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This paper aims to explore whether a United Kingdom (UK) clinical psychology training programme (the programme) was effective in producing graduates who are confident in leadership, within the context of the National Health Service and reflecting the British Psychological Society’s views of leadership.

Mixed methods design surveys were administered to prospective-, current- and alumni trainee clinical psychologists on the programme, enquiring about their view of leadership, motivation to lead (MtL) and aspects of the course that are helpful and which need further development. Data collected from 92 individuals were analysed using content and thematic analysis (TA).

From the TA, three themes were identified concerning the meaning of leadership as follows: professional identity, Improving the quality of services (team; organisations and wider context), professional skills. Overall, participants thought leadership was important to the role of a clinical psychologist, with prospective trainees reporting that the desire to develop as leaders influenced their decision to apply to the programme. Moreover, participants felt confident in leadership skills and that the training programme helped develop their leadership skills, with the alumni participants demonstrating a greater MtL. Placements, group study and specific modules were identified as contributing to the development of their leadership skills, but participants felt more teaching on leadership is needed. Recommendations have been suggested to improve the development of leadership skills on the programme.

The research was undertaken on a small cohort of trainees based in the UK.

Participants were motivated to become clinical leaders but this motivation needed to be nurtured and developed particularly through structured placement and teaching experience.

This service evaluation is the only audit of the leadership of the programme and the findings will contribute to the existing body of reviews in this area.

The English-speaking Caribbean is currently at a crossroads regarding the education and training of home-grown psychologists meeting the ever-increasing demands for mental health care in the region. This paper recommends an innovative approach to build capacity in mental health care in the English-speaking Caribbean that will require partnerships between the regional university, experienced registered practising psychologists, professional resources in the diaspora, public health and education institutions, which will produce trained clinical supervisors, PhD psychologists and improved mental health services in the region.

Documents about the postgraduate programmes in psychology from the regional university were sourced. PubMed, Medline and Google Scholar were searched for the English language published articles using the key phrases psychology AND/OR psychologist AND/OR education AND training AND mental health. Searches of the reference lists of included articles were also undertaken.

Postgraduate psychology programmes in the region have become stalled at the master’s level. Meanwhile, doctoral-level training is being sought outside the Caribbean largely due to the lack of availability of trained clinical supervisors. Moreover, training outside the region may lead to deficits regarding cultural relevance of practices, as well as impede the overall development of Caribbean psychology.

This paper provides insights into the current practice of education and training for Caribbean postgraduate psychology students and the implications for the development of the practice of psychology in the region. Recommendations for educational and training strategies are provided.

The proposed framework presented will help upgrade experienced master’s-level trained psychologists to PhDs with training in clinical supervision through Research Advancing Intensive Supervision Education (RAISE) doctoral programmes and can cultivate improved mental health services with a wider reach across the Caribbean.

Raising the training standards of the psychologists, preparing clinical supervisors and increasing access to practicum sites will improve the trajectories of psychologists within the English-speaking Caribbean and the mental health of the population. Such changes will help to ensure the use of culturally appropriate therapies with Caribbean clientele. There are many social implications for capacity building within the practice and research domains of the preparation of psychologists. For example, increased access to psychological care, improved well-being of citizens, decreased prevalence of work absenteeism and improved management of citizens’ mental health and well-being.

This paper provides insights into the current practice of education and training for Caribbean postgraduate psychology students and the implications for the development of the practice of psychology in the region. Recommendations for educational and training strategies are provided. The proposed organising framework presented offers a new conceptual model that can be used to guide the capacity building of psychologists within the English-speaking Caribbean. The proposed framework will help upgrade experienced master’s-level trained psychologists to PhDs with training in clinical supervision through RAISE doctoral programmes and can cultivate improved mental health services with a wider reach across the Caribbean.

The purpose of this paper is to explore the effect of a clinical leadership programme on senior clinicians within National Health Service Lanarkshire, in terms of key constituents for fostering leadership development, specific skills developed and impact this has had on clinical practice.

A qualitative research design was employed over several stages, involving 44 senior clinical managers, with member validation substantiating findings and thematic analysis used to analyse data collected.

The programme's impact was evident in acknowledged change to participants' attitude, behaviour and performance with examples conveyed to demonstrate both the effect on clinical practice and perceived organisational benefits gained. The use of role play, scenario planning and enquiry‐based learning approaches were deemed critical in achieving such change.

Time constraints merited two different cohorts being examined simultaneously during the various stages of the programme. A longitudinal study is underway encompassing the evaluations of several cohorts through various stages of the programme to enable time‐based comparisons to be made and enhance the rigour and scrutiny of the programme's impact on clinical practice.

The paper is foremost in determining structure and processes employed on the programme, specific leadership skills developed, subsequent effect on clinical practice and perceived organisational benefits gained but not necessarily contemplated by staff prior to embarking on the programme, such as the emergence of communities of practice.

To describe the methodology used to introduce Clinical Governance into the NHS and to review progress.

The RAID (Review, Agreement, Implementation, Demonstration) process and its use in introducing the Clinical Governance Development Programme into the NHS are described.

The NHS Clinical Governance Programme employs RAID, a modification of an accepted “bottom‐up” approach to achieving successful organisational change, as the means of effecting service improvement. The “Review” stage involves analysis and understanding of the service; “Agreement” ensures that all staff, the organisation and stakeholders are committed to recommended changes; the “Implementation” phase tests effects that the changes have made to the service and “Demonstration” allows evaluation and monitoring. Lessons learned from the process can lead to further improvements. Initially staff from the Clinical Governance Support Team introduced the Programme but thereafter the process can be run internally. Specialised programmes, e.g. The Stroke Programme, have developed out of the general programme and the RAID process has been disseminated to other public sector services. Over half of NHS organisations have participated.

RAID is described in the context of the NHS and its implementation is summarised.

The purpose of this paper is to outline the “Hybrid” “International” Emergency Medicine (HIEM) programme, which is an ethical pathway for the recruitment, employment and training of Emergency Medicine doctors; with a rotation through the NHS on a two-year medical training initiative with a Tier 5 visa, “earn, learn and return” programme. The HIEM programme offers an advantage to the Tier 2 visa by combining training, education and employment resulting in new learning to help improve the health system in Nepal and provide continued cultural support, clinical and leadership development experience in the UK NHS. Finally, this programme also provides a Return on Investment to the NHS.

A shortage of doctors in the UK, combined with a need to develop Emergency Medicine doctors in Nepal, led to a UK Emergency Medicine Physician (PS) to facilitate collaboration between UK/Nepal partners. A mapping exercise of the Royal College of Emergency Medicine curriculum with the competencies for the health system and quality improvement leaders and partners with patients produced a “HIEM programme”. The HIEM programme aims to develop first-class doctors to study in Emergency Departments in the UK NHS while also building trainee capability to improve the health system in Nepal with a research thesis.

The HIEM programme has 12 doctors on its programme across years one and two, with the first six doctors working in the UK NHS and progressing well. There are reports of high levels of satisfaction with the trainees in their transition from Nepal to the UK and the hospital is due to save £720,000 (after costs) over two years. Each trainee will earn £79,200 over two years which is enough to pay back the £16,000 cost for the course fees. Nepal as a country will benefit from the HIEM programme as each trainee will submit a health system improvement Thesis.

The HIEM programme is in its infancy as it is two years through a four-year programme. Further evaluation data are required to assess the full impact of this programme. In addition, the HIEM programme has only focussed on the development of one medical speciality which is Emergency Medicine. Further research is required to evaluate the impact of this model across other medical and surgical specialties.

The HIEM programme has exciting potential to support International Medical Graduates undertake a planned programme of development while they study in the UK with a Tier 5 visa. IMGs require continuous support while in the UK and are required to demonstrate continued learning through continuous professional development (CPD). The HIEM programme offers an opportunity for this CPD learning to be structured, meaningful and progressive to enable new learning. There is also specific support to develop academic and research skills to undertake a thesis in an area that requires health system improvement in Nepal.

This is the first time an integrated clinical, leadership, quality improvement and patient partnership model curriculum has been developed. The integrated nature of the curriculum saves precious time, money and resources. The integrated nature of this “hybrid” curriculum supports the development of an evidence-based approach to generating attitudes of collaboration, partnership and facilitation and team building in medical leadership with patient engagement. This “hybrid” model gives hope for the increased added value of the programme at a time of global austerity and challenges in healthcare.

This study examined the effectiveness of the Triple P‐Positive Parenting Program in a government child health service delivery context with Chinese parents in Hong Kong. Specifically, the study sought to identify pre‐intervention variables that might predict programme outcomes such as level of clinical improvement and programme completion. Participants were 661 parents of pre‐school and primary aged children participating in a group version of the Triple P‐Positive Parenting Program. There were significant decreases in disruptive child behaviours, levels of parenting stress, general stress and anxiety and an increase in parenting sense of competence. Greater change in reports of child behaviour problems was related to lower levels of family income, new immigrant family status, and higher pre‐intervention levels of parenting stress. The present study provides a profile of parents who are most likely to benefit from parent training programmes.

The paper aims to describe an evaluation study of advanced leadership programmes run for clinical leaders in the National Health Service (NHS) in England.

This was a limited, post‐hoc study, strongly influenced by a “moving target” problem, which collected and analysed reaction and learning‐level data through e‐mail questionnaires, document analysis and semi‐structured interviews.

Significant underlying unchecked assumptions in relation to the programmes were made and were never realised in practice. There were split funding arrangements and lack of clarity over the purpose of the programmes. While there were organisational and individual benefits achieved the programmes only partly met their original objectives.

The post‐hoc nature of the research study was a major limitation, together with the “bespoke” nature of programme delivery, This meant that the findings of the study were broad and general, rather than specific to each individual programme. Future evaluation studies would need to be planned with the programme design, rather than as an afterthought.

Robust project management arrangements are necessary for steering purposes in such complex leadership development programmes. A continuing diagnostic orientation is needed on the part of the programme provider. Programme titles matter – and create expectations. The contractual model potentially creates tensions between client(s) and provider.

Few evaluation studies of clinical leadership programmes have been conducted and reported. The case study offers a rich source of shared learning with regard to the complexity and challenges in this sphere.

The purpose of this study was to examine the overall quality of care being delivered, and to determine if gender, race, age, and education level affected the quality of care being delivered in inpatient mental health programmes. To accomplish this objective, the study utilised patient survey data collected in 2006. Measures were selected from the survey that best matched the Institute of Medicine's (IOM) six dimensions of quality framework: safe, effective, timely, efficient, equitable and patient‐centred. This study may be a useful tool to guide the assessment of clinical programmes and the role of leadership in this process.

National policies suggest that service users and carers should be involved in health care planning and delivery. Initiatives to involve service users and carers within the education of mental health professionals have been reported. However, there has been no initiative to involve such individuals in the selection of clinical psychologists. This study examines the experiences of service users, carers and members of the Doctorate of Clinical Psychology programme in the implementation of a new interview task for the selection of trainee clinical psychologists at the University of Surrey. This new initiative involves service users, carers and staff members working collaboratively to assess candidates in a discussion based task. The study employed two focus groups, one pre‐selection and one post‐selection, and used interpretative phenomenological analysis (IPA) to evaluate participants' expectations and experiences of the task. The findings suggest that there was genuine collaboration between service users, carers and programme team members that was deeply engrained in the programme ethos and was a step forward in normalising and empowering service users and their carers. Interviewers felt that this task helped select a different calibre of applicants who had an awareness of the perspective of service users and carers and were able to communicate effectively. Interviewers viewed applicants who were able to disclose and take ownership of their views favourably. The introduction of a successful new interview task at Surrey has set a marker for future collaboration with service users and carers in selection, which will have implications for other doctorate programmes in clinical psychology and the broader health care training community.

An innovative programme of “Darzi” Fellowships in Clinical Leadership provides doctors in postgraduate training with a unique opportunity to engage in improving systems of health care and develop their capability as future clinical leaders. The purpose of this paper is to report an impact evaluation of the programme, highlighting transferable design principles.

Qualitative and quantitative data were used iteratively and included a review of literature, analysis of background documents and internal evaluation results, face‐to‐face and telephone interviews, observation of educational events, online questionnaires and representative case studies.

Impact was found at the level of the fellows' learning, their organisations and the wider health system. Identified influencing factors included: clarity of purpose and aims, mutuality of workplace and external learning, learning for transformational change, ambitious but “do‐able” projects, a committed and learning‐oriented sponsor, a supportive organisational culture, high‐quality mentoring, a network of supportive peers, diversity of participants, ongoing monitoring and adaptation, planning for sustainability and the tracking of impact over time.

The extent to which results are generalisable needs to be considered within the constraints of this programme evaluation.

The “Darzi” Fellowship programme is effective and impactful, spawning clinical leadership development throughout a wider system. Whole system engagement of trainee doctors in leadership will require more than a Fellowship programme alone, but it is a start.

The evaluation adds to what we know about leadership development generally and provides a rare study in the medical context generating helpful principles for the design of leadership development programmes, particularly in the clinical setting.