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UK fellowship schemes have been set up to address low-level engagement of doctors with leadership roles. Established in 2013, the Welsh Clinical Leadership Fellowship (WCLF) programme aims to recruit aspiring future clinical leaders and equip them with knowledge and skills to lead improvements in healthcare delivery. This paper aims to evaluate the 12-month WCLF programme in its first two years of operation.

Focused on the participants (n = 8), the authors explored expectations of the programme, reactions to academic components (provided by Academi Wales) and learning from workplace projects and other opportunities. The authors adopted a qualitative approach, collecting data from four focus groups, 20 individual face-to-face or telephone interviews with fellows and project supervisors and observation of Academi Wales training days.

Although from diverse specialties and stages in training, all participants reported that the Fellowship met expectations. Fellows learned leadership theory, developing understanding of leadership and teamwork in complex organisations. Through workplace projects, they applied their knowledge, learning from both success and failure. The quality of communication with fellows distinguished the better supervisors and impacted on project success.

Small participant numbers limit generalisability. The authors did not evaluate longer-term impact.

Doctors are required to be both clinically proficient and influence service delivery and improve patient care. The WCLF programme addresses both the need for leadership theory (through the Academi Wales training) and the application of learning through the performance of leadership roles in the projects.

This work represents an evaluation of the only leadership programme in Wales, and outcomes have led to improvements.

The purpose of this paper is to report on research on the views of Presidents and Vice Chancellors of Open Universities of current threats and opportunities for their institutions as the author marks the 50th anniversary of the first Open University in the UK established in 1969. The paper offers a historical account of the development of the Open University model, and assesses the extent to which it remains in the key position as owner of innovation in the higher education sector.

Interviews were conducted with leaders of Open Universities or distance teaching universities. They covered a total of 14 universities.

The replies from institutional leaders reveal the current developments, opportunities and strategic challenges of the universities. It is suggested that the digital revolution along with a wider range of environmental changes for higher education have substantially eroded the first-mover advantage that Open Universities had undoubtedly enjoyed in the first 25 years.

The paper concludes that there are significant concerns that innovation in Open Universities is not sufficiently embedded to ensure that their contribution to the UN Sustainable Development Goals will be maximised, or even in some cases their survival, and that a key but undervalued element is leadership development for innovation and change.