20-21 - Oxford University

“The COVID pandemic has taught us that you can’t just sit on your hands when you’ve got no evidence. You still have to make decisions. You still have to act,” says Professor John Powell, Professor of Digital Health Care, Nuffield Department of Primary Care Health Sciences. “There is this argument, do we save public health or do we save the economy, but actually it’s a compromise between the two. If you get the public health right, you support the economy.”

It all comes down to healthcare leadership. And in the current pandemic, the challenge for healthcare leaders has been huge. “What the virus has done is illustrate the very important interplay necessary for dealing with a pandemic between leaders in different organisational structures and it has illustrated some of the skill sets we naturally believe are essential for leading organisations but it also illustrates that the modern healthcare leader needs an advanced skill set in many areas that traditionally we wouldn’t have thought were necessary,” notes Professor Richard Hobbs, Head of the Nuffield Department of Primary Care Health Sciences.

It couldn’t be better timing for the University to launch an MSc in Global Healthcare Leadership, which begins in October. While planning for the new Masters programme pre-dated COVID, the pandemic has highlighted the need for expert leadership in global healthcare. The part-time programme – which will be directed by Professor Powell – covers policy, healthcare innovation and the challenges facing leaders in healthcare nationally and globally, as they confront change and uncertainty and respond by setting effective strategies. It also provides insight into some essential tools of the trade such as methods used in evidence-based medicine, fundamental in informing health care policies. The programme pulls together expertise from across Oxford University’s Nuffield Department of Primary Care Health Services and the University’s Saïd Business School to teach a skill set that is not routinely available in other leadership programmes.

The new programme comes at a time when the pandemic has shone a very public spotlight on the challenges facing healthcare leaders and the differences in approach across the globe. One area in particular has been whether or not healthcare leaders in different global organisations are enabled to influence healthcare policy. “In countries that have done well, there does seem to be a tendency that scientists or people with more understanding of science issues are in political roles and decision-making roles, and they have done better than those countries where those skills are lacking in the political leaders,” says Powell. This highlights the need for more medical or health literacy among policy makers or, indeed, structural change at higher levels, he says.
However, Dr Eleanor Murray, Senior Fellow in Management Practice, Saïd Business School, points to a possible shortfall in healthcare leaders’ skill sets. “We’ve seen the issues over the period of COVID of the challenges scientists have had in being able to convey the evidence to persuade politicians to take a different approach. Influencing is an important leadership skill and being able to communicate healthcare challenges to politicians.”

Hobbs agrees but adds this also highlights another challenge. Politicians are more focused on short-term drivers while healthcare leaders are more focussed on mid to long-term drivers. Bringing the two sides together to articulate messages is something all leaders need to consider, he says.

Perhaps one of the biggest challenges facing healthcare leaders has been the response to the pandemic within their own organisations because their decisions may not only affect patients but their staff as well, says Hobbs. For instance, the sourcing of PPE, where to use it, to what grade and how frequently it needs to be changed, alongside staff working at pace for a year while continuing to provide high-quality service to patients, against a backdrop of increasing proportions of the workforce being sick or coming to the end of their battery life.

To this end, fostering resilience has been a big theme for healthcare leaders during the pandemic, says Murray. “Research shows you develop resilience as you encounter and overcome crises so just the fact that healthcare professionals will have had to work through and deal with the challenges of the pandemic will have helped develop their personal resilience, as well as developing strong support networks with family and friends and peer support networks in the workplace. The more people in organisations who have strong support networks and who can build on them with their colleagues are more likely to create strong resilience across the whole organisation.” From a leadership perspective, building these strong supportive cultures within an organisation and encouraging a learning mindset are critical to help build organisational resilience, she says.

Of course, COVID has also caused great change and disruption to healthcare systems, virtually overnight. According to Hobbs, prior to COVID just 3% of consultations with GPs were online. Within two to three weeks of the pandemic that had jumped to 60%. “That’s an absolutely unbelievable penetration of something there would have been huge resistance to, but it had to happen and the impact of digital health is going to be transformative. We really need leaders thinking about how that sort of innovation can transform the way they run their organisations and design their clinical services.”

Murray agrees, noting that the response to the pandemic has enabled the removal of structural barriers, which no longer appear to be the impediment they had previously seemed to be. The new challenge for healthcare leaders moving forward, she says, will be maintaining the removal of these barriers and not seeing that as a potential threat.

Digital transformation is just one challenge alongside the pandemic facing healthcare leaders, but there are many others that are not pandemic related. Climate change, health system costs, engaging empowered patients, countering misinformation and health conspiracy theories, improving communication and influence on policies, dealing with antimicrobial resistance, just to name a few. All of these require unique leadership skills to navigate the future healthcare space.

“Leadership in healthcare and policy making is going through such a tremendous series of changes,” says Kathy Harvey, Associate Dean, MBA and Executive Degrees, Saïd Business School. “No one knows how our health systems or health leaders will emerge at the end of this pandemic.” Given that Oxford University has been central to research around COVID and vaccines, it makes sense it hosts a Masters in Global Healthcare Leadership, she says. The programme is aiming for a broad international reach across commercial, research sectors, policy, healthcare providers and politics. “We want to create a community of healthcare leaders across the public and private sectors that will really make a difference,” Harvey says.

The pandemic has exposed the gaps in global healthcare leadership. Oxford University is drawing on its expertise to plug those gaps and prepare today’s healthcare leaders for tomorrow’s healthcare challenges

Training the next generation of healthcare leaders