Introduction Medical leadership is a vital skill required of doctors in the NHS, particularly senior NHS doctors and consultants. The GMC National Training Survey 2023 identified as many as one third of trainees do not feel that their training post gave them opportunity to develop leadership skills, subsequently feeling under- prepared for the non-clinical leadership aspects of a consultant job.

Preparation for Certificate of Completion of Training (CCT) (Prep4CCT) is a 1-day course for junior doctors in their last 18 months of speciality training at Nottingham University Hospitals Trust. The sessions are delivered by a combination of corporate and clinical staff, offering a range of topics in medical leadership and management, including NHS structure, governance and non clinical roles of the NHS consultant. It is part of a larger multi-faceted leadership curriculum in development, established to develop high quality leaders of a variety of levels in the Trust.

Aims and objectives of the research project or activity It is widely understood that development of future leaders in healthcare is vital to sustainability of local services and the NHS as a whole.

Prep4CCT aims to improve senior trainees’ confidence and equip them with leadership and management skills in the context of roles expected as an NHS consultant. The day aims to take away some of the unknowns of the job role and gain a unique insight into areas that are historically poorly accessed by trainees, such as: management roles, finance and the practicalities of roles such as educational supervisor and appraisal.

The day is designed as a spring board for trainees to develop from and explore roles that pique their interest prior to CCT so that they can embrace a consultant job with confidence, not trepidation about the non-clinical aspects.

Method or approach A mixed methods prospective study measuring preparedness and confidence in various leadership roles pre and post our ‘Prep4CCT’ 1 day course. The course consists of a carefully curated timetable of sessions including: Introduction to clinical leadership roles, hospital structure and NHS finance; ‘Providing Quality Patient Care’, ‘The Role of the Consultant and a question and answer session with 3 new consultants. Sessions were delivered as lectures or small group workshop based sessions. The course was advertised via email, distributed to all senior trainees in the trust, open to trainees within 18 months of CCT. Places were allocated via first come first serve, with a maximum of 32 places available. 27 trainees in total attended the event in November 2023.

Online pre and post-course questionnaires were sent to trainees via email for anonymous completion. The questionnaires were developed using Kirkpatrick’s model6 and asked questions on engagement, usefulness & relevance, as well as asked attendees to rate their understanding on a Likert scale of several relevant factors both before and after the course. Free text comments were summarised.

Findings Most attendees were 6–12 months away from CCT (48%).

Pre-course, 68% participants ranked their preparedness to be a consultant at 3 or less (0- not ready at all, 5- very ready). Only 32% trainees ranked their preparedness at 4 - 5 (very ready). An improvement in preparedness for consultancy was seen post course, with the majority of participants ranking themselves 4 or more on the scale. (55%).

In both pre & post-course questionnaires, attendees were asked ‘how confident do you feel with the following… topics?’. They scored themselves using a Likert scale (1–5). In 9/10 topics, improvement in ranked confidence was seen, with only 1 topic remaining the same confidence level pre and post course (teaching trainees).

The majority of attendees ranked themselves as having received ‘minimal’ formal leadership training before the course (64%), emphasising a gap in local leadership training. 32% of trainees had attended an external leadership and management course.

‘Job planning’ and ‘Introduction to Hospital Structure’ were rated the most useful sessions of the day (31.6% and 26.3% respectively).

Free comments analysed emphasised that trainees found the event extremely useful and it has a place in the senior trainee trust event calendar.

Key messages Our study demonstrates that there is a significant lack of formal leadership and management opportunities during training for senior trainees.

Currently, trainees turn to externally-run courses to gain more experience in leadership and we aim to change this and provide local high quality training.

Prep4CCT is part of a larger leadership curriculum being developed at Nottingham university Hospitals Trust owing to the appetite for more leadership training and the need to produce clinicians that are confident in medical leadership.

Prep4CCT as a stand alone event increased trainees’ preparedness for consultancy and confidence in a variety of leadership and management roles. Feedback on the event was overwhelmingly positive demonstrating the importance of events in fostering a culture where leadership is cultivated throughout all stages of training.

We plan on expanding the event to cover various transition points during a trainee’s career for example foundation doctor to core trainee and core trainee to registrar.