Leadership: How to get ahead in anaesthesia

Chima Oti describes his experience of attending a leadership and management module as an anaesthetic trainee

I was fortunate during my anaesthetic training to complete a leadership and management module. This was at ST5 level of training at the William Harvey Hospital in Ashford, Kent. I believe my experience would highlight the benefits of this module and make the case for similar modules in anaesthetic training to be done with an agreed minimum standard.

Background

The leadership and management module at William Harvey Hospital Ashford had already been in existence for over two years when I started. It is a recognised module and increasingly growing in popularity. It is only eligible to post-fellowship trainees and could only accommodate one registrar at a time. It lasts for 3–6 months. There was a dedicated Consultant Supervisor for this module.

So what’s the relevance?

Leadership and management skills are becoming increasingly relevant in the NHS as it undergoes changes to adapt to the dynamic requirements of patients. Clinicians have a role to play and it’s better to initiate these skills during training. The General Medical Council (GMC) states that being a good doctor means more than being a good clinician and, in our day-to-day roles, doctors can provide leadership to their colleagues and vision for the organisations in which they work and for the profession as a whole [1]. Consultants are all leaders and managers by virtue of their positions, and anaesthetic registrars should be prepared for these roles during training.

The module

The module consists of four main components, outlined here.

Attending management board meetings

These include clinical management board meetings chaired by the Medical Director with the Chief Executive in attendance. Other meetings include surgical division governance meetings; trust risk management group meetings; drug and therapeutic meetings; and local faculty and theatre group meetings. This enabled me to have an appreciation for management structure and how decisions regarding the running of NHS organisations are made. I kept a diary of events and a copy of the minutes from these meetings. I gained a better understanding of the relationship between lead clinicians and managers.

One to one with clinical managers

This involved meeting with certain individuals at agreed times. I was given the opportunity to ask questions about their roles and responsibilities, challenges, relationship with clinicians and future plans. I met the Chief Executive, Medical Director, Divisional Director, Director of Nursing and other managers. Here I gained insight into the work and training background of these managers and how they dealt with difficult situations and staff. I also used the opportunity to discuss the current changes in the NHS brought about by new Government policy and the steps taken to meet the increasing demands of the NHS by a rapidly changing population. I was able to shadow the manager of the Critical Care division and attend meetings with him on agreed dates.

Departmental rota management

This mainly involved allocating trainees to the theatre rota, incorporating their module requirements and various requests – including annual and study leave and educational requirements. I was able to appreciate the tasks involved in managing an anaesthetic department rota. This gave me the required foundation and experience needed to carry on in this role in bigger departments later in my training.

Attending leadership and management courses

The courses attended include leadership development and leadership and management training days. Once again, this served as a good introductory point for me. Since then I have carried on my interest in this area by attending more courses, most notably the Keele Clinical and Management Course which I found really useful.

My experience

I found the leadership and management training module extremely useful and helpful for my anaesthetic training and received support from all my fellow trainees and consultants. I was allocated time on the rota to attend these meetings and this was made possible by the departmental administrator. I summarised my experience during this six-month module and presented to the department during one of our audit meeting days. I also had a formal assessment and sign off discussion at the end of the module with my Supervising Consultant and this forms part of my training portfolio.

This module enabled me to appreciate the roles and responsibilities of managers. I also gained an insight into the ways clinicians and managers could work together to achieve similar goals. The importance of leadership and management skills in the NHS was further highlighted during this module.

Clinicians, by virtue of their positions and roles in the organisation, have a responsibility to be leaders and managers. The debate about whether clinicians make the best managers goes on but trainee doctors should have greater involvement in this area. Not everyone is necessarily a leader but everyone can contribute to the leadership process by using the behaviours described in the five core domains of the NHS Clinical Leadership Competence Framework (CLCF) which include: demonstrating personal qualities, working with others, managing services, improving services, and setting direction [2].

Conclusion

On the whole, I believe that attending this course was a positive step and I would highly recommend any form of leadership and management activity during anaesthetic training. The fact remains that we are relatively shielded as trainees from vital non-clinical aspects of patient care. Getting trainees involved early allows for a smooth transition into these roles when they make that step to becoming consultants. Also, more needs to be done in anaesthetic departments in the country to ensure that trainees get the necessary support to participate in leadership and management activities. There should be agreed minimum standards which are applicable across all training programmes that provide this module. This should be more than just an exercise in enhancing one’s CV. The benefits of this module are becoming more apparent as I approach the final stages of my training and prepare for my role as a consultant, leader and clinical manager.

Acknowledgements

I would like to thank my Supervising Consultant Dr Michelle Hamer for the great support she gave me throughout my training module.