A foundation degree course is offering leadership skills to previously neglected junior and middle managers, write Ian Carruthers and Rob Brittlebank.

Leadership development in the NHS has a high profile at senior and top management levels, and rightly so. Strong and effective leadership has to come from the top of the organisation to achieve the cultural change necessary to ensure a sustainable NHS in the future.

But what of the rest of the organisational tiers in the NHS, where the bulk of the day-to-day work is done and patient engagement through leadership on the ground is essential for effective healthcare? 

A joint initiative by University Hospital of North Staffordshire Trust and the faculty of health at Staffordshire University has sought to include more junior and aspiring leaders in leadership development. They have done this by running a foundation degree course for junior and middle managers who, for whatever reason, have not had the opportunity to access higher education through other routes. The course has been run on a half day per week basis, delivered on-site at the trust’s healthcare careers and skills academy by the university.

Case study: a course for aspiring managers

Linda King is a student on the foundation degree course

When I first looked at doing a degree there was never anything available which was specific to a healthcare setting. I undertook business administration qualifications but they did not fulfil the needs of my work role, offering only a broad overview of management.

Having a nationally recognised qualification within a healthcare setting has provided me with an insight and a better understanding of the NHS.

I have always been inspired to work as a manager, within the healthcare setting. This qualification has enabled me to understand more and build on my knowledge of the NHS. For example, understanding contemporary issues in leadership and management, exploring ethics, customer service for managers, understanding change and innovation and having an introduction into project management have all been a vital resource to my work and helped me to lead and manage my team in a positive and proactive way.

This qualification has been a huge success within the trust and I have been promoted to deputy education and development manager. I have enhanced my confidence and ability to respond to change and to meet the challenges the NHS brings. I believe that an organisation needs good managers to become effective leaders and this course has certainly given an insight for aspiring managers to meet those challenges.

Greater insight

At the time of developing the programme, the trust was part way through a major redevelopment of its hospitals, and a new £370m hospital.

Planning for the transformation of services into a new hospital, equipped with state of the art medical and diagnostic facilities, meant the hospital had to be run by highly skilled staff to ensure patients would receive the best care and treatment.

Looking at its structures and existing ways of working, the trust identified the skills its staff needed to work in the new buildings, especially the ones its leaders and managers would need to manage the transformation.

At differing levels the trust developed a series of leadership and management activities from skills development courses to multiprofessional senior management programmes.

It was for the emerging managers that the trust wanted something that had not been done before.

As part of these ongoing programmes the trust developed the foundation degree in leadership and management in healthcare award to support University Hospital of North Staffordshire Trust staff who wished to gain greater insight into their role, the trust’s purpose and their own and others’ leadership and management style. 

In conjunction with the Staffordshire and Shropshire Lifelong Learning Network, the trust met with the university to map out what was required. It was important that the award was designed around the NHS leadership and qualities framework, with emphasis on work-based learning. In addition, the formal learning needed to include input from trust senior managers and staffside representation and for the assessments to be meaningful there was a need to focus on the practical application in the workplace.

The trust also wanted to ensure successful completion of the award would ensure that:

  • staff gained knowledge and understanding of leadership and management in healthcare through work-based and university learning;
  • staff would explore their own values and behaviours and how they contribute to their leadership and management style;
  • there was a focus on the application of leadership and management knowledge;
  • there were enhanced career prospects for staff through extending their ability to manage themselves and lead others;
  • staff would develop self-directed learning through reading, reflection, debate and enquiry;
  • staff would enhance their ability to apply and develop personal and transferable skills;
  • the course would make a positive and rewarding contribution to their working life;
  • staff would be able to facilitate the learning of others through role modelling and supportive management and leadership in their workplace.

The trust embarked on a series of workshops to introduce the degree to staff and, in the spring of 2010, a cohort of aspiring managers commenced their learning. Ongoing partnership review meetings between the trust and the university ensured that both the course and its learners stayed on target.

Most staff undertaking the award have applied for and gained a promotion on to a higher Agenda for Change band and have been able to demonstrate their learning in practice.

The course was designed to a format of one afternoon a week over a period of two years, providing a programme of 240 credits overall and covering a range of modules relevant to managers at all levels in the trust. Leadership was a central theme to all of the modules, which were delivered in the context of the students’ work roles so there was a clear connection between the theory and its practical application. 

Payback time

Subject modules covered topics such as organisational drivers, ethical decision-making, leadership theories, resource and information management and leading change and innovation. The final module has required the students to undertake a work-based project, where they would take the lead in setting up, planning and delivering a change project within their own work setting.

As well as bringing together learning from the previous course modules and consolidating the students’ learning, this was designed to provide some “payback” to the trust in return for its investment.  

The benefits of the programme in terms of personal development are demonstrated by the successes of the students in gaining advancement within the trust during the course of their learning. This fits in well with the King’s Fund paper Together We Can, which advocates a distributed style of leadership within all levels of teamwork across the NHS.

By offering learning and development at a foundation degree level, trusts in partnership with accredited education providers can ensure that junior and aspiring managers are able to develop leadership skills within their work role. This will prepare them for more demanding leadership roles within their organisation and complement the skills of higher level managers, to ensure a culture of leadership capable of taking the NHS forward to meet the challenges of the reform agenda.

Case study: why it worked

Linda King is a student on the foundation degree course

The NHS is a turbulent environment which is subjected to daily change. This may not necessarily be at national level, but by local changes in the way we work, the systems and processes we work with through innovation, and the changing environment caused by the building of new facilities or restructured workforces.

These changes can only be achieved successfully with good leadership skills and the ability to recognise a management style that will be most effective to deliver desired outcomes.

Working as an operational manager, the course was perfect in terms of relating the theory to the practicalities of the day-to-day role. People and self-management, resource management, ethics, contemporary issues, change, organisational culture, project management and customer service - these modules assigned to the course are all something that we as leaders in the NHS are exposed to on a daily basis. 

Learning on the job has allowed me the opportunity to build strong working relationships and acceptance of leadership from a team that has been cultured adversely to any form of management.

In turn, I have built up and shared experiences with the team around patient engagement, in order to develop the best possible quality of service from the minute they enter the department to the minute they leave.

I have gained two promotions while on this course and after nearly 20 years’ service organisation.

Ian Carruthers is education and widening participation manager, University Hospital of North Staffordshire Trust. Rob Brittlebank is lecturer in leadership and management, Staffordshire University faculty of health sciences.