Dr Mark Catolico (ST6) October 2012- February 2013
Having worked as an NHS employee for nearly a decade you would imagine that one would have a reasonable grasp of what occurs ‘behind-the-scenes’.
As all anaesthetists know, our basic science knowledge allows us to comfortably handle the drugs and machinery we use in our daily work. We take great pride in our command of our medical discipline, but can that be said for our knowledge of the NHS hierarchy and management? Does April 1st 2013 hold significance for any mild mannered anaesthetic trainee, or is it another Fools day? Well the joke is on us if we choose to ignore this.
On taking up my clinical fellow post in neuroanaesthesia, I had several goals in mind; most of them were clinically orientated. The feeling of dread as I had to complete the Trust induction online was partly relieved on finding a small paper advert within my induction folder outlining a UCLH initiative, the Executive Shadowing Programme (ESP), borne out of the Darzi fellowships in clinical leadership. For a small fee, UCLH was offering the opportunity for junior clinicians to learn about how NHS management works. Not just through a series of lectures, but being able to shadow various executive board members of the Trust and gain a real insight into how the NHS business functions.
The ESP is a 4 month process which begins with a one day induction workshop. This is where you meet the organisers and your fellow shadowers; you will outline your expectations and goals for the programme and then learn more about the NHS structure through a series of workshops and lectures. You will be assigned a mentor, who may be non-clinical, but will definitely have an interest in guiding you through this process and be your regular contact (meeting at least once a month). A list of all the business/ management forums will be available to you and you will have the opportunity to attend as many or as few as you want. The induction process also introduces you to some of the executive directors, and allows you to quiz them whilst enjoying a pleasant cream tea!
My ESP experience started with great earnest, as I booked to go on at least half a dozen meetings in my first month. The NHS structure lecture completely baffled me and the amount of acronyms used, ie. CQUIN, QOF, QEP etc. also made this process feel much harder to comprehend.
Most of my ESP cohort were senior/ peri-CCT trainees, ranging from a GP with a sport medicine interest (GPwSI) to several neonatologists, a clinical pharmacology physician and a dentist. The majority had little to no experience of NHS leadership/ management and wanted the ESP to maximise their potential and help them fulfil the management requirements for future consultant posts.
Although not a formal management course, the ESP gives you an opportunity to see how management works in the frontline. Just being able to see how an effective meeting runs and the dynamics between the chief executive and his fellow board directors is enough to make the ESP a worthwhile process. Regular seminars by various executive directors on topics such as NHS finance, procurement and commissioning enhanced our learning. The numbers of flow/ Quality, Efficiency and Productivity (QEP) initiatives to improve patient experiences and reduce costs are truly astounding. The ESP gives junior doctors the opportunity to share their unique input which would otherwise be lost being temporary employees/ on training rotations.
The ESP rounds off with a feedback session, which allows everyone to give short presentations about their experiences and how ESP has changed their practice. I found the whole process extremely rewarding and in the light of the Francis report, we as a profession need to make such schemes readily available to all; which is why I commend the LDfA in promoting this scheme.
Thank you for your attention.