ARTICLE IN PRESS
Complementary Therapies in Clinical Practice (2006) 12, 80–82
EDITORIAL
Clinical leadership: Developing the role of
complementary therapy coordinators
Peter Mackereth and Ann Carter are coordina-
tors of complementary therapy teams working
in palliative and supportive services in Greater
Manchester. In 2003 the Christie Hospital
complementary team won the Prince of Wales
Foundation for Integrated Health Award for
‘‘Good Practice in Integrated Health’’. They
also won in 2005 both the Greater Manchester
and North West Regional NHS Awards for
‘‘Innovations in long-term conditions’’. In
November 2005 Peter Mackereth won ‘‘Public
Servant of the Year’’ with The Guardian
Newspaper.
This Guest editorial describes the need
and value of the development of clinical
leadership courses to promote, develop and
enhance effective integration of comple-
mentary medicine into mainstream health-
care practise.
Ann and I were both employed to be coordinators
of complementary therapies within supportive and
palliative care. Our shared experience of this
evolving role identified many ways in which emer-
ging lead practitioners and coordinators can be
helped and supported. The coordinator role has
evolved largely within the hospice settings in the
UK. It been recommended in recent national
guidelines for complementary therapies in suppor-
tive and palliative care as a pivotal role in
developing, managing and prioritising quality com-
plementary therapy provision.1
In the UK, there are currently few courses
dealing with issues coordinators may be
experiencing for the first time. After successfully
running several coordinators courses at St. Ann’s
Hospice in Manchester (UK) we identified a number
1744-3881/$ - see front matter & 2006 Published by Elsevier Ltd.
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of issues which concern coordinators. These
include recruiting therapists, interviewing skills,
documentation, writing policies and policy devel-
opment, supervision, research and evaluation of
services and clinical governance and team leader-
ship skills.
Additionally, The National Association of Com-
plementary Therapists in Hospice and Supportive
Care (NACTHPC) organises a Complementary Ther-
apy Coordinator Support Group (see Contacts).
These are useful and important developments both
in terms of educational opportunities and as a
means of networking. Coaching, mentoring and
supervision can also provide co-ordinators with the
support locally to develop their clinical and team
leadership skills.
Whilst the developmental needs of coordinators
are beginning to be recognised, leadership in
complementary therapies has yet to be fully
developed and its potential realised. The nurturing
of leadership skills is vital for practitioners to
improve clinical practise, deliver integrated health
care and establish role models for future clinical
leaders in integrated medicine.
The provision of skilled leadership encourages
individuals to assume greater responsibility
and clinical accountability for both specific thera-
pies team direction. To date in the UK, limited
funding and ad hoc provision of comple-
mentary therapies in healthcare settings has
meant that many therapists work in isolation, often
in a part-time, in a voluntary capacity or ‘adding
on’ complementary therapies to existing clinical
workloads. This situation raised a number
of questions: Can existing coordinators and
lead practitioners sustain their work given challen-
ging conditions, and in such a context is it possible
for future clinical leaders be identified and
nurtured?
 ARTICLE IN PRESS
EDITORIAL
Therapist to coordinator—a source of
inner conflict?
Many complementary therapists may feel that they
are not natural leaders preferring instead to focus
on practise rather than organisation. To be thrust
into a ‘leadership’ role based upon the length of
time in an organisation or amount of clinical
experience rather than recognition of inherent
leadership skills or training can be challenging.
Indeed, complementary therapy interventions
require a therapist to be practical and present,
and most coordinators may start with the dual role
of therapist and coordinator or other therapists or
of therapies integration within allopathic medical
procedures. As the coordinator role develops the
emergent leadership role and management of a
team can conflict with the clinical role of therapist.
In any area of enterprise, leadership skills need to
be recognised, honed and trained and not everyone
is suited to or wishes to undertake such a role. It is
erroneous to assume that clinical experience is co-
commitant with the ability to lead and there are
many examples in industry of poor leadership based
upon erroneous assumptions of judgement about
what it is to be a leader.
Leadership involves many facets including role
modelling, supervision and therapist training and
liaising with members of a multidisciplinary team.
Without training and support, a leadership role can
become very tough. There may be even more
dilemmas for managers in other clinical fields who
may not be fully cognisant about the nature and
remit of the role of the coordinator and how to
integrate this role into the clinical management
structure of a hospital.
Doing ‘leadership’ for ourselves
Clinical leadership programmes have now become
recognised by healthcare professionals as better
equipping practitioners to support, manage and
develop their teams. These schemes improve
patient-centred care linked to practitioner devel-
opment and mentorship.2 More recently a wide
range of clinical practitioners from medical and
allied health professionals are being encouraged to
participate in these programmes.3 This is an
important developments since to date there have
been limited development opportunities, thus
practitioners have been focussed on initiating and
attempting to sustain services and funding of
clinical posts rather than team development and
leadership.
81
It is apparent that recognised leaders of com-
plementary therapies are beginning to emerge,
who are usually very driven, committed and
dedicated individuals.4 It is acknowledged that
although increasingly used by the public, comple-
mentary therapies continue to be low on the
healthcare agenda. This is due partly to the
realities of healthcare priorities, such as waiting
lists, critical illness and advances in drug and
surgical treatments.
As a result the integration of complementary
therapies occurs in patches within public services.
In the UK this is most commonly within in
supportive and palliative care settings less directly
affected by acute measures outcomes or in areas of
clinical ‘worst case scenarios’—in other words
areas where conventional medical treatment ap-
pears to have failed. Emergence of new clinical
procedures having to confront clinical efficacy in
worst case scenarios before being integrated into
mainstream medicine is however, not new.
However, nurturing emerging leaders is essential
to any integration process and progress is slowed if
there are few practitioners who have substantive
contracts to develop their roles. Given that
complementary therapies are commonly used in
supportive and palliative care we propose that this
area of practise should be the focus of a clinical
leadership programme.
Keeping your feet on the pedal
Leadership is an energy intensive activity, with a
momentum partly propelled by an individuals’
enthusiasm. Leaders may well be a few steps ahead
of others, but they must also be instep with their
team members. Without this connection, leaders
can become remote, isolated and drift. Leadership
can be a mantle passed from one person to another
but only if taught by delegation rather than
abdication. Successful and sustained leadership
depends on a combination of factors that allow
the person to remain resilient and an effective role
model to others (see Box 1). We suggest that
leadership programmes should be accessible to all
complementary therapists who feel a need to
explore and examine these areas.
Summary
As complementary therapies struggle to feature on
health agendas around the world, it is likely that
lead practitioner and coordinator development will
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82 EDITORIAL

Box 1 Conditions/qualities for resilient leadership.

 Remaining curious about the work and its boundaries by evaluating and researching your practise
 Having the ability to present and disseminate best practise
 Using a facilitative style that recognises and supports others to lead
 Accessing, mentoring and supervision
 Maintaining ongoing clinical practise to maintain and develop expertise
 Seeking out and value champions and supporters
 Being comfortable with promoting you and your team’s work and skills
 Embracing change and transformation
 Identifying sources of financial support to develop you and your team (e.g. travel and academic
scholarships)
 Networking and collaboration
 Recognising and working with conflict and resistance to change

initially come from a bottom up approach, and will
be dependant on the enthusiasm, energy and
resources of the individual and local support.
There are significant external forces driving the
regulation of the CAM professions forward. In the
UK these include, research and improved education
and training reflected in the recent recommenda-
tions of the House of Lords Report (2000),5 and the
Prince of Wales Foundation for Integrated Health
(PoWFIH).6
Importantly, there are also opportunities to
promote best practise through quality publications,
such as publishing in Complementary Therapies in
Clinical Practise (CTCP) and through conference
presentations and scholarships and awards that
recognise of the work and contributions in leading
and developing this field of clinical practise.
We believe that clinical leadership programmes
would make an important and significant contribu-
tion to the integration if complementary medicine
in healthcare settings.
A clinical leadership programme in complemen-
tary therapies is due to commence in December
2006. For further information contact Linda Orrett,
Events Manager, Integrated Therapies Training Unit
(ITTU), c/o The Rehabilitation Unit Christie Hospi-
tal NHS Trust, Wilmslow Road, Manchester M20 4BX,
UK. Tel.: 0161 446 8236.
For information about ‘Coordinating Your Com-
plementary Therapy Service—a 2-day Workshop’ at
St. Ann’s Hospice Manchester contact Ann Carter on
Tel.: 0161 291 2912 (runs twice yearly—June and
November).
For information about NACTHPC contact
Marianne Tavares, Chair of NACTHPC, c/o 329
Harrogate Road, Leeds LS17 6QD, UK. E-mail
address: nacthpc@hotmail.com.
Author contacts: Dr. Peter Mackereth, Clinical
Lead & Lecturer Complementary Therapies, Chris-
tie Hospital NHS Trust, Wilmslow Road, Manchester
M20 4BX, UK. Tel.: 0161 446 8236. E-mail address:
Peter.Mackereth@christie-tr.nwest.nhs.uk.
References
1. Tavarres M. National guidelines for the use of complementary
therapies in supportive and palliative care. The Prince of
Wales’s Foundation for Integrated Health and the National
Council for Hospice and Specialist Palliative Care Ser-
vices;2003.
2. Cunningham G, Kitson A. An evaluation of the RCN clinical
leadership development programme: part 1. Nurs Stand
2000;15(12):34–7.
3. Ham C. Improving the performance of health services:
the role of clinical leadership. Lancet 2003;361(9373):
1978–80.
4. Mackereth P, Stringer J. CAM and cancer care: champions
for integration. Complement Ther Clin Pract 2005;11:
45–7.
5. House of Lords: Select Committee on Science and Technology
2000 complementary and alternative medicine. HL paper
123. London:House of Lord.
6. Russo H. Integrated healthcare: a guide to good practice.
London:The Foundation for Integrated Medicine;2000.
Peter Mackereth
Clinical Lead/Lecturer Christie Hospital NHS Trust
& Salford University
Ann Carter
Coordinator Complementary Therapy Service,
St. Ann’s Hospice Manchester