The quality of management and leadership remains the single biggest factor as to whether organisations succeed or not.

Educating standards, policies, incentives and a culture for improving and inspiring across the NHS non-clinical sector – to support the consistent delivery of high-quality patient care and maximise patient opportunity time – is now top of the agenda.

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

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 PMETB Standards for Trainers. 

It is also ILM accredited, and provides 50 continuing professional development points – five per day – covering consultants for annual CPD accreditation.

New and existing skills

The course was the brainchild of Gill Cheasley, the trust’s medical workforce governance manager, 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 skills they already display, 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 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 enough 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.

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”.

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.” 

Real information

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.

The course brings together for 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 which should benefit departments and, ultimately, patients. 

“Communication problems can - and do - get in the way of performance,” comments Dr Drabu. “But our former delegates now sit round the coffee table discussing clinical issues.”

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.

Stroke consultant Dr Khaled Darawil put his into practice immediately. Queens Hospital is one of the UK’s eight stroke centres and he needed to recruit a multi-skilled team quickly. “I was faced with the prospect of bringing in people from overseas, but the course showed me ways of recruiting local talent,” he explains.

A highlight for ophthalmologist Mr Niaz Islam was the session on business planning, and he saw the benefit of departments working together to achieve shared objectives. “If several departments help each other and merge two or three requests into one robust business plan, we will achieve more.”

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.”

Course content

Day 1 Understanding the leadership aspects of the consultant’s job (including the importance of teamwork and managing conflict)

Day 2 Organisational capabilities: clinical governance, business planning and finance (including how to conduct a situation analysis and construct a business plan)

Day 3 Managing service delivery/change management

Day 4 Developing and building on your influencing skills/managing conflict

Day 5 Negotiating and influencing skills

Day 6 Educational supervision: learning needs analysis; competency-based education, working with portfolios

Day 7 Mentoring and coaching trainees

Day 8 Addressing the issue of poorly performing doctors

Day 9 Revalidation/performance management and appraisal

Day 10 Recruitment and selection