Introduction Policymakers and academics have increasingly been advocating for the development of clinical leadership. Several initiatives exist locally, regionally and nationally aiming to nurture future clinical leaders. The National Medical Director’s Clinical Fellow scheme is a national leadership programme, which gives an opportunity to trainees to work in a number of different healthcare organizations and to develop their skills, knowledge and leadership capabilities. The General Medical Council (GMC) has been part of this programme for 8 years and over 20 fellows having completed it. It is essential to continuously assess the impact of the programme on the fellows, in order to be able to develop and improve it, so that both the fellows can optimise their experience and maximise the benefits obtained, while the GMC can ensure that the programme aligns with the organisational strategy, vision and overall objectives of participating in this national scheme.

Aims and objectives of the research project or activity This paper explores the immediate impact of a leadership fellowship on fellows’ self-reported leadership capabilities. Specifically, we report the change in skills, attitudes and values based on the Healthcare Leadership Framework (HLF), at the beginning and end of a one year fellowship. Our objective was to understand in which leadership domains the fellowship had been most impactful in the early stages. In addition to that, we aim to identify any leadership domains that we ought to further focus in developing through the fellowship.

Method or approach A questionnaire based on each of the HLF domains was distributed to the fellows at the beginning and end of a one -year fellowship based at the GMC, during the period 2019–2023, which consisted of 3 point Likert-scale type of questions. The questions were further mapped to the Healthcare Leadership Model, a more widely adopted overarching framework developed by the NHS Leadership Academy. The areas that the fellowship had the most as well as the least impact were identified. Additional questions in relation to the understanding of healthcare systems, the views about training and mentoring and future leadership career aspirations were also included.

Findings Twenty-one fellows responded to the baseline and end of placement survey. There was an improvement in self-reported scores across all domains of the HLF during the year. At the start of the fellowship CFs reported high baseline levels in the ‘Personal Qualities’ section (2.69 out of 3) including self-awareness and self-management, as well as in the ‘Working with Others’ section (2.61 out of 3). The most significant area of development over the year were seen in the categories of ‘Delivering the strategy’ (1.8 versus 2.61), and in the domain of ‘Setting Direction’ . When questions were mapped to the HLM, the area with the biggest improvement was the ability to evaluate information (2.01 versus 2.61), while there was no improvement in the ability to develop capability, showing that there are probably less opportunities for the latter during the fellowship. Lastly, a positive impact was seen in the understanding of the complex relationships between healthcare organisations, the perceived value of training and mentoring, as well as the interest in obtaining further leadership roles in the future.

Key messages This paper demonstrates that the leadership fellowship had a positive self-reported impact on development of leadership capabilities as assessed using the NHS Leadership Academy framework. We found an overall positive impact on fellows leadership skills at the end of the year. This group already had well developed self-management land personal qualities and we found the largest self-reported impacts in high level leadership activities including strategizing, creating a vision and actively leading .It also reveals areas that a less significant impact was seen. This study highlights that the fellowship objectives and opportunities could be better tailored to the individual needs of the fellows assessed at baseline and the identified areas for development based on the Healthcare Leadership Model could be incorporated into the personal development plan.