Clinical Leadership for the NHS in Wales: Clinical Leadership Development Scoping Workshop. Event Report

1. Clinical Leadership for the NHS in Wales
Clinical Leadership Development Scoping Workshop
3rd December 2013, Swalec Stadium, Cardiff

2. 2 | Clinical Leadership Development Scoping Workshop
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3. 3 | Clinical Leadership Development Scoping Workshop
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

4. 4 | Clinical Leadership Development Scoping Workshop
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

5. 5 | Clinical Leadership Development Scoping Workshop
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

6. 6 | Clinical Leadership Development Scoping Workshop
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

7. 7 | Clinical Leadership Development Scoping 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

8. 8 | Clinical Leadership Development Scoping Workshop
Figure 1: “Setting the scene” Summary of introduction for the workshop

9. 9 | Clinical Leadership Development Scoping 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.

10. 10 | Clinical Leadership Development Scoping Workshop
Figure 2: “What does an effective clinical leader look like”

11. 11 | Clinical Leadership Development Scoping Workshop
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

12. 12 | Clinical Leadership Development Scoping Workshop
Figure 3: Summary of presentation for the use of the NHS Healthcare Leadership Model in Wales

13. 13 | Clinical Leadership Development Scoping Workshop
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

14. 14 | Clinical Leadership Development Scoping Workshop
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

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For further information, contact:
James Ansell
Clinical Leadership Fellow
Office of the Chief Medical Officer
Welsh Government
Cathay’s Park
Cardiff CF10 3NQ
Email: james.ansell@wales.gsi.gov.uk