Clinical Leadership for the NHS in Wales: Clinical Leadership Development Scoping Workshop

Clinical Leadership for the NHS in Wales

Clinical Leadership Development Scoping Workshop3rd December 2013, Swalec Stadium, Cardiff

2 | Clinical Leadership Development Scoping Workshop

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Clinical leadership is more than providing a good standard of patient care. Clinical leaders identify where improvement is needed and enable change. The term is therefore relevant across all levels of the NHS in Wales. Taking responsibility for clinical leadership can improve patient outcomes, avoid wasteful use of resources and enhance the working environment.

In December 2013, Welsh Government facilitated a national workshop to discuss the clinical leadership role and to devise a strategy for moving forward. Representatives from multiple organisations with expertise in clinical leadership were invited to participate in this workshop to highlight the extensive clinical leadership development opportunities being delivered by the NHS and several ACADEMIc institutions across Wales. Whilst much of this work is of high quality, an “All-Wales” shared vision of clinical leadership development is required to enable collaboration, promote culture change and engage new leadership talent from the existing NHS workforce. This needs to be clinically driven to help encourage ownership and accountability. The opportunity to work with and learn from other public sector organisations both within and outside healthcare is an important part of this process.

Contents Summary “ Nationally and locally, clinical leadership and empowerment will be strengthened, and more use made of proven methods to improve practice such as collaboratives and benchmarking”. Together for Health, Welsh Government 2016

Summary 3

Participants 4

Overview 5

Workshop 6

Key outcomes 14


Clinical leadership development group

James Ansell (JA) (Clinical Leadership Fellow and Surgical SpR)

Anthony Davies (AD) (Secretariat / DPH Business manager, Welsh Government)

Glynis Hudson (GH) (ACADEMI Wales, Welsh Government)

Chris Jones (CJ) (Deputy Chief Medical Officer for Wales)

Bethan Johnson (BJ) (ACADEMI Wales, Welsh Government)

Jackie Parsons (JP) (ACADEMI Wales, Welsh Government)

Annie Procter (AP) (Consultant in Medical Genetics, Cardiff and Vale UHB)

Organisations represented at the scoping workshop

Abertawe Bro Morgannwg University Health Board

Aberystwyth University

ACADEMI Wales, Welsh Assembly Government

Aneurin Bevan University Health Board

Bangor University

Betsi Cadwaladr University Health Board

British Medical Association

Cardiff School of Nursing

Cardiff and Vale University Health Board

Cwm Taf Health Board

Faculty of Medical Leadership and Management

Office of the Chief Medical Officer, Welsh Assembly Government

Participants

Powys Teaching Health Board

Public Health Wales

Royal College of Nursing

Social Services Improvement Agency

Swansea University

University of South Wales

Velindre NHS Trust

Wales Deanery, School of Postgraduate Medical and Dental Education

Welsh Ambulance Service Trust

Welsh Clinical Leadership Training Fellows

Welsh Medical Advisory Committees

1000 Lives Plus


Current clinical leadership activity in Wales

From 2011-13, data was collected to clarify the current extent of clinical leadership development activity across Wales. This work was conducted by the Welsh Institute for Health and Social Care (WIHSC), the NHS Leadership and Development Team and the Office of the Chief Medical Officer (OCMO). The aim was to identify to the number and type of leadership development activities (LDAs) currently being delivered. LDAs were defined as programmes designed to enhance leadership capabilities and/or behaviours. The aim was to capture detail about group learning events, not those targeted at individuals such as coaching or mentoring interventions (although group programmes could include these methods as part of a wider programme). Information on ‘Management Development’, i.e. generic core management skills development, building capabilities around the mechanics

of management, rather than the behaviours of leadership was not collected as part of this scoping exercise.

The following healthcare organisations were contacted:

All NHS Health Boards

All NHS Trusts

All Welsh Universities

Wales Deanery

NHS improvement programmes

Each organisation was asked to provide information for the following areas:

The number of LDAs currently delivered

The number of participants attending LDA in the past 12 months

The number of times the LDAs were delivered in the past 12 months

The number of planned LDAs in the next 12 months

The results demonstrated that there are a significant number and range of LDAs being delivered across Wales. There were 57 individual LDAs organised during this time period, involving in excess of 1500 clinical staff. These ranged from short courses in clinical leadership to post graduate degree level programmes. Results from this exercise can be found at [LINK]. This exercise demonstrated the considerable amount of leadership development already being conducted across Wales by highly skilled and committed personnel. Focus is however, needed to ensure that the high volume of leadership development being undertaken does not lead to duplication and waste of resources. It would be advantageous to facilitate collaboration between multiple providers.

Overview


Clinical Leadership Development Scoping Workshop

The leadership scoping workshop provided an opportunity for organisations to come together to discuss the future of clinical leadership for the NHS in Wales. The aim of the workshop was to discuss three key areas in order to answer the following questions:

Discussion 1 (Clinical leadership development for NHS Wales)

What does an effective clinical leader look like?

What are we doing well?

What can we do more of?

What could we do differently? New ways of working?

Discussion 2 (Clinical leadership development for NHS Wales)

How may we use the Healthcare Leadership Model in Wales?

Discussion 3 (Future for collaboration on the leadership development agenda)

How can we work together more closely to share knowledge and experience?

What do we put in place to achieve this?

During the registration process, each participant was assigned to a working group with partners from differing organisations. The schedule of events and the methodology used is detailed in Table 1. A summary of the discussion from the workshop was captured using visual minutes (Figure 1).

Workshop


Title of session Lead / speaker

Introduction & Welcome

Current context for Clinical Leadership development in Wales Chris Jones (DCMO NHS Wales)

Overview of Clinical Leadership Development provision across Wales James Ansell (Clinical Leadership Fellow)

Table Discussion 1

Clinical Leadership Development for NHS Wales Facilitated by ACADEMI Wales

Update on the new NHS Leadership Academy ‘Healthcare Leadership Model’ Allan Nobbs, Tracy Lonetto (NHS Leadership Academy)

Table Discussion 2

Healthcare Leadership Model for NHS Wales Facilitated by ACADEMI Wales

Table Discussion 3

Future for collaboration on the Clinical Leadership Development Agenda Facilitated by ACADEMI Wales

Next steps and Actions Chris Jones (Deputy Chief Medical Officer NHS Wales)

Table 1: Timetable of events for Clinical Leadership Scoping Workshop


Figure 1: “Setting the scene” Summary of introduction for the workshop


Discussion 1: (Clinical leadership development for NHS Wales)

What does an effective clinical leader look like - skills, knowledge, behaviours?

What are we doing well? What can we do more of?

Multiple key skills, knowledge and behaviours central to effective clinical leadership were identified during the workshop (Figure 2). There are several aspects of clinical leadership development that are being administered effectively across Wales. The geographical infrastructure lends itself well to the development of strong links in clinical leadership across organisational and operational boundaries. Access to senior clinical leaders within NHS Wales and the availability of coaching and mentoring

is good. Multidisciplinary development occurs at all levels but more structure around clinical leadership training could improve its delivery. In particular, the Royal College of Nurse leadership programme and 1000 lives plus are well received and highly regarded.

What could we do differently? New ways of working?

A clear vision of future clinical leadership development needs to be established for Wales. Valuing and acknowledging individuals that demonstrate commitment to clinical leadership should be at the forefront. More structured clinical leadership training which allows ease of transition across organisations, including those outside the NHS is required. This may reduce overlapping of the current training programmes being delivered. Work is required to explore the potentials for undergraduate training and engagement in clinical leadership. International collaborations both inside and outside the health care sector could be a useful means of developing clinical leadership.


Figure 2: “What does an effective clinical leader look like”


Discussion 2: Clinical Leadership Development for NHS Wales

How may we use the Healthcare Leadership Model in Wales?

The group discussed the application of the Healthcare Leadership Model developed by the NHS Leadership Academy. This is a framework based on key leadership behaviours, designed to help those who work in healthcare to become better leaders.

The model details the following nine dimensions of leadership behaviour, each shown on a four part scale which ranges from “essential” through “proficient” and “strong” to “exemplary”:

1. Inspiring shared purpose

2. Leading with care

3. Evaluating information

4. Connecting our service

5. Sharing the vision

6. Engaging the team

7. Holding to account

8. Developing capacity

9. Influencing for results

The group felt that this was a useful document that could be applied to the NHS in Wales. The domains matched the ideas and discussion already undertaken during the workshop. It was felt that the model can been used to engage people in clinical leadership and places emphasis on leadership that reinforces care for staff and high quality support services (Figure 3).

www.leadershipacademy.nhs.uk

Healthcare

Leadership Model

The nine dimensions of

leadership behaviour

Version 1.0

http://www.leadershipacademy.nhs.uk/leadershipmodel-pdf-colour/%20

http://www.leadershipacademy.nhs.uk/leadershipmodel-pdf-colour/%20


Figure 3: Summary of presentation for the use of the NHS Healthcare Leadership Model in Wales


Discussion 3: Future for collaboration on the Leadership Development Agenda

How can we work together more closely to share knowledge and experience?

What do we put in place to achieve this?

The group were asked to highlight ways in which collaboration in clinical leadership development could be taken forward in Wales. The ideas generated from each group were collected and themed by the facilitator. All participants were then asked to vote for the most important themes to be (Figure 4). The most popular 3 topics (69% of the vote) were:

1. To establish a joint vision for clinical leadership development for Wales

2. To develop an All Wales collaborative for clinical leadership in Wales

3. To develop an All Wales virtual collaborative for clinical leadership

Figure 4: Methods of creating collaboration in clinical leadership development for Wales

A. Joint vision for clinical leadership

B. All Wales collaborative / forums

C. Website / virtual collaborative

D. Practical development tools

E. Leaders of leaders development

F. Collaborator external partnership development

G. Local networks

H. Leadership events

0 5 10 15 20 25 30 35

% of total vote


Key outcomes from the Clinical Leadership Development Scoping Workshop

An “All Wales” shared vision for clinical leadership development is required which facilitates collaboration across institutional boundaries.

NHS staff need the appropriate time, space and recognition for engaging in high value clinical leadership activity.

There is considerable variety and volume of clinical leadership development being delivered across Wales. Multiple clinical leadership development events are being run at several different institutions. Although this may allow a wider audience to be reached, the risk of duplication of resources needs to be considered.

A virtual collaborative of Welsh clinical leaders should be developed, with the aim of instilling a culture of responsibility and accountability for clinical leadership across the NHS in Wales. The NHS Leadership Academy, Healthcare Leadership Model may be used to underpin these principles.

This collaborative should be reflective of all NHS staff irrespective of grade or position at a health board level. Particular effort should be made to engage those who have expressed interest but are not necessarily involved with clinical leadership development. Collaboratives should consist of representatives from NHS health boards, trusts, universities, royal colleges, the faculty of medical leadership and management (FMLM) and national leadership improvement programmes.

Its aim should be to:

- Deliver Shared training and development

- Manage service improvement / delivery projects

� - Highlight good practice

� - Promote collaborative arrangements

The virtual collaborative should feed into the work of a new Welsh Clinical Leadership Group (WCLG).

Key outcomes


For further information, contact:

James Ansell Clinical Leadership Fellow Office of the Chief Medical Officer Welsh Government Cathay’s Park Cardiff CF10 3NQ

Email: [email protected]

mailto:james.ansell%40wales.gsi.gov.uk%20?subject=NHS%20Clinical%20Leadership%20Report%20-%20response