Abstract/Summary

Whilst there is considerable research on leadership development in the business sector, this topic is less well researched in the National Health Service (NHS), especially in relation to how clinicians in emergency departments learn to lead, what their experiences of leadership are, and their development needs for the future. This is surprising as the NHS is going through something of a crisis, with good leadership on the ground arguably being the key to its future success. This study makes an original contribution in exploring this issue from the perspectives of emerging leaders, middle management, and senior management, and specifically addresses the knowledge gap in identifying the training needs of clinical leaders in urgent and emergency care (UEC). The main research question was defined as ‘what are the experiences and perceptions, of clinical leadership development in the emergency department (ED) of an English Acute Trust?’ A sample of clinical leaders (emerging leaders, middle management, and senior management) (n=36) were surveyed, alongside 12 semi structured interviews. Quantitative data were analysed using descriptive statistics while qualitative data were analysed using a thematic approach drawing on a conceptual framework based on the inter-related concepts of culture, professional identity, and leadership development. This study offers insights into the perception of culture and the influence of values and behaviours across all three levels of management, on the organisational purpose and its norms. The impact of leadership progression on personal and professional identity, and the ethical dilemmas all clinical leaders must balance, in offering high-quality patient care, is also explored. The findings reveal that a bespoke approach to leadership development is needed. It advocates a more individual centric focus on leadership development in relation to inter alia multi-disciplinary team development, system collaboration and new ways of working. The study proposes an original leadership development framework for UEC staff. It proposes foundational development programmes to support clinical leaders, who are often good clinicians, to enable them to be the best leaders they could be. The results have implications for senior management and organisational development practitioners to ensure appropriate investment in talent management, succession planning and career pathway development are in place, in the future, to ensure the sustainable success of the organisation.