RT Journal Article SR Electronic T1 How leadership training saves money ‘service line leadership’ at Nottingham University Hospitals JF BMJ Leader JO BMJ Leader BMJ Leader FD BMJ Publishing Group Ltd SP 29 OP 36 DO 10.1136/leader-2018-000132 VO 3 IS 2 A1 Orme, Duncan A1 Campbell, Colin YR 2019 UL http://bmjleader.bmj.com/content/3/2/29.abstract AB New findings The evidence presented demonstrates that this leadership programme improved financial performance through increased participant confidence, leading to improved individual and team performance. Observations confirm that margins were maximised by clinicians when provided with granular understanding of costs and training in leadership. Limitations of the study and methodology are discussed.Background/aim The ‘Service Line Leadership’ programme was developed at Nottingham University Hospitals National Health Service Trust to support financial recovery, through leadership skills and improved understanding of cost. Over 3 years, the programme attracted 425 participants (69 consultants). This retrospective study quantifies the impact of the programme and how it influenced leaders.Methods The five measures used were: (1) evaluation of the financial return on investment, (2) analysis of the mean differences between 360° psychometric assessment scores before and after the programme, (3) a survey utilising a focused interview and a follow-up questionnaire, (4) a post-programme questionnaire examining skills acquired and (5) a workshop evaluation using a net promoter score.Results Savings of £3.3 million were identified through the delivery of 11 separate initiatives. Quality improvements were observed. Participants were found to have changed their leadership behaviours through improved communication of trust, leading to empowerment, confidence to challenge perceptions and being mindful of others. New techniques were acquired giving rise to increased confidence in personal leadership.Conclusion The return on investment based on projects of leaders employing the techniques from the programme, demonstrated a positive impact on the business model of the hospital.