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The National Institute of Mental Health England (NIMHE) appointed a Fellow in Ageing and Mental Health to take on a national leadership role for a three‐year period from 2003 to 2006. Starting from a position where the NIMHE website could only address older adult issues under social exclusion, a group of committed individuals in a range of organisations came together and a regional and national work programme in older people's mental health was developed. This paper offers reflections on the issues raised during the Fellowship in respect of older people's mental health services and this Fellowship model of leadership.

The purpose of this paper is to evaluate leadership training in the Sandwich Glaucoma Fellowship (SGF), a program in which fellows learn skills in a developed world institution and their home country to become leaders in glaucoma care.

This paper is a retrospective, qualitative and quantitative evaluation. Participants of the SGF between 2007 and 2019 were provided a survey eliciting demographic information, leadership training exposure, development of leadership competencies and feedback for the fellowship program.

Seven of nine alumni responded. The fellowship strongly impacted leadership competencies including integrity (8.8, 95% CI 7.8–9.8), work ethic (8.64, 95% CI 7.7–9.6) and empathy (8.6, 95% CI 7.7–9.5). A total of 85% of alumni indicated positive changes in their professional status and described an increasing role in mentorship of colleagues or residents as a result of new skills. Lack of formal leadership training was noted by three respondents. Informal mentorship equipped fellows practicing in regions of Sub Saharan Africa with competencies to rise in their own leadership and mentoring roles related to enhancing glaucoma management. Suggested higher-order learning objectives and a formal curriculum can be included to optimize leadership training catered to the individual fellow experience.

Leadership is necessary in health care and specifically in the context of low- and middle-income countries to bring about sustainable developments. The SGF contains a unique “Sandwich” design, focusing on the acquisition of medical and leadership skills. This evaluation outlines successes and challenges of this, and similar fellowship programs. Other programs can use a similar model to promote the development of skills in partnership with the fellows’ home country to strengthen health-care leaders.

This paper aims to evaluate the longer-term impact of the 12-month Welsh clinical leadership fellowship.

Semi-structured interviews with 10 out of 14 trainee doctors who were fellows between 2013-2016, exploring how leadership knowledge and skills were used in clinical practice, impact on patient care and influence on careers. Data, gathered in 2017 when participants had completed the fellowship between 1-3 years, were analysed thematically.

All found the fellowship rewarding. The experience was felt to advantage them in consultant interviews. They gained insight into the wider influence on organisations and the complexity of issues facing senior clinicians. Although subtle, the impact was significant, equipping fellows with negotiation skills, enabling them to better influence change. Indirect impact on clinical practice was evidenced by enhanced confidence, teamworking skills and progression of improvement projects. However, the use of skills was limited by lack of seniority within teams, demands of medical training and examinations. The negativity of others towards management and leadership was also noted by some.

Small participant numbers limit generalisability.

The fellowship is designed to equip participants with skills to lead improvements in healthcare delivery. Those more advanced in their medical training had greater opportunity and seniority to lead change and were better placed to apply the learning. This has implications for whom the training should be targeted.

A rare study exploring the longer-term impact of a leadership programme on later clinical practice, which adds to the body of knowledge of impact and efficacy of leadership training programmes in healthcare environments.

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.

This chapter discusses a new understanding of how leadership is performed and internalized, from which a sustainable model of supporting and promoting educational leadership at the institutional level can be developed. It focuses on what is actually happening in an institution to capture “leadership” in an English higher education institution (HEI). It considers leadership in the context of a continuous professional development route for Senior Fellowship of the Higher Education Academy (HEA) at a Post-1960 English HEI. HEA Fellowship and the UK Professional Standards Framework (UKPSF) are increasingly used within British HEIs to support the professional formation of university teachers. The SFHEA is an internationally recognized accreditation for experienced university staff (academics/support/administrative) able to provide evidence of a sustained record of effectiveness in their practice, incorporating leadership of specific aspects of teaching and learning provision. Participants are evaluated against the criteria and dimensions of practice set by the UKPSF (UK Professional Standards Framework for Teaching and Supporting Learning in Higher Education), which identifies the areas of competence that need to be demonstrated to achieve Descriptor 3, Senior Fellow. In the UK, it is increasingly the case that HE teacher development programs for new and experienced staff are accredited by the HEA against the UKPSF (Land & Gordon, 2015). There is a dearth of literature on program leadership and sustainable leadership in higher education. This chapter is, therefore, particularly timely and suggests that continuing professional development programs “model” good practice, which participants transfer to their own teaching.

The purpose of this paper is to understand the impact of the DeBoer fellowship, a citizen leadership development program in Myanmar. The challenge in Myanmar of catalyzing transformative change facing government and civil society cannot be overstated. Autocratic, centralized, and a traits-based approach to leadership has been, until recently, the primary way to assess leaders in Myanmar. In this dynamic civic context, new ways of leading and learning are needed.

Interviews of DeBoer fellowship alumni were analyzed using a single case study method. The project focuses on individual participants of the program as the primary unit of analysis. In addition, direct observation and contributions from DeBoer fellowship administration and faculty were used to describe this case study.

The DeBoer fellows understood their challenge as one of energize others, a concept of adaptive leadership. Moreover, individuals experienced deep degrees of transformational development. Civic agency was the least noticable concept that was studied.

Future research could more explicitly measure and examine the degree to which civic agency is being nurtured in leadership development programs.

Civic leadership curriculum designers should be more conscious of adult development theory when choosing programming objectives and activities.

Leadership development initatives in more authoritative systems can be effective developmental experiences for participants who are motivated to improve their organizations and communities.

To the authors’ knowledge, this is the first effort to analyze a citizen leadership program in Myanmar.

Improving Global Health is a one year leadership scheme which places trainee doctors and more experienced nurses, midwives and AHPs in a developing country (Cambodia or Tanzania) to develop leadership and quality improvement skills while contributing to Millennium goals in the developing countries. The purpose of this paper is to report on an independent evaluation of the programme, with the purpose of highlighting lessons learned to inform other leadership development initiatives, and in particular to highlight the vital importance of a receptive NHS environment if maximum value is to be gained from investment in clinical leadership.

The evaluation methodology comprised literature review; review of documentation, including on line questionnaires to Fellows; interviews with stakeholders and attendance at key scheme events in July‐September 2011. Fellows who had completed an overseas placement in either Cambodia or Tanzania during 2009‐2010 were interviewed using a semi structured questionnaire. Mentors and Steering Group members were interviewed using an amended version of the Fellows' questionnaire.

Impact was found at the level of personal development; working collaboratively; and understanding the value of audit, teaching and quality improvement. There was some impact on the NHS, however, the majority of Fellows struggled to find opportunities to apply their learning immediately on return from their overseas placement.

Resource and time constraints meant that achievements in meeting Millennium goals were excluded from the evaluation; the authors' working assumption is that only Fellows who enjoyed the Fellowship responded to the invitation to take part; judging the extent to which the Fellowship meets its goal of creating a cadre of improvement champions in the NHS will require time to elapse.

Lessons from implementation of this Fellowship scheme are transferable to the wider NHS.

The paper provides lessons on the design of leadership schemes intended to develop quality improvement skills, particularly for clinicians at an early career stage, illustrates the potential of a placement in a developing country to achieve this, and highlights the importance of a receptive NHS environment to realise maximum benefit from investment in leadership development.

The purpose of this paper is to examine the impact of a structured clinical leadership programme on healthcare professionals working within the British National Health Service (NHS). Clinical leadership is now regarded as essential in addressing the complex challenges in the NHS, yet few trainees of any healthcare discipline receive formal training. The study describes a peer-led evaluation of a year-long, multidisciplinary, experiential programme, the “Darzi Fellowship”, based in London.

An anonymous survey was analysed using a mixed-methods approach. Individual and collective experiences of fellows were evaluated, in particular the perceived impact the fellowship had on: the fellows themselves, their “host” organisation and the NHS as a whole.

A 90 per cent return rate was achieved. In all, 94 per cent reported that the experience had been valuable to them, 85 per cent feeling more empowered to effect change in healthcare systems. Crucial mechanisms to achieve this included increased self-awareness, personal reflection and the freedom to gain a greater understanding of organisations. Particular emphasis was placed on the value of developing clinical networks which promote collaboration across boundaries. Fellows emerged as more reflexive, critical and strategic thinkers.

This paper demonstrates the positive impact that clinical leadership training can have on participants, and the mechanisms by which future leaders can be created.

The novel, non-commissioned, peer-initiated and peer-led evaluation describes the personal experiences of fellows in a unique, multidisciplinary clinical leadership programme. The authors hope this will inform the development of future schemes in the NHS and provide learning for an international healthcare audience.

The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services, and to secure quality healthcare in the NHS beyond the lifetime of the programme.

A longitudinal empirical investigation of clinical leaders (n=80) over an eight-year period was framed through an activity theory (AT)-driven research methodology using a mixed-methods approach.

AT illuminated how change was sustained in the NHS in London through the Darzi Clinical Leadership Fellowship. By any reasonable measurement, this programme excels, with learning and positive behavioural change sustained after the Fellowship across the NHS. Further recognition is needed of the continuing development needs of fellows as they take on more responsible leadership roles in their careers.

Darzi fellows are a hard-to-reach group. The sample represents a response rate of 34 per cent. In total, 77 per cent of respondents emanated from cohorts 5 to 8 programmes.

The investment in a clinical leadership programme focused on systems leadership for quality generates value for the NHS.

Countless interventions flowed through London’s healthcare community and beyond as a result of the Fellowship. This research exposed how Darzi fellows continue to lead innovation for alternative healthcare outcomes. Many proactive fellows employ a suite of learned skills and capabilities to lead systemic change.

This research is the first known longitudinal clinical leadership development study undertaken. The Darzi programme has created a unique clinical network of mutually supportive, team-centric systems thinkers and doers, with an evidence-based approach to systems change. Many fellows are catalysing sustainable change in the healthcare environment.

The United Jewish Israel Appeal Ashdown Fellowship was launched in 2000 with the aim of creating high quality leadership for educational organisations in the British Jewish community. It sought to develop talented and committed people who demonstrated leadership potential. The purpose of this paper is to record the narrative of the programme, its strengths and challenges and to lay out some issues for thinking about the next phase.

A survey was sent to the graduates of the programme to ascertain their assessment of its impact.

Key factors which helped the development of the programme were secure funding, a stable board and professional staff, an emphasis on making fellows feel valued, and access to some of the best people within the academic field of leadership and management and within Jewish education.

The paper presents a case study of leadership development in practice.