The quality of management and leadership remains the single biggest factor as to whether or not organisations succeed, and nowhere more so than an institution as large as the NHS.

Consistently delivering high-quality patient care and maximising patient opportunity have placed education, standards, policies, incentives and a culture that inspires and supports consultants at the top of the agenda.

Barking, Havering & Redbridge University Hospital trust is focusing on leadership and management training for its consultants with the design and delivery of a bespoke 10-day training programme.

The content of the course, which is delivered in two blocks of five days over two months, meets accreditation requirements laid down in the Medical Leadership Competency Framework, Appraisal for Revalidation and the Medical Leadership Curriculum, Professional Development Framework for Educational Supervisors, as specified in the Postgraduate Medical Education and Training Board’s Standards for trainers. It is also accredited by the Institute of Leadership and Management, and provides a total of 50 continuing professional development points to consultants for annual accreditation.

The course was the brainchild of the trust’s medical workforcegovernance manager, Gill Cheasley, and former medical director Yasmin Drabu. They saw a need for an accredited programme bringing together leadership skills, management competencies and educational supervision requirements, offering consultants the opportunity to refresh existing skills, while learning and practising others.

“Consultants maintain training in their speciality and get CPD points, but there has been nothing, so far, to develop them as leaders and managers,” says Dr Drabu.

The pair worked with training company Miad to devise a course addressing these needs for the trust’s 300 consultants.

“We considered providing the course in-house but were concerned about sustaining consistency and quality and we needed the course to have credibility,” says Ms Cheasley. “We didn’t just want someone to give a lecture – we wanted actual learning to take place.”

The programme covers the business-focused aspects of a consultant’s role (planning, clinical governance and finance) plus the behavioural and people-oriented sides of leadership: decision making, problem solving, leading others through change (while maintaining service delivery), negotiation, influencing, managing conflict, supporting trainees in difficulty, mentoring, coaching, educational supervision, appraisal, revalidation, performance management and recruitment.

Integral to learning

The content aligns with the Medical Leadership Curriculum’s stance that such skills and competencies should be “an integral part of every doctor’s training and learning”. The ability to lead, motivate, engage and support teams and colleagues through change is vital, given Government plans to transform the NHS into one that can more effectively meet patients’ needs.

BHRUT chief executive John Goulston, says: “It gives consultants the confidence to play a significant role early in their careers. It also provides the most recently appointed with useful background in terms of how the NHS works, which parts of service need improving and how to work more effectively with colleagues.” 

This aspect was valued by microbiologist Dr Meredydd Nicholas. “This is the first time that I have had any real information about payment by results, commissioning or even how the NHS works. As a consultant, people assume that you already know about this and can run a meeting or write a business plan, when the reality can be different,” she says.

Another benefit was that the course brings together – for an entire 10 days – consultants in different specialties. Good working relationships are being forged by a better understanding of each others’ issues. This allows innovative solutions to be developed that should benefit departments and, ultimately, patients. 

The course was piloted in July 2009 among 15 new consultants. Having a two-month gap between the blocks enabled changes to be incorporated and gave delegates the chance to apply their learning.

Seeing any tangible change does not always happen overnight, though, says Ms Cheasley. “The consultants are more confident in applying the leadership skills - this often happens at least six months after the course ends.”

An initial concern that consultants would not commit to 10 days’ training, albeit in two parts, proved groundless. “It was made clear that the programme represented a considerable investment for the trust and consultants’ attendance for the full two weeks was expected,” comments Ms Cheasely. The word has, she says, spread that the content is highly relevant to their day jobs.

“It is a testament to its success that the course has been funded by the London Deanery for specialist doctors’ training and development and will be rolled out across London trusts during 2010.”