Supporting clinicians to develop knowledge and skills in leadership and quality improvement (QI) sciences improvement through training and fellowship programmes can be effective in enabling clinicians to become leaders, but training is not enough. It is important to identify individuals with a desire to lead and have the personal attributes which will make them effective leaders. In addition, there is also a need for a culture of support for change for leaders to be successful.
This is one of the main messages from our report published in April, Literature Review of the Effectiveness of Clinicians as Improvement Leaders following Training in Improvement and Large Scale Change and set the scene for the discussions at the report launch event. The event incorporated a round table workshop to identify where and how improvement organisations should focus their effort to equip clinicians with the skills and expertise to drive improvement and delivery of new models of care at scale in the NHS. The round table also explored ways to optimise the return on investment in supporting clinicians to develop improvement skills, behaviours and expertise. The round table workshop brought stakeholders together to build on the evidence / findings and recommendations from the literature review. At the event, participants had a presentation of the research findings by the authors, followed by a very lively round-table workshop.
The discussions at the workshop highlighted the importance of a supportive organisation culture to encourage trainees and alumni of the fellowship programmes use the skills gained to drive improvements and have an impact promoting new, unfamiliar ideas when they return to their host organisations post training. But training should not be restricted to just a few people; in fact, everyone in the NHS need to have at least a basic knowledge of quality improvement. To this end, there is need to explore appropriate models to scale up training so NHS staff are more knowledgeable and receptive about quality improvement. There is also a place for more intense clinical leadership training that will help develop individuals to lead change programs in more complex environments such as the systems that we are trying to work in for 5YFV. In addition, we need to think about ways to ensure on-going development and involvement of the clinicians in improvement – some approaches could include setting up systems to actively monitoring the progress of trainees and creating post-training opportunities, developing a leadership career path for clinicians, and concerted effort to retain the trained clinicians in the organisation or within the system when they complete their programme after investing in them to gain the improvement skills. Finally, a co-ordinated approach to tracking the return on investment for current training programmes should be set up to include follow up evaluations over a period of years to explore the long term impact of the programmes on Fellows and employers.
The report of the round table discussions provides useful insight for both sponsoring and training organisations to optimise the opportunities for clinicians to be effective as improvement leaders. This should enhance the capacity of clinicians to play a key role in the pursuit of quality, as well as securing their greater commitment and capability to effect service change and improvement, and to effectively drive the delivery of new models of care at scale in line with the with the vision of The NHS five year forward view.