Tove Steen Sorensen – Bentham Brighton Business School University of Brighton, UK Educating Doctors in Leadership – Does that give us future leaders?

Presentation structure The MSc Management (Leadership for Clinicians) Programme –What a leader need to know! Evidence of development –Reflection on learning & Action Learning sets –KSS Standards for Clinical Leadership, Portfolio, Learning Log & Viva –Communities of Practice –Independent evaluation of programme –Academic achievement –Transformational Leadership etc. Sustaining leadership in practice –Importance of having and being role models –Re-entry to NHS organisations Conclusion –Lessons for future medical education –Multi-disciplinary education –Support for existing & future leadership –Becoming good followers

The Leadership Programme - What a leader need to know! Joint initiative between KSS Deanery & the University of Brighton Initially a FT course (8) now also a PT cohort (16) All doctors based in NHS organisations with an identified leadership facilitator Curriculum to cover all main management & leadership functions As no-one would expect clinicians to practice without a professional qualification, it is acknowledged that it would be un-realistic to expect senior managers and leaders to manage and lead effectively without a qualification in management and leadership (High Quality for All, 2008)

Curriculum The Public Service Environment Leadership & Ethics Managing People Service Planning Organisational Learning & Leadership Managing Finance in the Public Service Public Services Strategy & Change Integrative Management Report

Evidence of development (1)  Reflection on impact of learning on professional and personal development – “I will never be the same again” –“ I now see the world differently”; “ I feel different from the other doctors” –“Without having gained these skills I would never have known how to change my services” –“I never realised that my organisation was so complex” –“I have gained enormous respect for managers – before I always though of them as ‘them and us’ –“All doctors should have this kind of knowledge – without it we cannot change the NHS”  KSS Standards for Clinical Leadership A Curriculum framework for the workplace, a learning log, a portfolio, a viva

Evidence of development (2)  Communities of Practice – distributed leadership Concept underpinning the programme and including the course participants and workplace leadership facilitators as well as a means of developing leadership and human capital for the future. Some of the students are now actively engaging junior doctors in different initiatives  Independent evaluation of programme “The potential for future impact is considerable, as a consequence of the implementation of the Fellows’ recommendations and service improvement plans, through their continuing contribution to the development of their services, and as a result of the wider organisational learning achieved through their insights. This longer-term impact will be heightened if the Fellows can sustain their motivation and learning, if there is continuing investment in their development and if they find employment in organisations whose cultures encourage those with leadership capability.” (Miller & Balint, Westminster Business School)

Evidence of development (3) Academic achievement –100% successful completion –higher than average number of Distinctions –Increased ability to deal confidently with complexity –Increased ability to integrate different functional disciplines Transformational Leadership –Questionnaire issued in Sept 2009 and in June List of 20 qualities of effective leaders -Self rating on a scale of 1 – 9 -Data collected to assess individual change as well as collective change Questionnaire adapted from Lim, B (1997) Transformational Leadership in the UK Management Culture. Leadership and Organizational Development Journal. 18:6 pp

Sept 2009 – rating of own qualities Range:88 – 162 = 74 Average: 122 Lowest quality = seeking new opportunities for the organisation (9) Highest quality = Giving positive feedback (2), Showing respect for other people’s feeling (14), Giving special recognition when work is very good (15), June 2010 – rating of own qualities Range:129 – 151 = 22 Average: 140 Lowest quality = seeking new opportunities for the organisation (9) Highest quality = Giving special recognition when work is very good (15) Greatest improvement = Challenging others to think about old problems in new ways (6) Student most improved score = + 45 points Student most reducing score = -15 points

Sustaining leadership in practice (1) Importance of having a role model “The consultants are stuck in the rut and not acknowledging what we can actually do” “You cannot leave it to the consultants” “Doctors are tribes with no focus on quality & customer care” How do the NHS ensures that it got the right role models??? Importance of being a role model “Need to take control and mobilise other junior doctors” “We need to create empowerment – to think of junior doctors as a team” “I would never have put myself forward before the course… I can now share with others about strategy and critical assessment of the White Paper” How does the NHS support emerging role models???

Sustaining leadership in practice (2) Re-entry to NHS organisations - challenges  Senior doctors as contrapreneurs  Refocus on purely clinical functions – looking for areas where their new skills can be utilised  Retain motivation and enthusiasm  Alone in the midst of the many – gone to the ‘dark side’

Conclusion Lessons for future medical education Provide knowledge about the NHS, public services & the wider environment, their interrelationship and inter-dependency Continue management & leadership education in the workplace to create transferable toolboxes of knowledge, skills & expertise Develop, support and promote leadership & management capital by encouraging behaviour such as:  Be brave and challenge where appropriate  Embrace chaos and complexity  Be a critical friend to colleagues and others  Take calculated risks  Involve and empower others, listen and communicate well  Place quality of all patients’ care in the centre not just a patient’s care  Manage resources wisely and efficiently on behalf of the public  Remain ethical and true to own values also in time of adversity  Work efficiently & effectively with others, across professional & organisational boundaries to the benefit of the organisation and therefore the patients Multi-disciplinary education – need for cross fertilisation Student feedback request multi-disciplinary education including managers as well as professionals & with NHS as well as other public service and third sector representatives.

Conclusion - continued –Support for existing & future leadership Competency frameworks are not sufficiently robust to ensure appropriate and sustainable leadership on their own Doctors/clinicians do not find that they currently have the leaders with the skills/competencies, they expect of them Move away from heroic short-term focussed leaders to distributed leadership or leader-less teams. –Becoming good followers as there is no leader without followers. Leaders are also followers – change of focus to create individuals who know how and when to lead and follow Followers implement change in practise and should be recognised as being as crucial to change as leaders Followers might need different leaders at different times for different roles –Need to develop leaders for tomorrow and not just today

END Thank you for listening Questions? Tove Steen Sørensen-Bentham Brighton Business School University of Brighton, UK