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Time to get serious about distributed leadership: lessons to learn for promoting leadership development for non-consultant career grade doctors in the UK
  1. Emmeline Lagunes Cordoba1,2,
  2. Suzanne Shale3,
  3. Rachel Clare Evans3,
  4. Derek Tracy2,3
  1. 1 Camden and Islington NHS Foundation Trust, London, UK
  2. 2 Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
  3. 3 Oxleas NHS Foundation Trust, Dartford, UK
  1. Correspondence to Dr Emmeline Lagunes Cordoba, Camden and Islington NHS Foundation Trust, London NW35BY, UK; emmeline.lagunescordoba{at}


COVID-19 has exposed the National Health Service (NHS) to the greatest challenge in its existence, highlighting the need for nimble, reactive and inclusive leadership. It is set against a backdrop of a workforce recruitment and retention crisis predicted to worsen in coming years. There is a need to do things differently in healthcare, including better diversity and distribution of leadership. We make the case for senior non-consultant doctors, in the UK more usually referred to as specialty and associate specialist or locally employed doctors. These skilled, experienced medics have much to offer yet are frequently overlooked, with little guidance or support from central organisations and medical colleges or within NHS Trusts themselves. In this commentary, we suggest ways this workforce might be better tapped into, to the benefit of patients and healthcare systems, as well as the doctors themselves.

  • SAS doctors
  • clinical leadership
  • consultant

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  • Contributors All four authors contributed to the planning and reporting of the work. ELC is responsible for the overall content as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SS is a member of the General Medical Council. This article is written in a purely personal capacity and the opinions expressed are the author’s own.

  • Provenance and peer review Commissioned; externally peer reviewed.