The need for closer working throughout undergraduate and postgraduate training between clinicians and managers formed a central theme of the discussion. More opportunities for clinical and other leaders to better understand each other’s roles and share challenges and frustrations could help foster recognition that beneath strong professional identities, managerial and clinical colleagues share the same values – those of putting the patient first. Simon heard of an example of such shared understanding arising from an initiative at Birmingham Children’s Hospital (BCH) with ‘paired learning’, where doctors in training and managers at all levels are linked as a pair to shadow one another, have conversations about management and leadership issues, and take part in quality improvement projects - a Programme based on the work of Dr Robert Klaber at Imperial. The initiative has evaluated well at BCH and is now embedded in the Trust’s educational programme. BCH also has plans to extend this opportunity to other professional staff groups, and to roll it out regionally and nationally.