news focus

Published: 10/10/2002, Volume II2, No.5826 Page 16

The NHS Modernisation Agency's programme of management training secondments is encouraging its trainees to spread the word with enthusiasm, as Lynn Eaton discovers

'The new NHS Modernisation Agency is unique in the world in bringing together healthcare improvement and leadership development in one place, ' trumpets its website.

Yet since its inception the question often raised is whether the agency is delivering on the promises made by its public relations department. Can it reinvigorate thinking? Can it transform tired and jaded managers?

Deliberately, the agency has not become a management training college. Although it has established a number of different training courses, such as the management education scheme by Open Learning, its ethos is to take NHS staff for short-term contracts to work on specific projects.

Unlike a management course, where you can't put the theory into practice until you return to your office, these secondments allow for a supported learning environment in which skills are developed and put into practice in situ. There is also the expectation that like bornagain Christians, the chosen few take what they have learnt back out into the service and spread the gospel of modernisation.

David Rose, for example, came to the agency on secondment in September 2000 to lead the agency's project on improving heart disease care. His job then was divisional general manager at University Hospital Birmingham trust where he was responsible for surgical specialties and critical care and was lead on the waitinglist initiative.

'I had spent eight or nine years doing increasingly senior operational roles. For me, the agency was an opportunity to see how care was delivered outside hospitals. I had always been in a hospital setting until then, ' he says.

It proved a good career move, too: he was appointed in June as director of service improvement and modernisation at Coventry, Warwickshire, Herefordshire and Worcestershire strategic health authority.

'If someone had said to me that that type of role would be available to me at the end of the two years with the agency, I wouldn't have quite believed them. I have learnt more in these two years than in any other two years in my career.'

He cites the experience of trying to improve waiting times for echocardiograms, involving a team at a north west London hospital. Inpatients had been waiting a week for the test and outpatients had been waiting six months. By involving the team in investigating the problem and engaging them in ways of solving it, they managed to change the rotas so more tests could be done - something that might have proved impossible had it been imposed from above.

Hinting at one of the biggest benefits the agency can offer, he says: 'There are ways of bringing clinical teams along with a change and making them want to make a change happen, ' he says.

For Kate Harmond, formerly regional director of nursing with South Thames regional office and just appointed director of modernisation at East Sussex Hospitals trust, the experience of working at national level was also invaluable.

'Before I joined the agency in January 1999, I wasn't really aware of the politics of it all, ' she says.'But it was one of those things you got used to, like working with civil servants, who are by far some of the brightest people I have ever met.'

She got used to being challenged and having to defend her ideas: 'They could be a pain at times, but they do make you think.

'Working with and presenting to ministers was amazing. They would ask those 'yes, but'or 'why not' questions, sometimes in quite an aggressive way. I learnt you can't over-prepare for that.'

Her projects covered trolley waits and waiting lists for preoperative assessment and endoscopy. The experience, she says, has helped boost her confidence and could do much to increase the confidence of other women in the NHS who are midcareer and wondering where they will go next.

GP Dr Paul Zollinger-Read is one of the few clinicians to have been seconded to the agency. He returned to his day job this month but is positive about his experience. 'I had never been on any management courses in my life, ' he laughs.Yet he is now taking up post as chief executive with Witham, Braintree and Halstead primary care trust in Essex.

He worked two days a week at the agency from early in 2000 as director of demand management, and continued his work as a GP in Braintree the rest of the time.

'I have learnt about change management, about allowing people to experiment and about providing a safe environment for them to do that. But I didn't learn people management skills as such.'

Dr Zollinger-Read says the lack of clinicians working with the agency is a weakness it needs to address urgently: 'You need far more clinical staff in there, but it is difficult because they can't get locums.

'One of the big problems was getting clinical staff involved.''I suppose it has helped me, 'he says.

'I wouldn't be chief executive without the training I've had.'