Managing the 'translation gap'

When it comes to management, many research and development experts in the NHS are self-taught. People in this situation often find themselves at the helm of large organisations, managing big budgets and several staff, having received no formal training in leadership. In one part of the public sector, the solution has been a leadership development course, run by the Ashridge Business School . Since 2008, NHS research arm, the National Institute for Health Research (NIHR), has been using the leadership programme to support its work in keeping up standards of UK clinical research and application, as set out in the government's strategy, Best Research for Best Health. "There is a sense that often good work is done in research, but not applied," says George Binney, a consultant at Ashridge. "This programme focuses particularly on world-class health research that has benefits for patients and public alike. It's concerned with bridging the 'translation gaps', and we're in the service of leadership that contributes to those things." Senior scientists, clinicians and doctors are involved, including, for example, staff working on cutting-edge gene therapy and stem-cell research at Moorfields Eye Hospital, as well as researchers in other areas, including the organisation and delivery of health services. The programme costs £1m a year - roughly £10,000 a head - and will run until March 2012, by which time 380 people will have received training. It caters for three groups: senior leaders at the forefront of UK research, 40 of whom were nominated by the director general of research and development at the Department of Health; development leaders - the potential successors to the most senior leaders; and trainee leaders - senior post-doctoral researchers who are establishing their own fields and taking on management roles. The goal is to catch this latter group at a crucial transition in their careers - people such as Felicity Callard, a senior researcher at the NIHR Biomedical Research Centre for Mental Health in London, who has been on the programme since autumn 2009, who says the changing structure of research requires new skills. "Scientific research within health demands complex collaborations between clinicians, clinical scientists and social scientists, as well as with universities," she comments. "This pilot is specifically designed to help people like me, who have hit a point where they're making strides in their research careers, with increasing management and leadership responsibilities. The application process was quite demanding, but in applying you're already committing to a certain amount of work, and I didn't take this on lightly. It is an in-depth engagement." Callard says that while the course is designed for those at a certain stage of their career, within that there is a wide range of people and one of the challenges of the course is managing that diversity. Dealing with conflict As well as peergroup sessions, and mini-workshops on specific topics such as dealing with conflict, senior leaders are able to take part in 24-hour, community-building events at Ashridge. Those with busy schedules are shadowed by a consultant for four days over the course of their 18-month programme. Sitting in on meetings, the goal is to observe style and methodology, then to discuss with them their various interventions and approaches to management. Being given the opportunity to reflect on what they're trying to achieve and how is a revelation for many, and this "live" interaction – a shared experience, rather than dry workshops – is part of the reason so many have engaged with the programme. Hywel Williams, professor of dermato-epidemiology at the centre of evidence-based dermatology at Nottingham University Hospitals NHS Trust, says the idea of leadership training hadn't occurred to him before. "As I've taken on more senior responsibilities, I've become more interested in what it is that makes people successful," he comments. "I was open-minded when the offer came along – you have to be in a position of readiness to reflect on leadership issues. You can't have these things imposed upon you. I've been forced to go on other management courses in the NHS in the past and haven't been impressed, but these people are real professionals who understand the psychology of large organisations." Williams says his schedule meant he couldn't get to many of the group events. "But the one-to-one sessions were a real luxury," he says. "I've developed a more efficient way of dealing with and prioritising work and I have had the confidence to apply for and secure a new national role. A detailed 360 degree appraisal was one of the best things. It was incredibly helpful in that I became more aware of my style of leadership and the kind of leader I am. The course has helped me to become more reflective with an inner sense of peace and space, which is half the battle."