Providing the time and space

for future success

FOREWORD

David Sloman Chair, London Leadership Academy Chief Executive, Royal Free London NHS Foundation Trust

Anne-Marie Archard Head of the London Leadership Academy

Welcome to the first London Leadership Academy report

Table of contents

Foreword ......................................................................................p.1

Challenges & opportunities ..........................................................p.2

Business model .............................................................................p.4

Strategy & progress ......................................................................p.8

Capital Leader ............................................................................p.10

Coaching and mentoring ............................................................p.12

Capital people ............................................................................p.14

Darzi Fellows ..............................................................................p.16

Future Plans ................................................................................p.18

Governance ................................................................................p.19

Our vision

To develop outstanding healthcare leadership in London in order to improve people’s health and their experience of the NHS.

Our mission

To be a regional centre of excellence for leadership development, delivering locally a national approach, and responding to the leadership needs of future and existing leaders across the capital’s NHS system to improve the quality of public health and patient outcomes.

Principles of our approachAs a learning organisation that occupies a unique space in the London healthcare system, we are committed to continually developing our approach to maximise our positive impact. Many of the principles of our approach to how we will work in London have been outlined in this report, and are also summarised here. These will be used as a reference when measuring our effectiveness in implementation over the next year.

As the London Leadership Academy, we: • Are by the NHS, for the NHS

• Set the agenda from a position of knowledge and expertise

• Work across London leveraging our position to make a positive difference

• Pilot good innovative practice that is shared and spread across London

• Focus on the challenges faced by healthcare leaders in London

• Provide a positive and supportive environment for learning, which allows risk-taking

• Choose only high quality partners with similar values

• Evaluate the impact of what we offer for individuals, groups and organisations

• Meet the needs of stakeholders and keep them informed and engaged

• Provide multi-professional development

• Develop NHS internal capability and capacity

• Grow our own capability to deliver as well as commission development

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Here we look back at what we have achieved since April 2013 when we were authorised to be the Local Delivery Partner of the NHS Leadership Academy for London. We also want to share with you our future plans on how we will be supporting healthcare leaders across London.

Over the past 18 months we have been working hard to build a learning community of leaders across the whole of London’s health system. We have brought staff together from all levels to learn and develop, as they and their organisations continue to deliver healthcare to some of the most diverse and challenging populations in the country.

We are proud to be part of the NHS Leadership Academy, supporting the delivery of a national portfolio of established leadership development programmes. As a pan-London organisation we look to complement this national work by designing, delivering and commissioning outstanding leadership development that makes a real difference to staff, and to the care they deliver to patients, living and working in London.

We believe that London Leadership Academy has a unique role to play in our capital city, working in partnership with health organisations across London. Under conditions of continued economic constraint, we recognise the need to deliver a robust and sustainable future for London-wide leadership development – and welcome this opportunity to share our experience with you, our valued stakeholders, through this report.

David Sloman & Anne-Marie Archard

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CHALLENGES & OPPORTUNITIES

Understanding London’s health leadership

The London FactorTo understand London’s health leadership, it is important to understand what London is, and is becoming.

The NHS in London has tremendous health and wellbeing challenges – caring for a population of over eight million people. It is a city where more than four million people a year go to A&E, where 20% of all babies delivered in England each year are born, and a city where the richest and poorest communities often live side by side – with many different health problems including diabetes, child obesity, drug use, infant mortality, tuberculosis, and early death from heart disease and stroke. There is also exceptional diversity with over 50% of the population from different ethnic backgrounds, 37% of whom were born abroad, and up to half a million people who are undocumented.

The political challenge of reconfiguring hospital services is significant; and many trusts are still working towards Foundation Trust status, at a time where integrated health and social care solutions need to be accelerated. All this against the backdrop of a diverse, bustling city creates a uniquely challenging situation for healthcare leaders. What’s more, there are strong pressures on CCGs to address key strategic themes such as transport and access, the environment and collaborative working: whilst needing to embrace effective digital technology. All these challenges provide a core context for our work, which is reflected in our programmes and research.

Over the last year we have commissioned research into both present and future London – and the challenges this does, and will present, for patient care and leadership development.

Responding to the challenges: the way we work • We are hosted by Health Education England and funded

by the NHS Leadership Academy (the Academy)

• We are one of the 10 Local Delivery Partners (LDPs) in England

• National leadership priorities are delivered through LDPs via a service level agreement

• We have our own portfolio of activities to respond to the specific regional challenges

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London 2034 – its people and environmentAt the beginning of 2014 we engaged with people across the London health economy and external experts to explore what London 2034 could look like. The headline findings spoke to the following assumptions about the future:

• Income and health inequality will continue to increase – made worse by the London housing market

• There will be increasing ‘virtualisation’ in care giving and health management. Social media will be a general fact of life and leaders will need to engage with patient, staff and stakeholders in a conversational and dialogic (rather than directive) way

• The genome project and related health technology developments will result in more self-diagnosis and personalised care

• Patient leadership will emerge as a significant model in health organisation and management

• Leaders will need to become more adaptable in how they engage with a volatile and uncertain world – and a diverse and potentially divided population. London leaders will be at the forefront of multi-cultural leadership

• Leaders will need to continue developing how they engage with the formal political establishment within London, over whom they have only indirect influence

We are designing our programmes to respond to these current and future challenges. For this reason our programme content will be revisited and refreshed on an ongoing basis, informed by new research we conduct, plus feedback from our stakeholders.

The population of London is growing. • We have a high birth rate and an ageing population

• Different communities have varying lifestyle patterns affecting their health needs

• As we live longer, people are more likely to develop long-term conditions, requiring ongoing health and care

• Some of our biggest health problems are getting worse: obesity, dementia, diabetes

• Our health and care services need to radically change to better meet the needs of modern Londoners

Eden Charles, Capital People Programme

BUSINESS MODEL

As a pan-London NHS leadership development organisation we have access to a wealth of health care leaders and leadership experience. This creates plenty of opportunities to bring the London leadership community together to learn new skills, create connections, build networks and deliver the best possible care to patients and service users.

What we do

Leadership for better health outcomes

What

we do1. Better quality

patient care

2. Better leaders providing care

• Being a Local Delivery Partner of the NHS Leadership Academy

• Work in partnership with experts in leadership development

• Supporting leaders to navigate the complexities of working in London

• Engaging with and delivering what stakeholders want

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Our business model is guided by our emerging strategic vision. This vision looks to build upon the

excellent programmes we have developed for London health leaders in recent years, whilst

working towards a mixed funding model as NHS budgets continue to tighten

and become more restricted. Leadership for better health outcomes How we create value

3. Adopt, implement and spread NHS values

4. Create diverse leadership

5. Behavioural change in leadership

• Creating time and space for leaders to think

• Building Capacity and Capability• Thought Leadership• Systems Leadership• Cross-sector Working

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Business model continued

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What we doBeing a Local Delivery Partner of the NHS Leadership Academy To deliver value to the Academy we are working to achieve the following:

• To establish ourselves as an exemplar for local development: linked to the national leadership development offering

• To build close working relationships with the Academy and our reputation as a value-adding Local Delivery Partner (LDP), including taking the lead for national Talent Management development

• To build on our experience of joint working with colleagues across the country and sharing knowledge across the LDP network

• To actively pursue independent and mixed funding models to secure the future of sustainable pan-London leadership development

Work in partnership with experts in leadership developmentWe have an expert team in place to lead the design and delivery of leadership development, and also work with a range of external experts when commissioning programmes across London. Going forward we will:

• Build on the existing strong relationships we have with development providers

• Explore the co-development of programmes, co-producing papers and research and sharing the overall risk and cost

• Seek out further sponsorship events (such as for the Leadership Recognition Awards)

• Continue to commission high quality development programmes from recognised experts, ensuring that our delivery partners use evidence based research and best practice in any programme they deliver for us

Cross-cutting London themes reflecting London-based issuesThere are several London themes that surfaced from our Frame our Future research, and our Capital Thought Leader programme, that we intend to carry through across our programmes. These include:

• The London context and complexity of leading in the capital city

• Systems leadership

• Cross-sector working

• Building networks

• Creating time and space for leaders to learn and reflect

• Intergenerational leadership

• Inclusion

• Sustainability

• Understanding big data and digital technology

• Patient leadership

This approach has been influenced by our participation in the International Integrated Reporting Pilot of the IIRC, where the focus was very much on Integrated Thinking, a discipline and methodology for solving complex problems.

Engaging with and delivering what stakeholders wantEnsuring that we meet the needs of our stakeholders is a top priority with our development programmes. Our Stakeholder Reference Group ensures that our development portfolio meets the needs of all stakeholders and sets the focus of our investment plan. We also regularly engage with other pan-London groups, including HR for London and the Learning and Organisational Development Network, as well as London Education and Training Boards and other NHS partnerships. Our priorities in this area are:

• Ensuring that the membership of our Stakeholder Reference Group reflects our main stakeholders and continues to evolve towards a Membership organisational model

• To keep building relationships that supports our move towards a Membership model, where increased membership income will help to enable the development and delivery of more London specific development work

• Reviewing what evaluation approaches have worked best and justifying the longer term impact of our programmes

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Creating time and space for leaders to thinkWe develop our offers on the premise that leaders need time and space to think away from the day-to-day pressures of their work. We bring together leaders from across London, allowing them to develop a pan-London perspective and also establish practical networks they can draw upon in their work. To deliver this we will:

• Continue to review and refine our development portfolio in terms of what offers the most value within the London context

• Continue to create compelling workshops and learning opportunities that bring together leaders from across the London healthcare system

• Constantly refresh and review our business plan to keep our priorities in line with the priorities of London leaders and London healthcare commissioners

Building Capacity and CapabilityA key area of our success is building capacity and capability within the NHS to become less reliant on external facilitators, coaches and organisational development support. To continue doing this we will:

• Advocate and support the development of internal coaching skills and the adoption of coaching as an effective approach for line managers, thereby improving relationships with staff and reducing the costs of employing external coaches

• Commission an organisational development programme to professionalise the NHS London workforce

• Make a significant impact to the quality of diversity and inclusion across London healthcare organisations, through our innovative Capital People programme

Thought LeadershipTo be credible within our London stakeholder communities we have to demonstrate our commitment to national best practice, whilst ensuring that the voices of those who deliver healthcare within the Capital are heard. Our activity in this area covers:

• Completing and publishing our Frame our Future research, which will provide a research base for identifying future leadership challenges and associated development priorities

• Writing and publishing papers, such as our article in the HSJ ‘Where now for Top Talent in the NHS’

• Influencing the wider leadership agenda by contributing national and regional thinking on topics including: shaping the leadership recommendations of the London Health Commission; and responding to the HSJ Inquiry into NHS Leadership

Systems leadershipBringing leaders together from across London is crucial to the development of integrated healthcare and integrated thinking in public services. We will support leaders to:

• Understand the London healthcare system and the role their organisation plays in the wider system; and gain insight into the challenges faced by colleagues providing health services in the capital

• Work more seamlessly together through our development programmes and networking events across London

• Build influencing and negotiation skills so they can become better leaders

Cross-sector WorkingWe actively encourage London health leaders to build practical learning networks with other bodies serving the community whom offer complementary services. Our cross-sector working will cover:

• Building on existing relationships with London’s Cross-Sector Leadership Exchange, which brings together leaders from health, the police and fire services. We are also increasing our engagement with London Councils and the Department of Health to create practical opportunities for shared working, delivery and organisational development

• Exploring cross-sector opportunities for establishing economies of scale in commissioning London specific development programmes

• Assessing the value created by cross-sector work and using this as a basis for future decisions on cross-sector development collaboration

...it started making me think and reflect on the issues that we tend to put at the back of our minds and which really should be foremost every time when we are discussing issues which are going to affect our population.”Dr Parvinder Garcha Hounslow CCG, delegate at the Ethical Leadership conference

How we create value

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STRATEGY & PROGRESS

Our strategic priorities

To develop leaders who are committed to the values of the NHS and demonstrate this in their actions and behaviours

To demonstrate clearly the increasingly high standard required of leaders to support and drive the healthcare strategy effectively

To contribute to the improvement in quality and safety of patient care through promoting excellence in leadership

To increase levels of diversity in leadership roles across NHS organisations in London

To signal a change in expectations of leadership capability and approach

Addressing London’s Leadership ChallengesOur strategic priorities are aimed at addressing leadership challenges facing the NHS in London, and they underpin all of the work that we do. They were developed in consultation with a range of key stakeholders, including our Stakeholder Reference Group, programme alumni, plus other healthcare leaders in London, in order for us to correctly identify and address leadership gaps in the capital.

In recognition of changes within the healthcare landscape, we will review our priorities as part of our business planning process for 2015-16 to ensure they are still fit for purpose and reflect the needs of our stakeholders.

Our key programmesWe’re proud of the work we’ve done to support and improve healthcare leadership in the capital since April 2013. Highlights from our first 18 months can be seen to the left, and more detailed information on some of our programmes can be found over the next few pages.

LLA are producing a plethora of very high quality learning initiatives that are invaluable for skills development and behavioural changes.”Participant Coaches & Mentor training

Capital leader

Darzi fellows

Coachingand Mentoring

Capital people

Leadership development access to all:

Over 900NHS staff attended our Masterclass series

Developing clinical leaders:

133fellows have been through the Darzi Clinical Leadership programme, across three cohorts

Encouraging a culture of equality:

Over 700NHS staff participated in our Capital People inclusion programme

Building rapport:

Over 350coaching and mentoring relationships matched

Addressing organisational needs:

33organisations were awarded bursaries to develop local leadership initiatives

Professionalising leadership capacity and capability:

20people undertaking the post-graduate certificate in Organisational Change Management

Breaking down silo working:

Over 100people across six organisations participated in paired learning

Identifying and fostering potential:

39organisations engaged with our work on talent management

Supporting core programmes:

Over 1200people registered with national leadership programmes in London

Highlights & achievements 2013-2015

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CAPITAL LEADER

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Supporting London’s most senior and aspiring leaders

Our Capital Leader programme is designed to support members of boards and governing bodies to be more effective.

Capital leaderDarzi fellows

Coachingand Mentoring

Capital people

As budgets are squeezed and they are faced with increasing pressures from the media and vocal public representatives, the programme is designed to offer that safe space where they can talk informally to colleagues in other organisations; they can explore the impossible together, taking the time to share their visions, concerns and strategic solutions.

Formats include breakfast briefings, workshops and evening events, featuring invited guests from the national NHS and political scene alongside leading thinkers from the corporate and academic world.

The sessions are also topical and included a networking dinner with Ian Dodge, Director of Strategy at NHS England on the eve of the release of the Five Year Forward View and a session exploring Integrated Care Organisations with the team leading the Dalton Review published in December. In January, Alastair Campbell shared with leaders thoughts about leading in an election year.

Our involvement in the International Integrated Reporting Council pilot programme has been a great success. The IIRC Chair Judge Mervyn King spoke at our 2013 Annual Board conference and met with senior leaders at a dinner for Chief Executives to explore how <IR> could positively influence reporting in the NHS. In 2014 London Leadership Academy was proud to be represented at the launch of the Public Sector pilot programme at the World Bank in Washington thus contributing to thought leadership at an international level.

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Our Annual Conference continues to attract senior leaders in significant numbers and in 2014 over 75 attended. The focus was Ethical Leadership, drawing upon lessons from Shakespeare’s Macbeth and using forum theatre to explore the challenges leaders face in times of ever-increasing scrutiny. Feedback was extremely positive with the Chair of one healthcare Trust stating: “Thank you so much for the invitation to attend today’s ‘Ethical Leadership’ Conference. I have to say it was one of the best conferences I have had the privilege to attend. The presentations, the case studies, the learning exercises and the table discussion was just superb.”

The Capital Leader programme also supports London’s future leaders and we are piloting ‘Next Generational Capital Leader’, a programme involving a series of high-impact interventions designed to generate rich learning for participants and their organisations. This is being developed with the CIHM, who also deliver the Darzi Fellows programme, and includes a three-day study trip to the Netherlands to provide an opportunity to see how other health services are run and what lessons can be taken. The programme’s activities are designed to take participants outside their comfort zone, within a sufficiently supportive framework to ensure learning and change.

Finger on the pulseWe know that it can be difficult for leaders to keep up to date with policy changes. Some of our recent Capital Leader events were designed in response to key national and regional priorities, including:

Freedom to act: commissioning challenges

Chief Executives, Chief Officers and Chairs of London CCGs, NHS Trusts and CSUs joined Ian Dodge, National Director for Commissioning Strategy and the RT Hon Stephen Dorrell MP for dinner & debate on the evening before the publication of NHS England’s Five Year Forward View. This was a unique opportunity to discuss future collaborative opportunities and challenges with London colleagues and guests under strict Chatham House Rule. Simon Stevens argued that the NHS must ‘think like a patient’ and ‘act like taxpayers’ when managing resources.

The Dalton Review

The Dalton review was published in December 2014 and this event explored the potential for providers of NHS services to develop different organisational forms, and recommended how to incentivise providers to work in new ways to provide better care more efficiently. This event was a key opportunity to consider the recommendations of the Dalton review, and debate the potential for providers of NHS care to develop different organisational forms.

Political dilemmas in an election year

Chief executives told us that the ‘politics’ are becoming increasingly more complex and challenging to manage. As we enter an election year on one hand, the centre is encouraging innovation, bravery, and radical solutions. On the other hand, local and national politicians don’t want the boat rocked as they seek votes from your local population. With this in mind, Alastair Campbell, best known for his role as director of communications for former British Prime Minister Tony Blair, will throw light on how to manage the politics and navigate the relationship and changing boundaries in the new landscape.

...clearly the NHS is in a period of turmoil and change. There are lots and lots of very difficult scenarios that people are faced with and coming out here gives us social space with other colleagues who are very much at the same level to think, share good practice and to reflect on some of the ethical dilemmas that we come across.” Anita Sharda Lay Chair, Health Education England

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COACHING & MENTORING

Creating confidence

Coaching and mentoring is the key to developing and unlocking leadership skills and potential. London Leadership Academy supports the development of coaches and mentors through accredited programmes and its coaching and mentoring registers.

Capital leader

Darzi fellows

Coachingand Mentoring

Capital people

I just want to take the opportunity to say thank you for your wise words, guidance and assistance in helping me to find some answers. You were a very attentive coach and I always felt that you understood my situation. You made the environment very comfortable (even when you were challenging!) and having the space to think things through with another person was very helpful.”Coaching client

I had my first mentor session recently, and I can safely say, already, that it’s had the most important impact! I cannot tell you how glad I am that I embarked on it.” Mentoring client

400CPD event places offered

26group supervision events held

60people trained as new coaches and mentors

27bursaries awarded to support local coaching and mentoring initiatives

CoachingLondon Leadership Academy offers a training programme for NHS leaders wishing to become accredited coaches. It is one of the most active and forward-thinking areas of our professional capability development. By establishing a process of accreditation, which is evaluated against recognised professional standards, as well as supporting the development of staff, it gives NHS organisations in London the confidence to use internal rather than external coaches. Once qualified, coaches go onto London Leadership Academy’s coaching register and commit to undertaking regular supervision and development (provided by London Leadership Academy) of their skills.

The register provides a confidential service to match NHS staff with qualified coaches, as well as an online facility to manage that relationship. There are currently over 100 coaches registered.

What is Coaching?Coaching is partnering with clients in a thought-provoking and creative process to help them fulfil their personal and professional goals. Recent research highlights the significant personal benefits that coaching brings to clients during times of change, enabling them to act consciously and decisively at times when it would be quite easy for them to become stuck or trapped.

As well as improvements in personal performance, the common benefits that people experience as a result of good coaching relationships include:

• An improved sense of direction and focus – which is often connected to a heightened sense of self-knowledge and self-awareness

• An increase in personal resourcefulness and confidence, which comes from a stronger sense one’s own personal strengths and the strategies that can help overcome weaknesses

• Improvement in the ability to form constructive relationships with a diverse range of people – as they learn to be less anxious and defensive, they become more adept at reading, empathising and connecting with others

MentoringLondon Leadership Academy also provides a confidential service to match mentees with appropriate mentors, as well as an online facility to manage mentoring relationships. Mentors on the mentoring register have all completed an accredited mentor skills programme and undertake regular supervision and development of their skills.

What is Mentoring?“ Mentoring supports and encourages people to manage their own learning so they can maximise their potential, develop their skills, improve their performance and become the person they want to be.” Eric Parsloe, The Oxford School of Coaching & Mentoring

Mentoring allows:• Off-line support to encourage innovation and creativity, from

someone with significant professional and life experience

• Working beyond professional/organisational boundaries: to put professional goals and ambitions in the wider context – the ‘bigger picture’

• Development of leadership skills to cope with inevitable ongoing changes: ‘time out’ to reflect on own and others’ learning and leadership approaches

• Feedback, challenge and support from an impartial person: the freedom to ask powerful questions and unlock potential

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...very knowledgeable... engaging... offered many thought-provoking [and] challenging exercises. The networking with like-minded peers is always invaluable _ thank you.”Coaching client

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CAPITAL PEOPLE

Capital leader

Darzi fellows

Coachingand Mentoring

Capital people

Responding to London’s inclusion challenges

...engaging, conclusive and well convened excellent facilitators.”Participant Capital People Unconscious Bias

700participants

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The ambition – responding to London’s inclusion challengesLondon Leadership Academy, with our partners BRAP, People Opportunities and FREDA Consultants, is championing a pioneering range of interventions focused on inclusion, one of the biggest challenges facing the NHS, particularly in the capital. We recognise that diversity and perceived differences can often divide and fragment what is hoped to be a united workforce. Our Capital People programme therefore helps organisations to positively address these challenges by giving leaders the skills, confidence and understanding to deliver strategies that close health inequality gaps and support diverse teams in the workplace.

It is our intention that as a result of the Capital People programme, equality and inclusion will be something that leaders in organisations unite behind, making a positive difference to:

• The way staff work together

• How organisations feel as places to work

• How organisations access health services

• How organisations go about closing gaps in inequality

Our work in this area covers:Workplace RelationshipsWithin diverse teams, managers often find it a challenge to navigate differing cultural needs and manage team performance. But managing diverse teams is a skill managers can learn and develop. Our work in this area takes this type of diversity seriously and gives people the skills to engage with it positively.

Commissioning for better health equalityCommissioners are under pressure to reduce health inequality and improve patient outcomes. The recommendations from the Francis report refer specifically to commissioners as upholders of NHS values. We will be working with a select group of commissioners to trial a 360-degree framework that delivers against commissioning expectations and promotes human rights.

Rights & Responsibilities, demystifying the legal maze of do’s and don’t at work As well as their day-to-day work, managers are expected to stay on top of all aspects pertaining to rights and responsibilities. This can often cause huge stress and strain working relationships. Our programme gives managers the confidence to make clear and informed decisions at work that are fair and compliant with equalities legislation.

Unconscious biasMany people go through a number of equality courses and still remain unclear as to why some unequal outcomes still persist. We provide people with insights into the different types of unconscious bias, and what leaders can do to develop bias control strategies in themselves, their team and their organisations.

TransitionsThis exciting and pioneering programme is designed to develop people from underrepresented groups, at more senior levels of their organisations, into more inclusive future leaders. Taking place over a launch event and six days, and spread over an eight-month period, it is a challenging programme that helps all participants to understand how they can increase diversity and reduce inequality. Each participant has the opportunity to work with a mentor who supports and challenges them to be the best leader they can be.

Impact: Over 700 individuals have participated in the Capital People programme from across 27 Trusts, 4 Clinical Commissioning Groups, Local Education and Training Boards and Public Health England.

This...has helped me with my confidence and to develop how I, as a manager, deal with staff from now on.” Participant Capital People Relationships

The level of discussion and participation from those involved was outstanding and the trainers were great.” Participant Capital People Rights and Responsibilities

To access our Capital People resources, including a number of short films, please see our website: http://www.londonleadershipacademy.nhs.uk/programmes/capital-people

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PAGE TITLEDARZI FELLOWS

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Developing relationships

Capital leader

Darzi fellows

Coachingand Mentoring

Capital people

It has been truly transformative in how I think about my role within the NHS.” Participant Darzi Fellow programme

The Fellowship in Clinical Leadership (also known as Darzi Fellowships) programme, is one of the most successful clinical leadership development programmes in London, with over 130 Fellowships having been awarded to date.

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What the programme is aboutThis innovative programme provides a cohort of clinicians, who are typically in the early stages of their career, with a unique opportunity to develop the capabilities necessary in their future roles as clinical leaders.

Fellowship posts are twelve months in duration and require clinicians to take that time away from normal work or training. In that time the fellows work on a major project (or in some cases a number of projects) covering service change, quality and safety improvement or leadership capacity building, under the guidance of a nominated sponsor – usually a Medical or Clinical Director or equivalent.

During the year fellows also participate in a tailored leadership development programme (leading to a postgraduate certificate) that aims to develop the organisational and leadership skills necessary for their future roles as clinical leaders. The excellent reputation of the programme means that fellows are often in high demand for a variety of clinical conferences, forums and knowledge-sharing events.

In the first programme the cohorts comprised mostly of medical trainees in secondary care specialties. Subsequent cohorts, however, included an increasing number of trainees from general practice, with placements deliberately arranged to promote cross-disciplinary learning. Since the fourth (2012/13) programme we have moved to a multi-professional model with clinicians chosen from all disciplines, including: nurses, pharmacists, dentists and paramedics, as well as doctors. It is worth noting that many cohorts are fully qualified although most are in the early stages of their career.

In 2014 the sixth and largest cohort took place, comprised of 60 Darzi Fellows. Commissioned by the London Leadership Academy, the programme is delivered by the Centre for Innovation in Health Management (CIHM), with funding from the three London LETBs.

Personally, I got a zest back for being a doctor as I now see I can have an influence on how services are run and how they can be better.” Participant Darzi Fellow programme

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FUTURE PLANS

We have made some notable achievements over the past 18 months and have plans for significant growth moving forward. Much of our work to date has been focused on developing programmes that support the development of individual leaders, and creating a learning community of leaders in London. We can now take what we have learnt from these experiences, both our achievements and where we could have done better, and plan more strategically for the future. To make the biggest impact with the investment from the NHS Leadership Academy, we have organised our future plans into five core areas:

1. Expanding our Capital People offer to support inclusive leadership across LondonWe recognise the importance of inclusion and the need to tackle ‘the snowy white peaks of the NHS’. We continue to expand our Capital People programme, working with our development providers and stakeholders, to design and deliver a range of interventions that will have a significant impact on the inclusion needs of the capital’s NHS workforce.

2. Develop a clinical leadership strategyThe need for solid clinical leadership is also a core part of the London Health Commission findings. Specifically, it noted the importance of the Darzi Clinical Fellows programme to London, which currently only impacts a small proportion of the capital’s clinical workforce. In partnership with stakeholders, we will develop a London-wide clinical leadership strategy to encourage more clinicians to take on leadership roles in their teams, departments and organisations.

3. Design, test and implement a regional approach to talent managementFollowing the launch of the national talent management hub, and a more tailored talent management approach by the NHS, now is the right time to look at how we can support a strategic approach to talent management at a regional level. Working with the North West Leadership Academy, we are designing a regional approach to talent management; one will be tailored to meet the specific needs

of each region; and the other approach will have a general framework that can be adopted by other areas. In London, we will kick off this approach with our HR community, helping them to understand the talent pool across their profession and how they can identify and fill gaps while supporting progression.

4. Working more closely with Kent Surrey and Sussex Leadership Collaborative (KSSLC) and all the LDPs Following the restructuring of Health Education England to have a Geographic Director responsible for London and the South East, we are actively working with the LDP for Kent Surrey and Sussex (KSSLC) to look at how we can work more closely together across our portfolios. We have already identified a number of opportunities for collaboration, and will include these in local discussions as we develop our business plans for next year. We will also communicate regularly with all ten LDPs of the NHS Leadership Academy to look at areas that would benefit from joint commissioning. By identifying areas of collaboration we will ensure that, as a national partnership, we deliver economies of scale and maximum return on investment.

5. Explore the development of a membership modelOver the next year we will be looking at the benefits of moving towards a membership model. Four of the ten LDPs already have a membership model. As well as providing additional revenue to supplement their national funding, it also develops stronger engagement with stakeholders. The NHS Leadership Academy is also exploring the possibilities of a national approach to membership, and we will try to decide collectively how this will be offered at a local level.

We will meet with a wide range of bodies in order to identify:• What value would a membership model have for them and what

would make membership ‘value for money’

• Who would be interested in becoming a member of the London Leadership Academy and what types of membership would be attractive (e.g. all-inclusive, partial or ‘pick and mix’)

• A business case for moving to a membership model: its costs, benefits and the underlying assumptions

5 key trends

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GOVERNANCE

Governance and risk

Introduction London Leadership Academy is hosted by Health Education England and funded by the NHS Leadership Academy (the Academy) to be their Local Delivery Partner in London. Much of the work is co-ordinated and led centrally, but delivered locally. The success of the Academy relies on its relevance, quality and impact for local leaders and organisations – and its relationships with local partners.

To secure more tailored and local support the Academy works through Local Delivery Partners (LDPs) who are essential in managing the promotion and delivery of Academy work. Local Delivery Partners also have their own portfolio of activity, which is specified, managed and owned locally.

We are funded primarily by the Academy and, are therefore, accountable to them for the delivery of a Service Level Agreement. This Service Level Agreement details the services required by the Academy from the Local Delivery Partners. The primary purpose of the agreement is to ensure consistency in how the programmes and interventions are delivered.

London Leadership Academy Stakeholder Reference GroupOur Stakeholder Reference Group act as our board and are responsible for ensuring that the design, delivery and implementation of our business plan reflects the leadership development needs of the London healthcare system. The Reference Group is comprised of a group of representative stakeholders who come from diverse organisational roles and backgrounds from across the London healthcare system. It is chaired by David Sloman Chief Executive of the Royal Free London NHS Foundation Trust.

The Reference Group provide feedback on the development of our priorities and use of funding, as well as review progress against our business plan. They act as champions for leadership development within their organisations and across the healthcare system, and also ensure that we work strategically to enhance local leadership development at organisational level, identifying and sharing best practice.

A review of the Academy, and the role of LDPs is currently underway, which could result in changes to our governance in 2015.

Illustration of our governance process

NHSLA: NHS Leadership Academy NCEL: North Central and East London

LETB: Local Education and Training Board

HE SL: Health Education South London HE NWL: Health Education North West London

NHS England

Developmentand review ofbusiness plan

Agreement oflocal priorities

Setting ofnational priorities

NHSLABoard

StakeholderReference

Group

LETB Executive

Group

London Leadership Academy(NHSLA Local Delivery Partner)

London System Stakeholders HE SL HE NWL

Governance assuranceCompliance with SFIsFinancials Employer

Funding Quality assurance

Performance managementSign off of business plan

NHS Leadership Academy(NHSLA)

Health Education NCEL(Host)

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Governance & risk continued

Risk We manage risk through the Heath Education risk management process, whereby risks are regularly reviewed and escalated if appropriate. As we are committed to being open and transparent, below is a heat map which demonstrates the impact and probability of 4 high-level risks, following our mitigation actions.

High-level risksStrategic risks that may have an impact on the hosting LETB’s, wider HEE or the Academy’s objectives shall be escalated through the appropriate channels, including:

• LETB Executive Group – for risks to HEE’s objectives

• LDP leads meeting forum – for risks to the Academy’s objectives and national priorities

Description of Risk Mitigation actions Impact Probability

1There is a risk that allocating budgets on a single year basis may constrain strategic planning and compromise delivery of longer-term programmes. This may result in a profile of activity peaking in the second half of the financial year

LLA are working with the Academy to seek to establish budgets and planning assumptions through to 2015/16

4 3

2There is a risk that the allocation of budgets on a single year basis may lead to significant and unknown changes, which could adversely affect the stability of staff structures and morale within the team

A service level agreement is being put in place with LLA and the Academy to agree a minimum requirement of delivery for 2015/16. Recruitment activity has been completed to appoint permanent members of staff to posts that have been filled by staff on FTC or from agencies.

3 3

3There is a risk that LLA may not successfully engage with stakeholders across all parts of the NHS system in London, due to the number of new organisations and differing priorities. This could lead to programmes not being accessed by a full representation of NHS staff in London

LLA has established a Stakeholder Reference Group with attendees from key organisations across London and are using this group to raise awareness of our work across all NHS organisations. We have established a strong brand with a standalone website and monthly newsletter sent to all stakeholders

2 3

4There is a risk that the LLA budget may be reduced in 2015/16 and that it may not be able to secure additional funding to mitigate this, which may limit future programme delivery

Work on exploring alternative funding models is underway and we are liaising with other LDPs who are already operating a membership model. We are also developing our ‘offer’ to healthcare leaders in London and how we demonstrate our benefit to the system

5 3

High risk Medium risk Low risk

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Funding London Leadership Academy also receives funding from the three London Local Education and Training Boards (LETBs) to commission and deliver the Darzi Fellow programme. We are accountable to the London LETBs through their LETB Executive Group for the delivery of this work.

In 2013/14 we received a budget of £3,449,115, this decreased to £2,791,300 in 2014/15 and has been distributed against national priority areas as the below pie charts demonstrate.

£750,000SLA Funding Distribution 2014/15

Professionalisation of Leadership £100,000Building Capacity and Capability £278,000System Leadership £60,000Talent and Inclusion Management £195,000Business Development £117,000

£2,041,300Discretionary Funding 2014/15

Building Capacity and Capability £576,300System Leadership £850,000Talent and Inclusion Management £346,000Business Development £269,000

Sotiris KyriacouCoaching, mentoring and facilitation

Marita BrownTalent management*Leadership recognition awards*OD Network PG Certificate in OD Leadership toolkit Alumni Paired learning Leadership for integrated care Operational support for coaching & mentoring

Mitzi WymanCapital People/Inclusion*Capital Leader Capital Thought Leader Integrated reporting Thinking Environment

Mark HumbleProfessional development programmes*Frontline nursing and midwifery programme*Graduate Training Scheme (GMTS)*Darzi Fellows Clinical leadership Masterclasses

*This indicates national programmes/activities

Anne-Marie ArchardNational LDP Lead for Talent Management Cross-sector Leadership

Supported by: Emma Harper Bernadette McShane Velita McQueen

Supported by: Samantha Richards Emily Miles

Supported by: Jonathan Pam Kay Buhari

Supported by: Charmane Williams Runa Begum

Supported by: Charmane Williams

NHS London Leadership AcademyStewart House 32 Russell Square London WC1B 5DN

020 7862 8587

Website: www.londonleadershipacademy.nhs.uk

Email address: londonleadershipacademy@ncel.hee.nhs.uk

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