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Purpose The improving global health (IGH) programme is a leadership development programme that aims to develop leadership skills and behaviours alongside quality improvement methodology in National Health Service (NHS) employees in a global health setting. Through collaboration, experiential learning and mentorship, the programme aims to produce both vertical and horizontal leadership development in its participants. This paper aims to describe the programme and its impact, in terms of leadership development, in a sample of participants. Design/methodology/approach Open coding and thematic analysis of leadership development summaries (LDS) completed by 39 returned IGH participants were conducted. LDS are written on completion of the overseas placement; participants reflect on their personal leadership development against the nine dimensions of the NHS Healthcare Leadership Model (2013). Findings These IGH programme participants have reported a change in the way they think, behave and see the world. A development in sense of self and experience in developing team members are the two most commonly reported themes. Adaptability, communication, overcoming boundaries, collaborative working, “big picture” thinking and strategic thinking were also identified. Research limitations/implications The study is limited by the relatively low number of completed LDS. More work is needed to understand the long-term effect of this type of leadership development on the NHS. Other leadership development programmes should consider focussing on vertical and horizontal leadership development. Originality/value This more granular understanding of the leadership skills and behaviours developed and how it is the programme’s design that creates it, has not previously been described.

Background The importance of leadership development in the early stages of careers in the NHS has been highlighted in recent years and many programmes have been implemented which seek to develop leadership skills in healthcare professionals. The Improving Global Health (IGH) Fellowship scheme is one such programme, it provides a unique leadership development opportunity through an overseas placement with a focus on quality improvement work. This evaluation examines the impact of completing an IGH Fellowship on the career and leadership development of participants, who are referred to as Fellows. Methods Fellows who had returned from overseas placement between August 2008 and February 2015 were invited to complete an anonymised online questionnaire, which collected information on: demographic details, motivations for applying to the programme, leadership development and the impact of the IGH Fellowship on their career. Fifteen semi-structured interviews were conducted to further explore the impact of the programme on Fellows’ leadership development and career progression. Interview transcripts were manually coded and underwent thematic content analysis. Results The questionnaire had a 67% (74/111) response rate. The number of fellows who self-identified as a leader more than doubled on completion of the IGH Fellowship (24/74 pre-fellowship versus 58/74 post-fellowship). 74% (55/74) reported that the IGH Fellowship had an impact upon their career, 35 of which reported that the impact was “substantial”. The themes that emerged from the interviews revealed a personal development cycle that consolidated the fellows’ interests and values whilst enhancing their self-efficacy and subsequently impacted positively upon their career choices. Three interviewees expressed frustration at the lack of opportunity to utilise their new skills on returning to the United Kingdom (UK). Conclusions The IGH Fellowship successfully empowered healthcare professionals to self-identify as leaders. Of the 45/74 respondents who commented on the impact of the IGH Fellowship on their career, 41/45 comments were positive. The fellows described a process of experiential learning, reflection and evolving cultural intelligence, which consolidated their interests and values. The resultant increase in self-efficacy empowered these returned fellows in their choice of career.

The Improving Global Health (IGH) programme develops leadership capacity within the National Health Service (NHS) in a novel way. NHS employees collaboratively run quality improvement projects within organisations in low-income and middle-income countries with whom long-standing healthcare partnerships have been built. Leadership behaviours are developed through theoretical and experiential learning, alongside induction and mentorship. The health systems of overseas partners are strengthened through projects that align with local priorities. This article develops solutions to two main problems: how reciprocal global health programmes can be designed and how global health programmes based in leadership can attract women and black and minority ethnic groups into leadership. The outcomes of both sides of the IGH programme are described here. The overseas perspective is described using the reflections of two current partners, highlighting improvements in the local healthcare system and demonstrating growth in local team members. The UK perspective is evaluated using two surveys sent to different groups of returned IGH participants. Leadership, global health and quality improvement skills improve, having a significant and long-lasting impact on career trajectory. The IGH programme is attracting women and black and minority ethnic groups into leadership. Through collaboration and reciprocity, the IGH programme is developing a new cadre of NHS leader that is diverse and inclusive. The use of long-standing healthcare partnerships ensures that learning is shared and growth is mutual, creating development within the overseas and UK partner alike.

Purpose – Improving Global Health is a one year leadership scheme which places trainee doctors and more experienced nurses, midwives and AHPs in a developing country (Cambodia or Tanzania) to develop leadership and quality improvement skills while contributing to Millennium goals in the developing countries. The purpose of this paper is to report on an independent evaluation of the programme, with the purpose of highlighting lessons learned to inform other leadership development initiatives, and in particular to highlight the vital importance of a receptive NHS environment if maximum value is to be gained from investment in clinical leadership.Design/methodology/approach – The evaluation methodology comprised literature review; review of documentation, including on line questionnaires to Fellows; interviews with stakeholders and attendance at key scheme events in July‐September 2011. Fellows who had completed an overseas placement in either Cambodia or Tanzania during 2009‐2010 were interviewed using a se...

Locke R., Leach C., Kitsell F. & Griffith J. (2011) Journal of Nursing Management19, 177–185 The impact on the workload of the Ward Manager with the introduction of administrative assistants Aim To evaluate the impact on the workload of the Ward Manager (WM) with the introduction of administrative assistants into eight trusts in the South of England in a year-long pilot. Background Ward Managers are nurse leaders who are responsible for ward management and delivering expert clinical care to patients. They have traditionally been expected to achieve this role without administrative assistance. Meeting the workload demands of multiple roles and overload has meant the leadership and clinical role has suffered, presenting issues of low morale among existing WMs and issues of recruiting the next generation of WMs. Method Sixty qualitative interviews were carried out with 16 WMs, 12 Ward Manager Assistants (WMAs), and six senior nurse executives about the impact of the introduction of the WMA post. Quantitative data to measure change in WM workload and ward activity was supplied by 24 wards. Results Ward Managers reported spending reduced time on administrative tasks and having increased time available to spend on the ward with patients and leading staff. With the introduction of WMAs, there was also improvement in key performance measures (the maintenance of quality under service pressures) and increased staff motivation. Conclusions There was overwhelming support for the introduction of administrative assistants from participating WMs. The WMAs enabled WMs to spend more time with patients and, more widely, to provide greater support to ward teams. The success of the pilot is reflected in wards working hard to be able to extend contracts of WMAs. The extent of the success is reflected in wards that were not participants in the pilot, observing the benefits of the post, having worked to secure funding to recruit their own WMAs. Implications for nursing management The widespread introduction of administrative assistance could increase ward productivity and provide support for clinical leaders. Continuing professional development for WMs needs to incorporate training about management responsibilities and how to best use administrative support.

PurposeThe purpose of this paper is to describe a novel approach to leadership development for UK healthcare workers, while contributing to health service improvement in a developing country.Design/methodology/approachA quality improvement faculty are used to teach and mentor National Health Service (NHS) International Development Clinical Fellows in quality improvement (QI) methods. Using accepted QI methods, sensitive and practical improvement projects are selected in partnership with local people in Cambodia in order to start achieving United Nations Millennium Development Goals related to child and maternal health. Simultaneously, NHS International Fellows gain an unparalleled opportunity to develop their leadership skills, which should benefit the NHS on their return to the UK.FindingsHealthcare quality improvement methods, developed in First World countries, are transferable to the developing world and also function as a vehicle for developing leadership skills in experienced healthcare workers.Practical implicationsThis leadership development programme fits with the stated aims of the Global Health Partnerships report, which encourages the NHS to play a global role in healthcare development in the developing world. Other First World healthcare systems could adopt this leadership development method to both improve the leadership capability of their own staff while also making a significant contribution to less well‐developed healthcare systems.Originality/valueThe combination of leadership development through quality improvement is novel – promising to benefit both providers and recipients.

Abstract Following the United Kingdom Clinical Research Collaboration’s (UKCRC) (2007) recommendations on careers in clinical research, there has been growing anticipation in the United Kingdom about the real potential for establishing career pathways for nurses and allied health professionals that will enable them to combine a focus on both clinical and academic roles. However, it is recognized that the implementation of this initiative will require charting largely untested waters, with issues ranging from establishing joint University: health service employment contracts, to harmonizing clinical and research roles and ensuring sustainability of funding for clinical academic posts. This paper will outline the implementation of a pilot clinical academic career initiative, which has been modelled on the UKCRC framework. We will illuminate the processes and structures employed and reflect on the factors that appear critical to the successful establishment of a clinical academic career pathway. Additionally, our experience has enabled us to identify challenges that will need to be addressed by a range of stakeholders if clinical academic careers are to flourish and deliver their potential at a national level as a modern career option for nurses and allied health professionals.

Background and Purpose The quadriceps angle (Q-angle) is currently the only measurement of patellofemoral mechanics available in the clinical situation which does not necessitate the use of sophisticated radiographic equipment. It is generally assumed that for a given subject position and measurement procedure, the Q-angle is an absolute value rather than one which may vary with time. However, this assumption has never been tested. The purpose of this study was to determine whether the Q-angle varies with time. Methods The Q-angle of 51 healthy subjects was measured continuously for one minute in the standing position using a video motion analysis system of proven accuracy and reliability. Results The Q-angle varied by an average of 3.12° (1.46°-6.97°) over the one minute tested, with a repeatability coefficient of 3.4°. Conclusion The data indicate that when measured in the standing position the Q-angle is not an absolute measure, but one which varies with time. It is proposed that when the Q-angle is measured in the clinical situation with a goniometer, the value achieved is not a definitive measurement, but a snapshot in time of the individual's Q-angle within a given range.

Objective quantification of muscle size can aid clinical assessment when treating musculoskeletal conditions. To date the gold standard of measuring muscle morphology is magnetic resonance imaging (MRI). However, there's a growing body of evidence validating rehabilitative ultrasound imaging (RUSI) against MRI.Objective: This study aimed to validate RUSI against MRI for the linear measurements of the distal fibres of vastus medialis muscle in the thigh.Twelve healthy male participants were recruited from a local university population. The distal portion of their right vastus medialis was imaged with the participant in long-sitting, using MRI and RUSI whilst the leg was in extension and neutral hip rotation. Cross sectional area (CSA) and three linear measures were taken from the MRI and compared with the same linear measures from RUSI. Statistical analysis included comparison of MRI and RUSI measures using the paired t-test and correlation using intra-class correlation coefficients (ICC 3,1).Mean differences between the linear measures taken from the MRI and RUSI were -0.5mm to 2.9mm (95% confidence intervals -0.6 to 8.3mm), which were not statistically different (p>0.05) and were highly correlated (ICCs3,1 0.84-0.94). Correlations between the three linear measurements and muscle CSA ranged from r=0.23 to 0.87, the greatest being muscle thickness. Multiplying the linear measures did not improve the correlation of 0.87 found for muscle thickness.Linear measures of vastus medialis depth made using RUSI were shown to be as valid as using MRI. Muscle thickness measures using RUSI could be used within an objective assessment of this muscle.

To evaluate the impact on the workload of the Ward Manager (WM) with the introduction of administrative assistants into eight trusts in the South of England in a year-long pilot.Ward Managers are nurse leaders who are responsible for ward management and delivering expert clinical care to patients. They have traditionally been expected to achieve this role without administrative assistance. Meeting the workload demands of multiple roles and overload has meant the leadership and clinical role has suffered, presenting issues of low morale among existing WMs and issues of recruiting the next generation of WMs.Sixty qualitative interviews were carried out with 16 WMs, 12 Ward Manager Assistants (WMAs), and six senior nurse executives about the impact of the introduction of the WMA post. Quantitative data to measure change in WM workload and ward activity was supplied by 24 wards.Ward Managers reported spending reduced time on administrative tasks and having increased time available to spend on the ward with patients and leading staff. With the introduction of WMAs, there was also improvement in key performance measures (the maintenance of quality under service pressures) and increased staff motivation.There was overwhelming support for the introduction of administrative assistants from participating WMs. The WMAs enabled WMs to spend more time with patients and, more widely, to provide greater support to ward teams. The success of the pilot is reflected in wards working hard to be able to extend contracts of WMAs. The extent of the success is reflected in wards that were not participants in the pilot, observing the benefits of the post, having worked to secure funding to recruit their own WMAs.The widespread introduction of administrative assistance could increase ward productivity and provide support for clinical leaders. Continuing professional development for WMs needs to incorporate training about management responsibilities and how to best use administrative support.