ABSTRACT
ContextThe Achieve, Develop, Explore Programme for Trainees (ADEPT) Clinical Leadership Fellowship Programme was established in response to growing recommendations to underpin healthcare reconfiguration in Northern Ireland (NI) with a collective leadership strategy. This is a Clinical Leadership Fellows programme available to specialist, general practice and dental trainees in NI as an out of programme experience year. It is recruited competitively through a scored application followed by a 3-part interview. The fellowship programme is coordinated with host organisations, who sponsor fellows to work with organisational leaders in an apprentice model and undertake a self-directed project. This leadership training was provided by the HSC Leadership Centre until 2020, which supported achievement of an Institute of Leadership and Management (ILM) level 7 Certificate. The current 2021-22 cohort have joined the Faculty of Medical Leadership and Management (FMLM) Fellow Scheme.Issue/ChallengeWith the ADEPT programme now in its sixth year and many of its graduates consultants or general practitioners (GPs), a need was identified to assess how the fellowship has shaped participant career performance, decision making and views on leadership training. This study aimed to determine the demographics of ADEPT Fellows and evaluate the impact of the fellowship as perceived by ADEPT alumni on career goals, choices, achievements, and development of leadership skills related to the NHS Healthcare Leadership Model.Assessment of issue and analysis of its causesDemographic data for all ADEPT fellows was held centrally through Northern Ireland Medical and Dental Training Agency (NIMDTA) and assessed anonymously. A mixed-methods questionnaire was composed using Smart Survey. Likert-scale questions were designed to determine the extent to which participants believed ADEPT supported their development of strong and exemplary elements of the nine dimensions of the NHS Healthcare Leadership Model. This questionnaire was split into 4 sections;demographics and project outline, self-assessment of leadership skills before and after ADEPT, career planning and progression and suggestions for programme improvement. The questionnaire was distributed electronically to all ADEPT alumni in November 2021 and remained open for 4 weeks.ImpactThis study validates the usefulness of the ADEPT clinical leadership programme both at an individual and organisational level.InterventionThere have been 46 ADEPT fellows to date (72% female;all fellows were white). ADEPT fellows were most commonly from Psychiatry (33%), Paediatrics (17%) and Obstetrics and Gynaecology (15%). There were 19 responses from the alumni cohort of 46 (41%). 75% of respondents reported that their project resulted in publication, presentation or award. Leadership skill development was identified as best in Evaluating Information and Engaging the Team, whereas skills in Sharing the Vision and Developing Capability saw less improvement. The majority felt that the fellowship had been useful in securing their position as a consultant or general practitioner and 50% went on to pursue senior leadership positions.Key MessagesThe ADEPT Clinical Leadership Fellowship delivers effective leadership training as measured by the nine domains of the NHS Healthcare Leadership Model. It provides value for host organisations through the projects undertaken and by developing doctors who are more likely to engage in future formal leadership roles. ADEPT alumni saw the value in their leadership experience and felt it should be embedded in standard postgraduate training schemes to reach a wider audience.Lessons learntA recurring theme in the healthcare sector is that doctors who have gone through years of formal training often fail to recognise the innate leadership skills they have acquired on their journey to become a consultant. This was evident within the ADEPT group as the majority did not identify themselves as leaders prior to undertaking the fellowship. Distinguishing, nurturing and reframing these skills or use outside of the clinical area are important considerations when developing leadership training in healthcare.Strategy for improvementThe programme will require ongoing review especially given the increasing demand placed on healthcare leadership from the sequelae of the COVID pandemic and an aging society with complex health needs. A ten year follow up to include opinions on the FMLM Fellow Scheme is suggested.