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What kind of leadership will be required to deliver NHS England’s vision for the future of the NHS – the Five Year Forward View, and how is the University of Birmingham supporting this endeavour?

This was the subject of a round table discussion hosted jointly by the Health Services Management Centre (HSMC) and the Medical and Dental School (MDS) and with NHS England Chief Executive Simon Stevens in July, held opportunistically during a visit to receive his honorary doctorate. The round table event was attended by clinical and general managers who have been participating in programmes run by HSMC, including the NHS Leadership Academy’s Elizabeth Garrett Anderson programme delivered in conjunction with Manchester University’s Business School and KPMG; and University of Birmingham medical students and Academic GP trainees with a particular interest in leadership and new models of NHS care.

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.

The round table also explored how general practice training is evolving rapidly to meet the needs of the expanded scope of primary care as envisaged in the NHS Five Year Forward View. We debated how best to enable young doctors, nurses and managers to experience primary care as a desirable, flexible and rewarding career choice from the outset, challenging the persisting view of hospital medicine and management as somehow more diverse and attractive. The point was made that in the course of medical training, students in many medical schools typically get a disproportionate exposure to acute-based medicine, given that the vast majority of the public’s contact with the NHS is with their GP or pharmacist. Medical students at Birmingham are exposed to patients in a primary care setting from their first week at University which they find really stimulating and hugely enjoyable. There are regular placements then with GPs in their surgeries during every year of their five year training programme. This Community Based Medicine strand of the course consistently has excellent student feedback for the quality of the experience.

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Following challenge from Simon Stevens about the changing nature of NHS service provision, the young leaders at the session asserted that regardless of the professional background of a health care leader, they will have to navigate the same challenges.  These will include reshaping the NHS as more of a preventative rather than curative service, engaging people more in managing their own care where they have long-term conditions, and helping the public and NHS staff understand that the NHS will become less reliant on hospital care and more strongly based on a scaled up primary care service.

The combined contribution of HSMC and MDS means that the University is in a unique position to continue to develop the clinical and managerial leaders of the future who will increasingly work across organisational and professional boundaries. The departments will continue this dialogue over coming months, exploring a range of exciting possibilities for future cross-university collaboration in leadership development, and seeking to create and support the leaders who will take health and care into its next stage of development.

Paired learners at Birmingham Children's Hospital

Image: Paired learners at Birmingham Children's Hospital: Dr Nicki Kelly and Lydia Salice (Service Manager for Specialised Medicine, Dermatology, Endocrinology/Diabetes, and Outpatients)