Evaluation of the first 5 years of the Next Generation GP leadership programme: balancing autonomy and accountability.

BACKGROUND: In 2017, a group of trainee general practitioners (GPs) came together to design and deliver a six-session leadership development programme for their peer trainee and early career GPs: the Next Generation GP programme. Over 2500 GPs took part in Next Generation GP between 2017 and 2022. AIM: To evaluate the origins and development of the Next Generation GP programme, its early impact on individuals and general practice, and what it reveals about GPs' needs for career and leadership development at a time of major workforce and demand pressures. METHODS: A rapid review of evidence on general practice workforce and career trends informed the design of qualitative research interviews (n=28) with a purposive sample of programme participants, primary care leaders and educational experts. This was supplemented by analysis of secondary data from participant evaluations of programme workshops. RESULTS: Many programme participants reported: improved competence in leadership skills, increased understanding of the health system, having new support networks and more energy for their GP role. Respondents pointed out the strengths of the programme, also highlighting ways in which it could be adapted to enable a transition to a more sustainable position within broader clinical and leadership career development. CONCLUSIONS: Next Generation GP has to date largely fulfilled its programme objectives. It now needs more tangible, longer-term objectives against which to assess outcomes. This evaluation has contributed to evidence about primary care leadership needing more policy attention, for the balance of autonomy and accountability within GP leadership needs careful and sustained support.

A long and winding road: non-traditional routes into medical leadership.

INTRODUCTION: Clinicians enter the medical profession through a variety of routes. This paper explores how non-traditional routes into the medical profession can follow through into subsequent medical leadership practice, influencing issues of confidence, self-image and assumptions about leadership as a concept. METHOD: The first-person reflections of a doctor who entered the profession and the National Health Service from the German system and with a non-standard background are considered. We then discuss how those involved in leadership education can use diversity as a developmental tool. The article starts and ends with personal reflections and observations from a Consultant Opthalmologist, interposed with insights from the pedagogy of leadership development by a University academic. CONCLUSIONS: We conclude that medical leadership development can be enriched through recognising the value that non-traditional routes in clinical leadership can bring, and that educators can use the leverage of difference and diversity to create positive loops of development activity.

Transforming primary care: scoping review of research and practice.

PURPOSE: The purpose of this paper is to reflect on research evidence and practice experience of transforming primary care to a more integrated and holistic model. DESIGN/METHODOLOGY/APPROACH: It is based on a scoping review which has been guided by primary care stakeholders and synthesises research evidence and practice experience from ten international case studies. FINDINGS: Adopting an inter-professional, community-orientated and population-based primary care model requires a fundamental transformation of thinking about professional roles, relationships and responsibilities. Team-based approaches can replicate existing power dynamics unless medical clinicians are willing to embrace less authoritarian leadership styles. Engagement of patients and communities is often limited due to a lack of capacity and belief that will make an impact. Internal (relationships, cultures, experience of improvement) and external (incentives, policy intentions, community pressure) contexts can encourage or derail transformation efforts. PRACTICAL IMPLICATIONS: Transformation requires a co-ordinated programme that incorporates the following elements - external facilitation of change; developing clinical and non-clinical leaders; learning through training and reflection; engaging community and professional stakeholders; transitional funding; and formative and summative evaluation. ORIGINALITY/VALUE: This paper combines research evidence and international practice experience to guide future programmes to transform primary care.