and explores leadership roles and responsibilities of the clinician in terms of levels of engagement. Recent developments in the UK's National Health Service (NHS), the largest health care organisation in the world, are used as illustrations of how theory has informed clinical leadership development.
  
  
  METHODS
  Narrative review and discussion.
  
  
  RESULTS
  The tensions arising from the situation of health care professionals within managed health care are described. Leadership is defined alongside its relationship to management. Key theories of leadership are considered and applications of theory to practice explored. The role and usefulness of the 'competency framework' in leadership development is debated.
  
  
  CONCLUSIONS
  Health care is delivered by complex systems often involving large numbers of individuals and organisations. The effective clinician needs to understand these pathways and systems of care if they are to be able to function effectively, and must be comfortable working both within, and with, these systems for the benefit of their patients. Engaging in leading and managing systems of health care, on whatever scale - team, department, unit, hospital or health authority - is therefore a professional obligation of all clinicians. Just as leadership is argued to be necessary 'at all levels', so 'leadership development', assessment and feedback must be provided throughout the education and training of health professionals.
authors.affiliation: London Deanery, 32 Russell Square, London, WC1B 5DN, UK. tim.swanwick@londondeanery.ac.uk
authors.forename: Tim
authors.initials: T
authors.lastname: Swanwick
authors.forename: Judy
authors.initials: J
authors.lastname: McKimm
mesh_terms: D002983:Clinical Competence; D006291:Health Policy; D006801:Humans; D007857:Leadership; D017146:Models, Organizational; D016134:Organizational Policy; D011320:Primary Health Care / Q000458:organization & administration*; D013222:State Medicine; D006113:United Kingdom