A collaboration between the NHS Leadership Academy and undergraduate clinical education providers could stimulate an interest in – and capability for – this neglected area, says Ali Raza

I possess a diverse experience in the healthcare sector as I was training as a medical student before I decided to join Northern Ireland’s equivalent of the NHS management training scheme in 2014.

As part of my formal learning on the scheme, I participated in modules with the NHS Leadership Academy. My managerial experience helped me spot what I believe is a fantastic opportunity to rejuvenate the clinical leadership in this country through a new collaboration between the NHS Leadership Academy and undergraduate clinical education providers.

The evidence of a crisis in clinical leadership has been well documented. An inquiry commissioned by HSJ in to the future of NHS leadership found that “almost one in six” trusts they surveyed had no substantive medical director.

A new collaboration

The report makes a number of recommendations aimed at addressing the clinical disengagement with management. These range from tangible changes like higher pay to cultural changes in accountability practices. To my surprise, only one of the 12 recommendations focuses on integration of leadership training in to undergraduate clinical education.

The recommendation’s two-fold message is for undergraduate training to engender greater commercial awareness of the NHS, which I welcome, and the need for “formal grounding’ of leadership training in undergraduate education”.

My frustration as a medical student stemmed from a desire to be at the helm of service improvement, for which I was unable to acquire the necessary managerial experience or qualifications whilst conducting my undergraduate studies. At the opposite end of the spectrum I knew colleagues who considered honing their technical clinical expertise their sole business. Therefore, I would argue for this “formal grounding” to nurture both the interest in and capability for clinical leadership.

This collaboration would permit medics and nurses to take one year out of their studies to enter the management scheme, thereby obtaining both managerial experience and qualifications

I believe that a new collaboration between the NHS Leadership Academy, which sponsors the NHS schemes, and undergraduate clinical education providers would support this formalisation process. This collaboration would permit medics and nurses to take one year out of their studies to enter the management scheme, thereby obtaining both managerial experience and qualifications, before returning to their studies.

Rebranding the courses which integrate the scheme year, for example, from ‘Medicine & Surgery’ to ‘Medicine, Surgery & Clinical Leadership’ would, I believe, focus the minds of aspiring healthcare professionals towards clinical leadership before their educational journey even commences.

Furthermore, I believe this idea goes a step beyond the HSJ recommendation. While the recommendation indicates a need for instilling leadership training in the undergraduate curriculum, I argue for a collaborative effort of this kind to embed the triad of theory, experience and qualifications necessary for building capable clinical leadership.

As an alumnus of the Health & Social Care Northern Ireland (HSCNI) General Management Training Scheme (GMTS), I have had a unique exposure and insight in to the NHS Leadership Academy courses and training for future healthcare managers.

Commercial awareness

I participated in five modules of experiential learning with the Leadership Academy, which covered a diverse range of topics including emotional intelligence, human factors, and workplace politics. These modules were part taught and, crucially, fostered learning through experience, a sentiment echoed in HSJ’s Recommendation 12.

“An element of “system knowledge” needs to be built into clinical curriculums in an engaging way, along with an early understanding of what is involved in leadership. This should not simply be a classroom presentation of organisational structures and funding flows.”

These reflections convince me that a scheme must exist for students in clinical undergraduate education to take advantage of these fantastic learning opportunities

In fact, my experience with the Leadership Academy achieved far more than what Recommendation 12 aspires to. Not only did the experience build commercial awareness of the NHS, it taught participants about clinician and managerial cultures in a way that nurtured cross-professional empathy and understanding. I learnt the importance of self-management, a vital skill to possess regardless of role within the NHS.

Most importantly, I acquired practical experience in leadership and team exercises, which would be invaluable to aspiring clinical directors and consultants. These reflections convince me that a scheme must exist for students in clinical undergraduate education to take advantage of these fantastic learning opportunities.

Though resolution of practical issues around creating such a collaboration with the NHS Leadership Academy and rebranding clinical courses could prove to be a lengthy process, I hope there are others who would, in principle, champion the idea of embedding managerial experience and qualifications in to undergraduate clinical education. Hence, the clinical leaders of the future can be nurtured from the very beginning.

Ali Raza is undertaking a masters in healthcare lLeadership on the Elizabeth Garrett Anderson Programme, run jointly by the universities of Birmingham and Manchester.