Clinical leadership and management in the NHS – Paired Learning

Dame Turner-Warwick's podium piece ¹ highlights some of the historic differences between managers and clinical leaders within the NHS. It also expresses frustration at the failure to advance proposals to support the development of non-clinical managers, in order to create an equal partnership between clinicians and managers.

Recent clinical leadership initiatives, such as the development of the Medical Leadership Competency Framework, ² have moved away from training small numbers of top leaders to a model of shared leadership with a focus on supporting the development of leadership capabilities in all clinicians. Focused primarily on developing personal qualities and team working skills to plan, deliver and evaluate services, this encourages a work-based approach to leadership development. With the launch of the NHS Leadership Framework ³ there is now a common approach to leadership development for all staff in health and care.

As many organizations move towards working practices and structures where managers work closely alongside clinical leaders to plan and deliver care, we believe this also provides an opportunity for clinicians and managers to learn together through peer-learning initiatives.

At Imperial College Healthcare NHS Trust we have established an innovative ‘paired learning’ scheme which has paired SpR level clinicians and Band 7 and 8a managers together in a leadership development scheme. This work-based programme uses a combination of informal conversation, work-shadowing, workshops and improvement project work to enable participants to better understand each other's perspectives and to drive learning. Evaluation of the programme showed demonstrable outcomes related to improved quality of patient care and greater efficiency. In addition participants reflected on their personal learning and the potential for future culture change in terms of stronger partnerships and collaborative working.

We would encourage other organizations to consider a ‘paired learning’ approach to leadership development, which is flexible, inexpensive and focused on managers and clinicians working and learning together.