Transforming the NHS through transforming ourselves

Background: Leadership development impacts on quality of care and workplace cultures for staff. Clinical Leadership embracing transformational and other collective leadership approaches are key enablers to developing effective workplace cultures at the micro-systems level. Following the development of a shared purpose and values framework, an internal, inter-professional clinical leadership programme was set up to grow a critical community of transformational leaders across one NHS organisation in England. This programme had previously been unsuccessful in engaging medical doctors.

Aims and Objectives: This paper shares how a dedicated practice development based clinical leadership programme set out to support medical doctors across one organisation with their leadership journey, equipping them to become both transformational and collective leaders and facilitators with the skills to begin to develop and sustain effective workplace cultures, that are person centred, safe and effective.

Methods: Practice development methodology with its collaborative, inclusive and participative approach for developing person centred cultures combined with clinical leadership strategies, formed the basis of the programme which emphasised the use of active and action learning drawing on the workplace as the main resource for learning, development and improvement. Self-assessment and co-creation of insights about clinical leadership together with collaborative analysis of evaluation data led to the syntheses of insights through the use of reflection and action planning.

Findings/Results: Findings are presented at two levels: 1) Five individual authentic reflections by authors to illustrate their leadership journeys which also demonstrate how a range of tools were used and their impact from reflections. Insights and learning include recognition of the benefits of peer support and networking; development of a disciplined approach to learning and self-management; 2) A collaborative reflection and critique that embraced the feeling of a sense of team ethos and community cohesion, for the first time in a safe environment; as well as, a sense of collective shared purpose and values.
Conclusions: We conclude that the programme helped to identify the impact of leadership on workplace cultures and to begin to embed ways of working that are collaborative, inclusive, participative and celebratory. This unique approach by one organisation to leadership development has enabled a journey of self-transformation for medical clinical leaders to commence.

Practical implications arising from our learning:
• An internal model grows clinical leadership capacity across the organisation through peer support and networking and collective leadership.
• Investing in a safe confidential space for clinical leads and other staff groups is a strategy for leadership development practice.
• There is need to develop more skilled critical companions to support leadership, improvement and development activities
• Clinical leadership development, informed by practice development methodology, demonstrates potential for enabling transformative and collective leadership for achieving person-centred cultures in the workplace.

Keywords: Clinical leadership, collective leadership, critical companionship, micro-systems, transformational leadership, workplace culture

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Mansoor Akhtar FRCSED (Gen Surg), MRCS, PG Cert Trauma Sciences, MBBS, Locum Consultant Surgeon, Queen Elizabeth the Queen Mother Hospital, East Kent Hospitals University NHS Foundation Trust, Margate, Kent, England.
James Norbert Casha (MD, MChOrth, FRCS Ed&Eng, FRCSEdOrth, KM, KCHS) Consultant Orthopaedic and Spinal Surgeon, Kent and Canterbury Hospital, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent; Honorary Senior Lecturer, Kings College, London, England.
Julia Ronder MD, MRCPsych, MBBS, BSc, Consultant in Paediatrics, Georges Turle House, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, England.
Mohamed Sakel FRCP UK, MRCP UK, Post-Grad Dip Rehab Medicine UK, MBBS Bangladesh. Director Neuro-Rehabilitation/Consultant Physician,, Kent and Canterbury Hospital, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, England.
Catherine Wight FRCPath, MBChB, BmedBiol, Consultant Cellular Pathologist, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford, Kent England.

Kim Manley CBE PhD, MN, BA, DipN (Lond), RN, RCNT, PGCEA Professor, Practice Development, Research and Innovation; Co-Director, England Centre for Practice Development, Canterbury Christ Church University, Canterbury; & Associate Director Transformational Research and Practice Development, East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, England.