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Best And Worst DHBs for Clinical Leadership


Best And Worst District Health Boards for Clinical Leadership

Four district health boards (DHBs) need to take urgent remedial action to improve the way they involve senior doctors and dentists in health decision-making, according to the Association of Salaried Medical Specialists (ASMS).

Executive Director Ian Powell says Auckland, Wairarapa, Hutt Valley, and Southern DHBs are at the bottom of the pack when it comes to providing time, opportunities and support for clinical leadership.

“There’s a strong message here for chief executives and senior managers running the public hospitals in those DHBs,” he says. “These DHBs are in serious difficulties, and have been ranked very poorly by senior doctors working for them.

“Clinical engagement isn’t just a nice-to-have idea – it’s at the very heart of ensuring that health services are meeting the needs of patients and communities. If senior doctors and other clinical staff are not centrally involved in leadership decision-making over the design, organisation and delivery of health services, and how to resource them, then the risks of compromising the quality of patient care and of financial inefficiency dramatically increase.”

The ASMS has been analysing the results of two membership surveys on clinical leadership and the level of genuine commitment to it within DHBs. The surveys were carried out late last year and the overall findings have been reported in previous issues of the ASMS quarterly magazine, The Specialist.

The latest magazine, just out, drills down into these results in more detail, looking at each DHB and how it relates to others. The magazine can be viewed electronically at

“Too many DHBs are narrowly preoccupied by top-down formal leadership structures and underestimate how valuable establishing a culture that encourages the opportunity for widespread leadership by all senior doctors.”

Mr Powell says the surveys indicate that Lakes, Canterbury and West Coast DHBs are performing the best on clinical leadership.

“They’re doing well for a number of reasons but one of the most important is the level of genuine commitment of their chief executives and other key staff to widespread clinical leadership by all senior doctors. This sets the culture within the organisation and has a big impact on performance. There’s always room for improvement but these three DHBs are really setting the pace for others to follow.”

How all of the DHBs performed:

• Pretty good – Lakes, Canterbury, West Coast

• Could do better but showing promise – Northland, Waitemata, Counties Manukau, Waikato, Tairawhiti, Hawke’s Bay, Taranaki, MidCentral, Nelson Marlborough, South Canterbury

• Need to really lift their game – Bay of Plenty, Whanganui, Capital & Coast

• In serious difficulties – Auckland, Wairarapa, Hutt Valley, Southern.

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