Master of Science in medical leadership and management and its role in the current NHS

Medical leadership within the NHS

Effective leadership is increasingly important to all doctors within the NHS. Clinical leadership is not only important as part of individual continued professional development but it allows the involvement of doctors in the care and provision of services, now and in the future. With increasing pressure to improve efficiency in the NHS, change is seemingly a constant feature in today's NHS. Doctors often feel aggrieved at their perceived lack of involvement, particularly if the new directives seem to interfere with core values held by the profession (Box 1).¹ Clinicians may feel that NHS managers and politicians have a different agenda to their clinical values – the so-called ‘ethos gap’.¹ Doctors are well placed to help bridge this divide and shape the future of the NHS but should be encouraged to develop the practical and theoretical leadership skills to best utilise their expertise and influence.

Box 1.

General Medical Council's principles for good medical practice.

Lord Darzi's report, High quality care for all, placed a new emphasis on leadership from the frontline, highlighting bold plans for developing clinical leadership within the NHS.² Clinicians are encouraged to take responsibility in fostering innovative practice, develop new services and address poor performance within their NHS organisation.

Subsequently, the Medical Leadership Competency Framework, jointly developed by the Academy of Medical Royal Colleges and the NHS Institute for Innovation and Improvement, outlined core leadership competencies considered essential to all doctors.³ It is intended that these competencies are integrated into each specialty curriculum (Box 2).

Box 2.

General Medical Council's principles for good medical practice.

Traditionally, there has been little formal leadership and management education as part of the core medical curriculum; for most junior doctors this involves a short management course in the later years of the specialist training programme, with limited ‘on the job’ experience. In recent years, there has been an increased interest in extended programmes, as either work-based learning or as qualifications, such as the Master of Science (MSc) in medical leadership (or clinical leadership), which aim to provide the knowledge, tools and practical leadership and management experience required to contribute fully to the modern NHS.⁴

The authors are currently undertaking an MSc in medical leadership and have provided an overview of their experiences.

What is the MSc in medical leadership?

The MSc in medical leadership is a university-affiliated postgraduate qualification. The majority of universities offer the option to achieve a postgraduate certificate, postgraduate diploma or master's degree. The course provides an opportunity to study the background academic knowledge of leadership and management theory and its application in practice. Students are encouraged to use this theory to critically reflect on their own approach to leadership to develop their own competency and confidence. Table 1 provides information on some of the courses available in the UK.

Entry requirements

The majority of courses are aimed at any healthcare professional that has leadership or management responsibilities, although a minority has a specific entry requirement for senior clinician/consultant level. A formal leadership or management position is not necessary to benefit from this course.

Course format

The majority of courses are structured in a part-time modular format, with the opportunity to study for one (postgraduate certificate level), two (diploma level) or three years (full masters qualification). The postgraduate certificate qualification requires attendance at tutored sessions at the university in two- or three- day blocks approximately four times per year. Flexibility to attend these sessions is therefore required from an employer. In addition a written assignment is attached to each module. Most assignments are short essays varying from 1,500–5,000 words and require considerable background reading.

The modules covered by each university vary but follow broad themes of leading and managing people, finance, human resource development, innovation and creative thinking, project management, strategic leadership, coaching and mentoring. For those wishing to proceed to the diploma phase, there is a similar modular format, followed by a 12-month organisational-based dissertation at master's level. The majority of universities offer an online resource developed for part-time students to liaise with others, to contact tutors, and to provide course and reading material.

How much does the MSc cost?

There is considerable variation in quoted course fees; from £6,500 to £25,000 for the full masters qualification. Some deaneries or strategic health authorities offer bursaries for postgraduate qualifications for doctors in training.

Is it worthwhile?

Absolutely. Leadership and management are crucial concepts in the constantly changing, complex environment of the NHS and doctors are regularly faced with related challenges. The course provides an academic theory-based framework into which healthcare professionals can integrate their experience. The knowledge of leadership theory gained through taught sessions, background reading and assignments develops critical thinking skills, an understanding of topics and concepts to relevant leadership and management and encourages reflection of what effective leadership entails. This is integrated with the practical tools to improve the ability to lead and to enable a genuine dialogue with NHS managers. In the current environment it is increasingly likely that formal experience in leadership will be actively sought. This qualification provides evidence of this and highlights a trainee's ability and enthusiasm to learn.