Leadership in General Practice

As a General Practitioner, your role extends far beyond patient care; you are a leader within your practice and your community.

General Practice is the setting in which patients will often first seek help, where uncertainty is managed, where prevention and early intervention are integrated with the care of acute and chronic illness, and where relationships often extend across generations. General practitioners work not only with individual patients, but also with families, communities, multidisciplinary teams and an increasingly complex wider health system. In this environment, leadership is not an optional extra or a responsibility reserved for those in formal leadership roles. It is an essential component of everyday practice.

Leadership in general practice takes many forms. It may be seen in the consultation, where a clinician helps a patient navigate uncertainty and make informed decisions; in the practice team, where colleagues collaborate to improve access, safety and quality of care; or across the wider system, where general practitioners advocate for populations, influence service development and respond to changing health needs. 

The demands placed on general practice make effective leadership increasingly important. Ageing populations, multimorbidity, workforce pressures, health inequalities, digital transformation and rising patient expectations have all reshaped the landscape of care. General practitioners are expected to deliver high-quality clinical care while also contributing to service improvement, team development, resource stewardship and the coordination of increasingly complex pathways. 

In this section of the curriculum we encourage trainees to consider the attributes and behaviours of effective leaders, the importance of teamwork and organisational culture, the role of leadership in quality improvement and change, and the challenges of leading in a demanding and uncertain clinical environment. 

LD1    Evaluate the evolving role of primary care within the broader Irish Healthcare system, considering its structure, funding models, economic constraints and ethical challenges and assess their impact on service delivery and patient outcomes 

LD2 Develop Leadership and teamwork skills in primary care, including effective communication, delegation, motivation, advocating for patients and collaborating effectively with colleagues.

LD3    Reflect on and develop your leadership style by understanding a range of leadership approaches and adapt your leadership style to suit different situations. 

LD4    Coordinate patient care by collaborating with healthcare professionals including hospital doctors, public health nurses, allied health professionals, physiotherapists and pharmacists and understanding the organization of primary care services 

LD5    Demonstrate a responsible approach to healthcare resource allocation, balancing individual patient needs with broader public health considerations 

LD6    Lead and manage change within primary care practice understanding the factors that influence change 

LD7    Take a holistic approach by addressing  individual patient needs alongside community health and sociocultural factors

LD8    Evaluate and contribute to optimisation of your practice environment, including facilities, staffing and workload to ensure high quality patient care 
 
LD9    Contribute to the profession through mentorship education and engagement in healthcare improvement initiatives

ICGP Leadership Academy

ICGP Peer Support Buddy Program

Workplace Based Learning

Within the workplace there are important opportunities to develop leadership skills. Leadership can be learned through active participation in the everyday life of the practice, including encouraged attendance and contribution at primary care team meetings, where trainees gain insight into team dynamics, collaborative decision-making, care coordination and the management of complex patient needs. With appropriate supervision, trainees should be supported to take on leadership roles from an early stage in their careers, for example by chairing a meeting or leading a quality improvement project. Some trainees may be interested in partaking in the peer support buddy program. Some trainees may take on leadership roles within training such as acting as a class representative or becoming involved in the Network of GP Trainees. Such experiences help trainees to recognise that leadership is not dependent on seniority or formal authority, but is an important part of practice, grounded in communication, responsibility, teamwork and a commitment to improving patient care.

Day Release

In Day Release, trainees can explore the professional, organisational and leadership dimensions of general practice. Through facilitated discussion, case-based learning, group work and engagement with colleagues from across the training scheme, trainees can reflect on leadership experiences encountered in their workplaces and consider different approaches to communication, teamwork, conflict management, service improvement and change. Day release can also provide opportunities for trainees to develop leadership in practice, for example by organising educational sessions, contributing to trainee representative roles or leading peer-learning activities. 

Registrar Tutorials

Registrar tutorials provide a valuable setting in which GP trainees can explore leadership in a manner that is closely connected to their individual clinical experiences and professional development needs. Through regular discussion with their trainer, trainees can reflect on encounters that involve uncertainty, team communication, ethical challenges, workload management, patient advocacy and the organisation of care, recognising the leadership dimensions within everyday general practice. Tutorials can also be used to set leadership-related learning goals, review participation in practice or multidisciplinary meetings, plan and evaluate quality improvement activities, and discuss opportunities for taking on appropriate responsibility within the practice. By offering constructive feedback, role modelling and guided reflection, the trainer can help the trainee develop confidence, self-awareness and the practical skills required to lead effectively and compassionately throughout their career.

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs. 

EPA 13: Patient Advocacy

An Entrustable Professional Activity (EPA) on patient advocacy provides a meaningful opportunity for a GP trainee to demonstrate and reflect on leadership in everyday clinical practice. The trainee might record an experience in which they identified that a patient faced barriers to accessing appropriate care, such as social disadvantage, communication difficulties, fragmented services or delayed referral, and took action to address these concerns. In documenting the EPA, the trainee can describe how they listened to the patient’s priorities, communicated with relevant professionals, navigated services, raised concerns appropriately and helped coordinate a patient-centred plan. Reflection should consider the leadership skills involved, including initiative, professional responsibility, collaboration, respectful challenge and the ability to influence care in the patient’s best interests. Feedback from a trainer or multidisciplinary colleague can further support learning by identifying strengths and areas for development, demonstrating that patient advocacy is not only a core professional responsibility, but also an important expression of clinical leadership.