Introduction The importance of clinicians as leaders and managers of health care is increasingly being recognised. For instance, the Clinical Leadership Competency Framework highlights the ‘critical importance of [clinical leadership] to the delivery of excellence and improved patient outcomes’. The importance of clinicians as leaders has also been acknowledged by the government, with the recruitment of clinicians into strategic leadership roles being prioritised in the NHS long term plan.

It is perhaps surprising, therefore, that leadership and management training is not integrated into Higher Specialist Training (HST), and exposure to such experience is limited. Consequently, new consultants feel underprepared for the leadership and management aspects of the consultant role, particularly relating to topics such as managing people, managing conflict, system differences and structure of the organisation and managing complaints.

Recognising these issues, we developed a bespoke 3-day leadership course for middle grade doctors, incorporating these topics as focal themes.

Aims and objectives of the research project or activity The aims of this project were:

1. To introduce NHS leadership and management concepts to middle grade doctors.

2. To increase knowledge and confidence in dealing with common aspects of leadership and management.

The programme was designed with the aim of equipping middle grade doctors with essential skills and knowledge necessary to be an effective leader, and to help prepare them for the transition to the consultant role.

Method or approach The programme ran across 3 days over the course of 5 months during 2023. Middle grade doctors from all specialities and including both training and non-training grades, were invited to attend.

Sessions were facilitated by clinical and non-clinical speakers in leadership and management positions at our trust, and sessions covered a range of topics including Leadership Styles, Emotional Intelligence, NHS management structure (including a Q&A session with some of the trust’s leaders and managers), Clinical Incidents, Educational Supervision, Doctor’s in Difficulty, Complaints, Conflict Resolution and Service Development. Delegates were also invited to participate in a ‘Buddy Manager’ scheme, where they were paired with someone in a leadership or management role, to gain hands-on experience by shadowing them.

Pre- and post-course questionnaires were sent out to establish baseline opinion, understanding and experience and to evaluate the impact of the programme on confidence and understanding.

Findings Twenty-four delegates from 13 different specialties attended the course.

Pre-course data highlighted a lack of leadership training and experience. For instance, 78% felt that their training was not sufficiently addressing complaint management skills, only 33% had received training in conflict resolution and only 13% had attended a root-cause analysis meeting.

The programme resulted in improved understanding of a wide range of leadership topics. For instance, 92% of delegates reported being more aware of their influencing style following the programme, and 100% indicated improved understanding of the trust board management system. We also demonstrated improved understanding of the new consultant role, from 8% to 92%, and of the job planning process, from 4% to 85%.

Delegates reported greater confidence in responding to clinical incidents (from 40% before the course to 79% afterwards), their ability to manage complaints (from 17% pre-course, to 100% post- course), and in the prospect of undertaking educational supervisor roles (from 44% to 93%).

Feedback for the programme was universally positive, with delegates rating all sessions as good or excellent, and 100% stating that they would recommend the course to colleagues. All participants (100%) were more inclined into pursuing a leadership role following the programme.

Key messages This programme has demonstrated a gap in medical training relating to the development of leadership skills required to ensure confident leaders within the NHS, and a need for greater opportunities for leadership development during postgraduate training.

The programme has shown that training sessions can significantly improve understanding of leadership topics and confidence in undertaking leadership roles. That delegates felt more inclined towards pursuing leadership positions following the course, shows that such programmes can also inspire clinicians into these roles. This is important given the NHS long term plan to encourage clinicians into leadership positions.

Our findings should encourage aspiring and current leaders within the NHS to follow suit in developing programmes to help nurture and develop tomorrow’s leaders. We recommend more comprehensive inclusion of leadership and management topics into HST curriculums, as well as the provision of such training for middle-grade doctors across all trusts as standard.