Background The COVID-19 pandemic posed unique challenges to healthcare workers, who were required to adapt to a changing environment. This crisis put the spotlight on leadership qualities to provide safe, high-quality care. Furthermore, the NHS adapted from a divisional to ‘command and control’ based leadership that risked staff disengagement and exclusion.

Aim To understand how leadership and management across three teaching hospitals in London were handled during the pandemic, and how lessons learnt can be applied to improve future healthcare leadership.

Methods A survey was sent to all anaesthetic trainees across three teaching hospitals in London. This contained 10 questions concerning the quality of leadership and care observed during the pandemic.

Results 68% of trainees felt more valued during the pandemic. 63% felt more listened to and better able to express concerns. 50% felt less included in decisions made. Only 23% thought NHS England and 14% thought Public Health England exhibited good leadership and communication on how to prepare for and manage the crisis. Locally, 91% reported good leadership within their teams, and 91% agreed that patient care was sufficiently prioritised. Leadership qualities identified during the pandemic included compassion (reported by 86%), difficult decision making (reported by 82%) and staff engagement (reported by 68%).

Conclusions The results suggest participants felt more valued and listened to than previously, and suggest compassionate leadership was exhibited on a local level. The pressure on leaders during the pandemic highlighted the need for developing leadership and management skills. However the majority of trainees (68%) are not considering a career in leadership and management. We suggest implementing the NHS Leadership Academy’s Healthcare Leadership Model App into anaesthetic training as a platform to engage trainees in developing their leadership skills, and provide the NHS with future healthcare leaders.