Guidance for developing the role of medical directors
Clinical and Medical Directors Subcommittee
May 2007
Summary
The core activities of the medical director
The medical director is a statutory board-level post (in NHS and mental health trusts and in NHS Boards in Scotland) and which the BMA campaigned to ensure was retained with the establishment of foundation trusts in England. Increasing numbers of primary care trusts (PCTs) in England are establishing a medical director post alongside reformed professional executive committees, and local health boards (LHB) in Wales also have medical directors.
There is a multiplicity of structures for management within NHS organisations, and the role of the medical director will vary as a result of this. Within different management structures, however, there remain a number of key aspects of the medical director’s role, first identified in the CCSC’s original guidance, which act as the building blocks for the construction of the medical director’s job description. They are:
- providing professional medical advice to the board and its officers, and coordinating and facilitating the communication of medical professionals’ views on medical matters to the board
- providing medical leadership to the medical and clinical workforce
- providing medical input to the development of strategy and strategic thinking
- taking the key role in the support and development of undergraduate and postgraduate teaching of doctors, in PCTs this would involve liaising with the Director of Postgraduate General Practice Education to support FY2 doctors in general practice and GP registrars
- communicating the organisation’s perspective to clinicians, ie acting as the board’s ambassador
- supporting the work and development of clinical directors in the hospital sector, (including acting as arbitrator between clinical directors and consultants where necessary, eg over job plans), and the development of clinical leads within PCTs in England and LHBs in Wales
- taking a key role in doctors’ disciplinary procedures and in anticipating and preventing, as far as possible, cases of poorly performing doctors
- taking part in the management of investigations of a clinical nature concerning doctors, such as those arising from complaints or untoward events where patients are involved
- taking part in the consultant and other medical appointment procedures and clinical excellence award systems (or equivalent) as a member of the management team
- taking the lead role in the improvement of clinical quality through the application of practice guidelines, clinical audit, clinical effectiveness activities, risk management and staff development where appropriate
- taking the lead role, often jointly with the director of nursing, in supporting and developing clinical governance
- facilitating and supporting multi-professional practice, and appropriate role re-design around changing patient pathways.
- taking a key role in the research and development strategy, either directly or, in some trusts, by working closely with the research and development director
- acting as the management representative in dealings with the local negotiating committee
- and leading the management-side of the local joint negotiating committee for medical and dental staff
- in primary care acting as a key board member with the Local Medical Committee and in England with the Professional Executive Committee, and the Practice Based Commissioning Executive
- often acting as Caldicott Guardian for the organisation
- fulfilling new statutory roles under legislation on management, use and disposal of controlled drugs as part of the government’s response to the fourth Shipman report
Issued by:
Clinical and Medical Directors Subcommittee
British Medical Association
BMA House, Tavistock Square
London, WC1H 9JP
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