- Author
- Sharon Millar
- Date published
- September 2006
- Pages
- 20
- Download publication [201kb PDF]
This report identifies lessons from a formal evaluation of the pilot of The Health Foundation Leadership Fellows Scheme 2003–2005. The aim of the pilot was to inform the development of a scheme to identify and develop a cadre of leaders with the potential – collectively and individually – to bring about improvements in the quality of healthcare. The 16 award holders involved in the pilot were provided with coaching, mentoring, action learning sets and master classes.
In designing the scheme, it was assumed that personal development was a necessary precursor to the development of leadership competencies; these competencies, in turn, would ensure that the fellows were equipped and in suitable posts to bring about quality improvements. However, the evaluation has shown that, in delivery, the quality improvement emphasis of the scheme was less explicit than originally intended, and the fellows remained predominantly focused on their personal development. This learning has been incorporated into the design of subsequent cohorts to ensure that the key driver of the scheme is quality improvement objectives.
The evaluation also identified some unintended consequences, which were largely highlighted through discussions with CEOs and from direct observations. These related to inter-group competition and perceptions of equality. Steps have been taken to ensure that these unintended consequences are minimised for future cohorts.
Despite the predominant focus on personal development in the pilot and the unintended consequences of the scheme, there is evidence that the fellows achieved numerous quality improvements.
Quality improvement outcomes and activities
- Quality improvements that were observed included reduced waiting times, increased access to services, and better quality care for patients.
- It was reported that organisations have become more efficient through improved team performance, and the implementation of effective systems and specific healthcare initiatives.
- Some of the professional networks to which the fellows belong are benefiting from their leadership knowledge and skills.
- The fellows have been observed acting in five roles to bring about quality improvements: behaving as change agents; acting as catalysts for leadership development; empowering others; acting as authoritative voices for quality improvements; and acting as advocates for leadership development. The evaluation identified that the development of skills in leadership competencies, such as political awareness, strategic thinking, stakeholder engagement and influencing, has enabled the fellows to perform effectively in these roles.
- Although the potential for quality improvements is likely to be realised over a longer period of time, there is already evidence of benefits being derived through improved leadership performance, improved team and organisational performance, and membership of nationally or regionally influential healthcare groups.
The evaluation indicates that certain contextual factors affect the benefits that the fellows derived from the scheme, and, therefore, the potential for quality improvement.
Factors that may influence quality improvement outcomes
- Some of the fellows benefited more than others from participation in the scheme. Those who gained the most were bright and talented individuals who, at the start of the scheme, lacked confidence, political awareness, strategic thinking and influencing skills.
- There is some evidence that managers found the scheme more suited to their preferred style of learning and their roles within their organisations. Clinicians found it more difficult to secure high-level organisational support in order to apply their learning.
- Informed organisational support – where fellows were given the opportunity to apply their learning in their workplace and to develop networks – appeared critical in achieving maximum benefit.
- Multi-disciplinary learning was an unusual but highly valued aspect of the scheme, and was identified as the most significant benefit by the majority of fellows.
