A College strategy for professional development in leadership and management

1 Purpose of paper

Council members are invited to:-

1) Comment on the relevant areas for the College to take forward

2) Agree key areas for future activity

2 Background Competency in leadership and management is fundamental to the work of a psychiatrist and

underpins all aspects of psychiatric practice;

Leadership in mental healthcare involves leadership practices and organizational intervention in

addition to personal behavioral style or competences;

Leadership and management competencies are clearly defined in the NHS Leadership

Framework;

Leadership development should focus on organizations and systems as well as individuals and

should be informed by the organizational context in which individuals work;

Leaders in mental healthcare should demonstrate:-

o A commitment to promoting high quality care;

o A willingness to collaborate;

o An ability to adopt a wider perspective;

o An interest in team and organizational rather than individual success;

o A desire to strengthen their capabilities through continuing learning, training, and

reflection.

Psychiatrists are uniquely positioned to provide leadership within mental healthcare teams,

services and organisations.

1

3 Strategic PlansWe propose:-

Establishing networks

1. The formation of a National Leadership Networka. A national leadership network to facilitate high quality networking between psychiatrists

holding formal leadership and management positions

2. The formation of Regional Leadership Networksa. Regional leadership networks to provide members, of all specialities and levels, with

opportunities for:

i. Networking

ii. Accessing peer support (including mentoring and coaching)

iii. Sharing best practice regionally and, via the College, nationally

b. Networks to be led and co-ordinated and sit within current divisional and national

structures

3. The creation of the role of Leadership Championa. Named individuals might function as “leadership champions” within the regional

leadership networks and offer members:-

i. A point of contact and coordination around leadership development

ii. Signposting to leadership and management information

iii. Signposting to local and national leadership development opportunities,

programs and events

iv. Introductions to allied individuals and organisations

b. Leadership champions might be formally registered with the College and work closely

with counterparts in primary and secondary care and leaders in postgraduate and

undergraduate psychiatric training

4. Meshing with external work streams a. The Royal College will develop close links with key national allied organisations in

particular:

i. The Faculty of Medical Leadership and Management

2

ii. User and carer groups

iii. Provider organisations

Establishing networks is vital to ensure that the College remains a flexible and responsive organisation

that can reflect mental healthcare priorities and arrangements.

Continuing Professional Development initiatives

5. The provision of leadership and management resourcesa. The College to provide its members with high quality leadership and management

resources in the form of:-

i. An online repository of leadership and management case studies which would:-

1. Illustrate leadership and management best practice in mental healthcare

and in each arena of practice (academic, research, clinical)

2. Supplement the clinical examples offered in the NHS Leadership

Framework

3. Celebrate success

b. Support for revalidation

c. Model job descriptions for formal positional leadership and management roles

6. The provision of leadership and management traininga. The College to provide high quality face to face training in leadership and management

topics

b. Groups with specific learning needs around leadership include:-

i. Psychiatrists making the transition to consultant grade

ii. Psychiatrists in formal leadership and management positions

iii. Those providing supervision to psychiatrists in formal leadership and

management positions

iv. Those involved in teaching leadership and management skills

c. College members have specifically requested access to:-

i. Tools and training around commissioning in mental health and financial and

resource management skills

ii. A formally accredited leadership and management course for psychiatrists

3

Curricula and competency issues

7. Embedding leadership and management competencies in psychiatric practice

a. The College should encourage and enable its membership to identify and achieve the

relevant leadership and management competencies as described in the NHS Leadership

Framework and its supporting materials

b. Leadership and management competencies for psychiatrists should be embedded in:-

i. Training

1. Competency Based Curricula for Core and Specialist Psychiatry Training

2. Annual Review of Competence Progression

3. Workplace Based Assessments

4. Membership examinations

ii. Continuing Professional Development

1. College delivered CPD activities

2. Appraisal

iii. Revalidation

iv. The College web pages

Raising the profile of leadership

a. The importance of leadership can be highlighted and the work of the College publicized

via:-

i. Presentations at College events including the International Congress

ii. Publications on line and in print

iii. Regional and local networks

iv. Electronic resources

b. There may be value in conducting an internal consultation or survey on members’

perceived leadership needs and known resources

c. The College offers opportunities to be a professional leader via roles at Faculty and

national level (including leadership of initiatives, committees, acting as champions and

providing expert resources)

d. Rewarding leadership achievement with College awards

o nts as consumers to Monitor;

4

o Represent the interests of patients to the NHS in strategic commissioning;

o Monitor the NHS and disseminate information nationally and locally;

o Pursue and refer individual or collective patients complaints;

o Contribute to the public debate about the NHS at a national level.

4 The leadership landscapeThe pace of change in the NHS is rapid and the Royal College leadership strategy will most likely evolve in

tandem with current and emerging national political, healthcare and leadership strategies. Strategic Health

Authorities will be abolished in April 2013 and the organisations listed below will be providing oversight,

organisation and input in the emerging leadership development landscape.

The National Leadership Council (NLC) (www.nhsleadership.org.uk) was set up to underpin and

champion the priority attached to leadership in the NHS and aims to ensure that the NHS system supports

and fosters effective leadership, and to challenge where it does not (NLC, 2011). The Council is

responsible for ensuring that the NHS has a systematic way of identifying and developing the leaders of

today and tomorrow. It works to support world-class leadership talent and leadership development and to

ensure that this exists at every level of the NHS. The Council is a sub-committee of the NHS Management

Board, is chaired by the NHS Chief Executive David Nicholson, and has identified five priority areas for

NHS leadership with specific work streams set up to focus on each. These areas are: Clinical Leadership,

Board Development, NHS Top Leaders, Inclusion and Emerging Leaders.

The Academy of Medical Royal Colleges (www.aomrc.org.uk) comprises the Presidents of the Medical

Royal Colleges and Faculties and this group meets regularly to promote, facilitate and where appropriate

co-ordinate the work of the Medical Royal Colleges and their Faculties.

The Faculty of Medical Leadership and Management (www.fmlm.ac.uk) is a new UK-wide organisation

that aims to promote the advancement of medical leadership, management and quality improvement at all

stages of the medical career for the benefits of patients. Revalidation for doctors will be introduced during

2012 and the FMLM is developing support for participants and appraisers focussing on leadership

elements of each doctor’s role including those of doctors with a substantial leadership and management

commitment. The FMLM is developing standards for management and leadership and supports those

involved in management and leadership education.

The NHS Institute for Innovation and Improvement (www.institute.nhs.uk) provides a range of products

and interventions to help build leadership capability and capacity across the NHS.

5

The Academy and the NHS Institute are collaborating on a UK-wide project called “Enhancing Engagement in Medical Leadership” which aims to promote medical leadership and help create

organisational cultures where doctors seek to be more engaged in management and leadership of health

services and non-medical leaders genuinely seek their involvement to improve services for patients.

The Academy and the NHS Institute have published “The NHS Leadership Framework” (NHS LF); this is

an overarching framework describing leadership capabilities, competences and behaviours in the NHS.

The NHS LF relates to all doctors in the NHS, is described in more detail in the following section.

Medical Education England (www.mee.nhs.uk) provides independent expert advice on education and

training and workforce planning for doctors, dentists, healthcare scientists and pharmacists.

5 NHS Leadership Framework

5.1 – Overview of the NHS Leadership Framework

The NHS Leadership Framework (NHS LF; www.nhsleadership.org.uk/framework.asp) is an overarching

framework describing leadership capabilities, competences and behaviours in the NHS. It is underpinned

6

by a consistent set of guiding principles which reflect the values of NHS staff as captured in the NHS

constitution and represents the foundation of behaviour for staff throughout the NHS.

The NHS LF relates to all staff in the NHS irrespective of their professional role, function or level and

comprises 5 core dimensions. The 5 core dimensions relate to the 5 domains of the Medical Leadership

Competency Framework and Clinical Leadership Competency Framework plus two more for senior

leaders intersected by 5 levels to enable leaders to understand their progression/development from self to

leading systems:-

1. Demonstrating personal qualities: Effective leaders need to draw upon their values, strengths

and abilities to deliver high standards of service. This requires them to be demonstrate

effectiveness in Developing Self Awareness, Managing Themselves, Continuing Personal

Development and Acting with Integrity.

2. Working with others: Leaders work with others in teams and networks to deliver and improve

services. This requires them to demonstrate effectiveness in Developing Networks, Building and

Maintaining Relationships, Encouraging Contribution, and Working within Teams.

3. Managing services: Effective leaders are focused on the success of the organisation(s) in which

they work. This requires them to be effective in Planning, Managing Resources, Managing People

and Managing Performance.

4. Improving services: Effective leaders make a real difference to people’s health by delivering

high quality services and by developing improvements to services. This requires them to

demonstrate effectiveness in Ensuring Patient Safety, Critically Evaluating, Encouraging

Improvement and Innovation and Facilitating Transformation.

5. Setting direction: Effective leaders contribute to the strategy and aspirations of the organisation

and act in a manner consistent with its values. This requires them to demonstrate effectiveness in

Identifying the Contexts for Change, Applying Knowledge and Evidence, Making Decisions, and

Evaluating Impact.

There are two additional dimensions which may apply to all leaders but particularly apply to senior

leaders.

6. Creating the vision: Effective senior leaders create a compelling vision for the future, and

communicate this within and across organisations. This requires them to demonstrate

7

effectiveness in developing the vision for the organisation, Influencing the vision of the wider

healthcare system, Communicating the vision and Embodying the vision.

7. Delivering the strategy: Effective senior leaders deliver the strategic vision by developing and

agreeing strategic plans and ensuring that these are translated into achievable operational plans.

This requires them to demonstrate effectiveness in Framing the strategy, Developing the strategy,

Implementing the strategy, and Embedding the strategy

Staff will exhibit a range of leadership behaviours across these 7 dimensions dependent on their context.

Intersecting these dimensions are 5 levels of leadership. These are broadly progressive and are designed

to illustrate the stages of development as a leader.

Level 1: Leading as a professional involves building personal relationships with a range of colleagues,

often working as part of a multi-disciplinary team. L1 leaders need to be able to recognise problems and

work with them to solve them. The impact of the decisions leaders take at this level will be limited in terms

of risk of a successful outcome.

Level 2: Leading others involves building relationships across and within teams, recognising problems

and solving them. At this level, leaders will need to be more conscious of the risks that their decisions

may pose for self and others in terms of a successful outcome.

Level 3: Leading services involves networking across teams and departments. Leaders will challenge

the appropriateness of solutions to complex problems. The potential risk associated with their decisions

will have a wider impact on the Service.

Level 4: Leading organisations involves building broader partnerships across and outside traditional

organisational boundaries. At this level leaders will be dealing with multi-faceted problems and coming up

with innovative solutions to those problems. Their decisions may have significant impact on the NHS

brand and outcomes.

Level 5: Leading systems is about sustainable, replicable relationships across the system (relationships

that will be retained even if a leader leaves the organisation). L5 leaders may lead at a

national/international level and would be required to participate in whole systems thinking, finding new

innovative ways of working and leading transformational change. The impact of their decisions would be

critical to the future success of the NHS.

8

5.2 - Supporting tools

There are a number of supporting tools (www.nhsleadership.org.uk/framework.asp) to help support

healthcare professionals in understanding and using the NHS LF, such as a free self assessment tool, a

360° tool, e-learning modules, and material written specifically for educators and trainers. Clinicians will

also find additional material, such as additional examples for learning and development and scenarios,

available throughout the website. 

5.3 – Advantages of Competency Frameworks

Competency frameworks offer a clear benchmark for the specific behaviours, knowledge and

understanding underpinning the outcome of effective leadership. They can be used as a basis for

continuing professional development (CPD) by assessment against relevant standards and frameworks.

The Third Sector Leadership Centre (2007) suggests that competency frameworks can be used by

leaders:-

As a checklist for measuring individual performance;

To increase awareness of roles and responsibilities;

To identify professional development needs within their role;

As a foundation for career progression;

To accrue evidence that may lead to a nationally recognised qualification;

To identify group and / organisational developmental needs;

As a record of previously acquired competencies, skills and knowledge;

To enhance confidence to perform a role well.

9

5.4 – Disadvantages of Competency Frameworks

Competency frameworks are based on what strong performers have done in the past and thus may not be

relevant in rapidly changing circumstances. It is unlikely all leaders within an organisation must possess

the same set of competencies to be successful - or make the organisation successful. There is also a risk

of embedding one particular group of attitudes and not seeking out the right skills and attitudes for new

ways of working.

An extensive list of knowledge, skills and attributes may be overwhelming and appear unachievable and by

listing individual competencies frameworks can imply to readers that leadership resides in a single

individual, whereas notions of contemporary shared leadership argue for leadership as an embedded

characteristic of organisations.

5.5 - Leadership competencies in mental healthcareLeadership competencies for mental health do not differ from those in health; core leadership

competencies are universal. However, the knowledge required of policies and programs are different for

mental health than for health and vary according to the region and locality in which they are applied.

There is also greater emphasis within mental health on:-

Team work

Interagency work

Collaboration with independent providers of healthcare and non-healthcare organisations (such

as Social Services, the probation service, courts, housing, the Third Sector, user and carer

forums and the media)

Reducing discrimination and stigma against people with mental health problems and learning

disabilities

Encouraging true partnerships between carers, patients and professionals

Promoting best practice in mental health

The importance of clinical commissioning in mental healthcare is increasingly recognized and needs to be

incorporated into training and continuing professional development activities alongside knowledge of the

basics of evidence-based practice and quality improvement.

6 What is leadership?

10

Leadership and management is a core strand of the emerging NHS and psychiatrists and allied

professionals are expected to be competent at both. Leadership and management can be highly rewarding;

considerable satisfaction can be derived from setting up and delivering a new service or model of care,

working with underperforming colleagues and seeing them improve and generating improvements in clinical

outcomes. The time when the sole function of a psychiatrist was to provide clinical care has passed; the

NHS Leadership Framework (Academy of Medical Colleges, 2011) identifies leadership competencies that

are expected of all doctors throughout their career - from medical school to retirement.

6.1 - A fourfold typology

There is no consensus in the leadership literature as to the basic meaning of leadership, whether it can be

taught or its effects both measured and predicted (Grint, 2011) and the concepts of leadership and

management overlap (Storey, 2004). However, the following four fold typology encompasses a significant

proportion of leadership definitions (Grint, 2011):-

1. Leadership as Person – who leaders are; their personality traits, skills and standards of personal

effectiveness;

2. Leadership as Process - how leaders get things done; defined by social interactions, attempts at

influence, communication, empathy, empowerment and coaching;

3. Leadership as Position - where leaders operate; defined by organisational leadership roles,

position, authority and/or professional status;

4. Leadership as Results - what leaders achieve;

The above typology is heuristic, pragmatic and non-hierarchical and empirical examples of leadership are

likely to embody all four types. Defining leadership allows individuals to understand each other’s position

and arguments and has vital implications for how organisations function and who is rewarded and

sanctioned; there may not necessarily be a need to agree on a definition however it is important for

individuals and organisations to know what the definitions are in order to identify which particular definition

is being referred to.

Comparing leadership and management

Kotter (1990) distinguishes leadership from management as follows:-

11

Leadership Management

Creating an agenda Establishing direction Planning and budgeting

Developing a human resource network for achieving the agenda

Aligning people Organisation and staffing

Execution Motivating and inspiringControlling and problem solving

Bringing order

Outcomes Implements and manages change Predictability and order

6.2 - Leadership is relational

Leadership is relational and cannot be understood in the absence of followership (Grint & Holt, 2011);

leaders need willing and committed followers if they are to fulfill their functions effectively. This principle is

echoed in the definition given in the NHS Leadership Framework (Academy of Medical Colleges, 2011):-

“Leadership is a process whereby an individual influences a group of individuals to achieve a common goal”

A leader in mental healthcare develops, maintains and manages relationships within and beyond their

organization and through this changes organization practices and processes. Leadership is thus a

continuous and constantly evolving process which is driven in part by interactions with followers.

Effective followers assume responsibility for their actions and support the leader and the group with

energy and positivity. They take moral action when needed, contribute to transformation and where

appropriate constructively challenge.

6.3 - Leadership across boundaries

Psychiatrists are increasingly required to engage in the wider environment beyond their clinical area and

this is reflected in new definitions of medical professionalism (Hobkirk & Deuchar, 2011). The ability to

work across boundaries and persuade others over the right course of action is an important skill for a

leader in mental healthcare; leadership should not be inward looking nor confined to a single service or

organization.

12

Many of the problems that mental healthcare organisations address – poor physical health, substance

misuse, aggression – are not simply problems of mental health, they are often deeply complex social

problems that span and sit between different NHS and government departments and institutions; attempts

to treat them using a single institutional framework are likely to fail. Mental healthcare organizations

therefore need leadership across boundaries into social care, local government, the voluntary sector and

the wide variety of other agencies with which they interact and without whose co-operation they will not

achieve their primary objectives. This necessitates leadership that is shared, distributed and centered on

the delivery of high quality care.

6.4 - Shared leadership

Effective mental health care requires colleagues from diverse professions and with competing

perspectives on what is important to work collaboratively to meet organizational aims. This requires

intricate leadership arrangements with negotiated authority between clinicians and professional

managers, between clinicians from different professional backgrounds and across one NHS body to

another. The ability to unite this diversity of talent is a hallmark of a successful leader.

6.5 - Distributed leadership

Distributed leadership means that leadership responsibilities and accountability are shared by those with

relevant skills and expertise, rather than resting with an individual. Leadership is distributed away from the

top of an organization to multiple levels. Distributed leadership is based on three key ideas:

The belief in leadership teams: belief in the power of the individual is giving way to a belief in the

power of the collective;

As mental healthcare organizations become increasingly complex systems to manage and lead,

we need more leaders than ever before;

Ensuring that there are many leaders will enable us to create pools of talent, from which we can

develop tomorrow’s leaders.

6.6 - Leading for quality

13

At a time of great transition and challenge, leaders in mental healthcare at all levels and from all

backgrounds have a responsibility to ensure that the delivery of high quality patient care and outcomes is

at the heart of everything they do. Quality, as defined in High Quality Care for All (Darzi, 2008), has three

dimensions: ensuring that care is safe, effective, and provides patients with the most positive experience

possible. Leaders in mental healthcare must therefore focus on systems of care, and not just institutions,

and on engaging staff and followers in delivering results. For example, doctors who are provided with

clear information about costs along with the authority to tackle them – through service line reporting in

hospitals or prescribing costs – deliver higher quality and better care results (Ham 2003; Ham &

Dickinson, 2008). Organizations should actively encourage and engage in current and future best

practice to improve upon their performance and develop.

In essence, management directs flows of resources to achieve defined objectives (Pollitt, 1993) and

require a readiness and ability to complete tasks (Pattison, 1997). Leadership can be seen as

transformational and not necessarily predicated on hierarchical seniority (in fact often most effective when

not), managerialism can be seen as transactional and predicated on designated authority. There is no

doubt that managers require leadership skills to be effective, but the converse is not true.

7 Psychiatrists as leadersPsychiatrists can assume both formal and informal leadership roles and can provide leadership in a

variety of arenas - clinical, academic and research– and at every stage of their career, from medical

school to retirement.

A consultant psychiatrist cannot see every patient (the money and the time are simply not there) or be

personally responsible for every patient seen by a member of the team that they lead. However, a

consultant psychiatrist can, and indeed is uniquely positioned to, lead a team in such a way that practice

and outcomes for patients are good and are continuously improving. A consultant psychiatrist can be

accountable for this leadership role. (We define responsibility as a personal undertaking to do something.

We define accountability as an undertaking to make sure that something is done.)

The seniority of a consultant psychiatrist within the multidisciplinary team can confer accountability for

clinical leadership, but this is not automatic. The imperatives of leadership should include:

Clinical decision-making in multidisciplinary contexts

Managing dynamics in team settings

Professional development of colleagues

14

Service improvement and the drive for quality

Ensuring equity of access

An ambassadorial role for health services, and an acceptance of wider roles outside the

employing organisation

Horizon scanning, to anticipate developments in policy and practice, and then encourage

evolution in service delivery

Psychiatrists are well placed to join up efforts at a strategic level, the service level and frontline and have

many attributes which are of value in an organisational management or leadership setting (Greiner, 2006):-

Skills in assimilating diverse and conflicting evidence;

Experience of multiple theories of behaviour;

Experience of group functioning;

Embodiment of leadership qualities;

Training in individual and group therapy.

8 Leadership development in Mental Healthcare

Leadership development must take place in the context in which an individual works; developmental

experiences are likely to have the greatest impact when they can be linked to or embedded in a

professional’s ongoing work and when they are an integrated set of experiences. Clinicians must have the

time and space to review established practices and to introduce new and more effective ways of

leadership development. Best practice organizations recognize leadership as a key component of jobs at

all levels and are committed to creating leaders throughout their organizations. Leadership development

should therefore be:-

Multi faceted and include an array of developmental experiences which are meaningfully

integrated;

Ongoing and not a single program or event;

Linked with work assignments, HR systems and business strategies;

15

“...there is an opportunity for the UK to become an exemplar in Medical Leadership and its development.”

Ham et al, 2008

Be guided by competencies at all levels.

In the past clinicians have been deterred from taking up leadership roles (Ham, 2007; Jonas, McCay &

Keogh, 2010) owing to:-

Unclear incentives for clinicians to become leaders;

A lack of remuneration;

A lack of peer and professional recognition and respect;

A lack of formal training;

Underdeveloped career pathways for these roles;

A culture of anti-managerialism;

Completion for time and attention with clinical work, research, opportunities to enhance personal

income and leisure time;

Variable and limited support;

A perception that leadership is a nebulous, non-rigorous and unscientific concept;

Organisational approaches to overcoming these barriers include:-

Ensuring easy transition in and out of leadership roles;

Recognising the contribution of leaders clinical leaders both financially and by valuing their

contribution;

Building upon the development of medical director and clinical director roles and extend clinical

leadership arrangements;

Creating contexts in which effective clinical leadership can be exercised;

Creating an organisation in which professionals are willing to follow their peers who take on

leadership roles;

Developing a better understanding of leadership within individual health-care organisations;

Creating leadership teams rather than perpetuating a reliance on “heroic” individuals;

Expanding the evidence base to lend support to programmes of leadership and organisational

development;

Providing professionals with the time, resources, information and skills needed to achieve change;

Individual approaches to overcoming these barriers include:-

Identifying / recognising leadership strengths and weaknesses (e.g. via 360 feedback from

mentors, colleagues & students);

Understanding the various facets of leadership;

16

Aligning oneself with an individual with complementary strengths and weaknesses;

Establishing relationships with peers with similar responsibilities in order to energise one’s

motivation around a task;

Joining leadership / management groups who can provide support;

Read key publications.

8.1 – Leadership development tools and methods

Some of the options available for leadership development are outlined below and learners are encouraged

to take advantage of “blended learning” opportunities. Each tool and method has its own advantages and

disadvantages and the right approach will depend upon individual and / or organisational circumstances

and goals. The Third Sector Leadership Centre (2007) recommend that leadership development tools and

methods should be matched to:-

Individual learning styles (Honey and Mumford, 1982 (www.peterhoney.com) describe four

different styles of learning: Activist, Reflective, Theoretical and Pragmatic);

The development need (skills, knowledge, the application and implementation of leadership,

leadership recognition or certification);

The amount of time available (days, a week, longer term);

The need for predictability (unpredictable, predictable).

Individuals should adopt a cumulative approach to learning, considering basic concepts and local systems

early on in their training and complex concepts and wider systems when more established.

8.2 – Leadership development opportunities

Action learning – working as part of a small group of peers or an “action learning set” to address real life problems, develop solutions and take action (www.ifal.org.uk);

Assessment tools – specialised diagnostic questionnaires which offer insight into leadership styles, strengths, abilities gaps and developmental needs (e.g. Myers-Briggs Type Indicator);

Coaching – a time-limited, goal-orientated, one-on-one developmental relationship based on real work issues (www.cipd.co.uk/subjects/Irnanddev/coachmntor);

Competency frameworks – define the outcomes of effective performance expressed in terms of demonstrable outcomes and / or behaviours (e.g. NHS Leadership Framework, 2011);

17

Developmental work assignments – learning from ongoing work initiatives and integrating these experiences with each other, other developmental methods and strategic organisational imperatives;

Feedback - 360 degree feedback is a formal, multi-source, instrument for feedback;

Mentoring - a long-term, open-ended, one-one developmental relationship in which a senior person supports the personal and professional development of a junior person (www.mentoring-uk.org.uk)

Leadership within a team

Self-directed learning – taking responsibility for finding, managing and assessing one’s own learning e.g. basic internet research, reading books and journals, attending and contributing to networks and forums;

Shadowing – provides opportunities to observe and understand an unfamiliar part of a system without being required to act;

Workshops and masterclasses – time-limited learning sessions focused on specific topics which provide opportunities to gain up-to-date information, develop particular skills and to share learning; workshops delivered by experts in their field are called masterclasses;

8.3 – E-learning

In a time of financial austerity, improved access to high speed internet and new ways of working,

technology is increasingly being used to support communication, shared learning and engagement around

medical training and development.

The potential of technology to drive Leadership Development is yet to be exploited. Although many e-

learning approaches in medical education are in their infancy we can, over time, expect increasing

numbers of undergraduate and postgraduate healthcare trainees and qualified clinicians to be accustomed

to using technology as a main driver of their development. E-learning is not a replacement for conventional

face to face teaching and should compliment traditional methods perhaps as part of a “blended learning”

package. E-learning has the potential to deliver cost effective training, an important consideration in times

of financial austerity however significant costs can be incurred as a consequence of the extended time that

is required to develop and refine e-learning packages that are of suitable sophistication and utility.

E-learning can:-

Deliver learning opportunities to geographically dispersed leaders;

Allow individuals access to learning opportunities when it best suits their schedule and extend

learning over time (cf limiting it to time spent in classroom);

Enhance the emergence and sharing of knowledge among participants.

18

Communities of Practice (CoP) (Lave & Wenger, 1991) provide a collaborative environment in which

individuals can connect to other people, information and knowledge and virtual CoPs can incorporate wikis,

blogs and discussion boards. CoPs can be password protected and further information about them can be

found at http://www.idea.gov.uk/idk/core/page.do?pageId=8152674 . Virtual networks can:-

Facilitate the rapid and widespread dissemination of information nationally and internationally;

Encourage the development and sharing of new ideas and strategies;

Support faster problem-solving;

Minimise duplication of effort;

Provide potentially endless access to expertise.

Simulated learning involves presenting students with structured scenarios relevant to a chosen topic and

encouraging reflection upon them individually and collectively; they are used extensively in undergraduate

medical education, for example in courses run by Imperial College London and Warwick University.

The Royal College has the potential to act as a powerful hub for leadership development and sophisticated

networking by capitalising upon its expertise, high level awareness and digital technology and hosting

introductions between like-minded individuals with shared interests.

8.4 – Leadership and management opportunities

Organisations and networks Faculty of Medical Leadership and Management - www.fmlm.ac.uk National Leadership Council – www.nhsleadership.org.uk Committees and special interest group within:-

- The Royal College of Psychiatrists – www.rcpsych.ac.uk- Royal Society of Medicine - www.rsm.ac.uk- British Medical Association – www.bma.org

The Network – www.the-network.org.uk nhs2040 - www.nhs2040.org/

Formal leadership development schemes NHS London Prepare to Lead – www.london.nhs.uk/leading-for-health/programmes/prepare-to-

lead NHS North West Mentoring Scheme - www.nwmentoring.nhs.uk/

Secondments and fellowships SHA medical leadership fellowships for trainees Chief medical officer’s Clinical Advisors Scheme –

www.careers.bmj.com/careers/advice/view-article.html?id=2893 NHS London Darzi fellowships –

www.london.nhs.uk/what-we-do/developing-nhs-staff/leading-for-health/darzi-fellowship

19

Harkness fellowships – www.commonwealthfund.org/Fellowships/Harkness-Fellowships.aspx McKinsey and Company - www.mckinsey.com Winston Churchill Memorial Trust – www.wcmt.org.uk/reportcategories/medical-health.html Health Foundation GenerationQ -

www.health.org.uk/areas-of-work/improvement-programmes/generationq/

Educational qualifications and courses Masters in medical leadership, University of Warwick -

www2.warwick.ac.uk/study/postgraduate/courses/depts/medschool/taught/leadership/ BMJ Learning and Open University clinical leadership programme –

www.clinicalleadership.bmj.com/student Masters in Business Administration (MBA) Postgraduate certificates and diplomas in management and leadership related subjects

E-learning E-Lead - www.e-lfh.org.uk/projects/lead/index.html BMJ’s Clinical Leadership modules - www.clinicalleadership.bmj.com

9 NetworkingNetworking involves the creation of interdependent and often mutually beneficial relationships and can be

pivotal in leadership and managerial development, improving career prospects, enhancing performance

and increasing visibility. Networks can be formal (e.g. participating in national groups or being an active

member of a society) or informal (getting to know, interacting and working with others who share a

common purpose or set of interests) and occur internally or externally to an organisation (e.g. within a

Trust or an external special interest group). The creation of networks requires sustained and conscious

effort by the individual and support from the employing organisation and can enhance knowledge of

different systems and sectors.

Like-minded individuals within peer networks can provide each other with support, encouragement and

developmental opportunities and a synergy of individual expertise and enthusiasm can result in the

achievement of goals or projects that would have previously felt unattainable to individual participants.

Networking with senior leaders can provide opportunities to experience and witness interactions and

events not normally encountered and offer exposure to a range of contacts, deepening and extending

networks. It can help expose individuals to a broad range of perspectives, views and information and bring

opportunities to contribute to projects and key decision-making processes.

9.1 – Principles of effective networking Act with integrity and trust;

Help others and you will be helped in return;

Target groups and contacts relevant to your aims and capabilities;

20

Plan your networking;

Follow-up meetings and contacts in order to make things happen;

Be a positive influence;

Be able to describe yourself succinctly and impressively in person and on paper.

Networking opportunities include conferences, seminars, training courses, networking websites, networking

events, lectures and talks, universities and Royal Colleges.

Michael HobkirkSpecialist Advisor, Leadership Development, Royal College of Psychiatrists

21