Live Q&A: how to improve leadership at your trust

Readers' comments (27)

• Anonymous | 12-Nov-2012 12:48 pm

  How much did it cost to set this up? Where did the funds come from? sounds interesting

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• Amy Thompson | 12-Nov-2012 2:55 pm

  Why did the trust want an alternative to the Darzi fellows, were there seen to be problems with it? What are the advantages of this programme?

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  Rachel Purkett | 12-Nov-2012 4:14 pm

  And a question via email asking for details on the application process you used, how many applicants you had, and how you selected them.

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  Rachel Purkett | 13-Nov-2012 9:31 am

  A question from Twitter: what else is the trust doing to improve clinical leadership, apart from this programme?

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• Anonymous | 14-Nov-2012 10:27 am

  Whta do the current NHS reforms mean for clinical leadershp? Shld we be worried?

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• Umesh Prabhu | 14-Nov-2012 3:30 pm

  Clinical leadership is the key to the success or failure of any organisation. Organisational culture and leadership decides the energy of the organisation and right leaders can create both of them. If culture and leadership is wrong then it produces corrosive energy.
  
  Leadership has 'mini me' concept. Bullying leader creates more bullying leaders underneath him and good leaders create good leaders. This is the reason why the Trust Board leadership and culture are very important. But a Trust Board which sits in their ivory tower hoping that all their clinical leaders are good will be making a serious mistake.
  
  It must be the right Clinical Leaders who always put patients at the heart of everything they do and are able to take their colleagues with them not by bullying but by working with them. True medical leaders are rare commodity of our NHS. We got to educate and train our doctors to be the leaders of our NHS and good leader never compromises patient safety and quality. These leaders must be performance managed to make sure that they deliver what is expected of them and every leader must have 360 feedback regarding the way they deliver and treat their colleagues.
  
  Leadership is about having the courage to do the right thing for our patients but the way we do it equally important.

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• Anonymous | 15-Nov-2012 9:09 am

  From Twitter:
  
  Sarah Malcolm @SarahJMalcolm
  
  really interested to know how acute trust leaders feel relationships will change with having clinical commissioners?

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• Anonymous | 15-Nov-2012 9:40 am

  From Twitter
  
  Healthskills @Healthskills
  
  interested in how impact on organisational performance of the programme will be evaluated.

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  Rachel Purkett | 15-Nov-2012 9:58 am

  Welcome Dr Jessie Welbourne, Dr Arun Gupta, Stefan Scholtes, Dr Jenny Dean and
  Dr Jag Ahluwalia, who will be answering your questions about clinical leadership today.

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  Jenny Dean | 15-Nov-2012 10:08 am

  Thank you Rachel, we're excited to be here.
  
  My first response is to Amy Thompson's question from the 12th Nov on the advantages compared to the Darzi Fellows: The focus of the programme was very experiential through the projects and other chief resident responsibilities, and intellectual through the discussions in the taught days rather than too much theoretical assessment. In my view, this made the Chief Resident role more closely match the reality of clinical and medical directors roles: taking on additional management and leadership responsibilities whilst taking a limited amount of high quality time out for training and development. So the chief residents have to learn how to juggle many different stakeholders and a complex schedule in addition to everything else; but equally importantly, they are still embedded and very much part of their clinical world.
  
  

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• Jessie Welbourne | 15-Nov-2012 10:10 am

  The funding - There was a clear recognition of the importance of junior doctors in the delivery of high quality services and at the same time a recognition that many juniors did not feel part of the process of the institution. In addition, there was a desire to deliver a leadership program for senior trainees at the time when Darzi fellows were being instituted around the country. A decision was made to incorporate both objectives into a formalised training program.
  There was not support from local trainees to do this as an out of programme activity. The funding was therefore secured from the deanery as well as from the trust, post graduate centre and from trust funds.

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  Rachel Purkett | 15-Nov-2012 10:10 am

  Thanks Jenny

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• Jessie Welbourne | 15-Nov-2012 10:12 am

  The applicaiton process - the application process was open, advertised and chief residents were appointed after competative interviews. Many were turned down!
  

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  Rachel Purkett | 15-Nov-2012 10:14 am

  Thanks Jessie

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  Jenny Dean | 15-Nov-2012 10:15 am

  With respect to both the health reform changes and the relationships between acute trusts and commissioners:
  
  This year, the 3rd year of the programme, we have grown the taught element of programme to also include GPs at a similar level to the chief residents. Many of these are already involved in commissioning. This is an exciting development to be able to gain greater understanding of perspectives across the two groups; as well as the opportunity to work on integration projects. Therefore turning any changes from the health reform and clinical commissioning into an advantage as well as understanding the impact of the changes onto the respective services.

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• Jessie Welbourne | 15-Nov-2012 10:17 am

  The trusts improvements for clincial leadership -
  We run a number of courses for junior and newly appointed senior doctors which focus on leadership skills.
  As an academic health science centre we are engaging with the leadership acadamy to promote management leadership training in the trust.
  The division structure of the trust is clinically lead and training in leadership nad mangment is promoted on the job through a range of activities and responsabilities.

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  Rachel Purkett | 15-Nov-2012 10:20 am

  Thanks Jessie - any other initiatives you are planning for the future?

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  Jenny Dean | 15-Nov-2012 10:26 am

  @Health Skills via Twitter 15Nov 9:40am
  
  Evaluation, particularly value-for-money has been an important consideration for the programme and unsurprisingly one of the main challenges. Many of the benefits are long term and also difficult to assign to any particular element of the whole programme and chief resident concept. There benefits to the chief residents themselves (easier to measure) as well as the organisation, as you refer to and which is particularly relevant since they are investing in the programme.
  
  We have a multi-focused approach to organisational impact assessment: the most tangible is through the service improvement projects that the chief residents lead, which together generate both quality and financial improvements to the Trust. We constantly evaluate the value of the taught programme through candid discussions between the Trust and the Business School and probing discussions with the chief residents themselves, particularly at the end of the year. We also collect evaluation surveys for each session and of the programme as a whole a few months after it ends to ascertain what has 'stuck'. Many of the benefits to the organisation are long term, by providing the management and leadership skills and engagement that the Trust will benefit from. In the near future the programme will benefit from a more formal evaluation, once there are a number of cohorts to assess from and these longer term benefits start to emerge.
  

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• Jessie Welbourne | 15-Nov-2012 10:28 am

  to Healthskills on Twitter -
  The evaluation of the program is a key component to enure the continuation of the program and much thought continues to be given to the outcomes and best ways of assessing these. in addition to feedback and attendacne from the chief residence, and those from the faculty delivering the program and the divisional directors, one of the key outcome measures relates to the chif residents projects delivery and outcomes. The key factors are delivery of the key agreed objectives by the chief residents espceially relating to delivering on their projects and improving trainees with their training
  

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• Jessie Welbourne | 15-Nov-2012 10:35 am

  NB, my comments are written in conjucture with Jag Ahluwalia and Arun Gupta
  

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