Lord Darzi's review of the NHS emphasises medical leadership as one of the keys to driving up quality in the health service. Oliver Warren describes one programme that is helping to make this a reality
Prepare to Lead is a leadership development mentoring programme for GPs and specialist registrars. It forms a key component of NHS London's Leading for Health programme. The scheme was piloted in the department of biosurgery and surgical technology at Imperial College London, and NHS London has now rolled it out across the strategic health authority as part of its response to the clinical leadership challenges it faces in delivering the Healthcare for London vision.
The purpose of the programme is to provide NHS London with a cohort of medical leaders in the next five to 10 years who can drive healthcare change across the capital, take a strategic view, contribute ideas and lead change for quality improvement.
It aims to do this by identifying people with leadership potential early and then equipping them with the necessary knowledge, skills, attitudes and beliefs to ensure that some of the brightest people in the service are involved in strategy and organisational delivery before the mid-point of their careers. Central to the process is a formalised mentoring relationship with a senior healthcare leader in the London region
Places on the SHA-wide scheme were advertised in February 2008, and entry was limited to candidates holding a training number with the London Deanery. There were around 70 applicants, who were shortlisted to 33. These were interviewed by a panel of senior healthcare leaders who had been briefed to select candidates with the potential to become the senior NHS leaders of the future.
Twenty-one people were selected for the scheme and invited to an introductory evening in April, where they were asked to define their personal and collective learning objectives. This information was used to help match them with the mentor who would be most appropriate for them, both professionally and personally.
The mentors are all senior healthcare leaders in London and include NHS London director of policy and strategy Paul Corrigan, Royal Marsden foundation trust chief executive Cally Palmer, and Department of Health workforce director Clare Chapman. Each mentor has agreed to meet their mentee every four to six weeks for a year and to provide one day-long "experience", such as a major meeting, trip or event.
Following the matching process, Prepare to Lead was officially launched on 15 May. The event included an afternoon workshop with UK mentoring expert David Clutterbuck, followed by a reception attended by the three main sponsors of the scheme: health minister Lord Darzi, NHS chief executive David Nicholson and NHS London chief executive Ruth Carnall.
While the mentoring relationship is key to the scheme, many other learning opportunities are being provided, including NHS London chief executive master classes and a course on politics, power and persuasion.
There are also monthly evening or half-day seminars on topics such as lessons from working in the private and public sectors, patient safety, and working inside Number 10. The speakers, who include DH workforce director Clare Chapman, Luton and Dunstable Hospital foundation trust chief executive and NHS patient safety campaign director Stephen Ramsden, and NHS London director of strategy and policy and former special adviser on health to the prime minister Paul Corrigan, have agreed to give their time for free because they support the scheme and its objectives.
Even at this early stage of the scheme, many of the participants are taking on their first leadership roles. One has been appointed to be an educational adviser at the National Institute for Health and Clinical Excellence and another recruited to the position of clinical adviser to the chief medical officer, both after being made aware of the opportunity and encouraged to apply by their mentors. Another participant has been elected chair of BAMMbino, an appointment we hope will lead to further links between the two organisations.
A number of participants have worked in NHS London, in teams evaluating the local hospital model and end of life, maternity and child health pathways. Three primary care trainees are due to take up fixed-term part-time strategic roles in September. Finally, two others have been offered additional roles in their trusts by their chief executives. Both are involved in service delivery, giving them true hands-on experience.
We feel these outcomes show the programme is offering real benefits, even though it has only been in existence for three months. We obviously hope many more follow.
We believe this scheme is unique in UK healthcare. The combination of pro-actively developing doctors in training, as opposed to consultant-level medical staff, and using mentoring by senior leaders as opposed to directly senior clinical colleagues makes this scheme different.
This scheme is not a quick fix but a long-term strategy. It is not a short, three-day course to help people achieve consultant posts but actively seeks to make high-calibre doctors available for chief executive and medical director roles in the next five years. We believe it offers a more sustainable way of ensuring successful clinical leadership talent spotting and development in London, and offers instant benefits for both mentee and mentor, to the eventual gain of the service user.