CLINICALPSYCHOLOGISTSASFUTURELEADERS

ProjectReportMay2016

“Thankyousomuchforalltheupdatesandemails.IjustwantedtoletyouknowthatIhaveaconditional0.6fteband8ajoboffer!IdefinitelyfeelasthoughtheCPFLprogrammehasalready

helpedme”

“IjustwantedtosaythatsofarIamreallyenjoyingbeingpartoftheCPFLwidercohort.Thankyou”

“Thisprogrammereallyhasbeenagreatlaunchpadforpreparingmeforthenextstageinpursingaleadpost,andIgenuinelyfeelbetterpreparedformyupcominginterviewandpotentialnewrole.”

TableofContentsExecutiveSummary.................................................................................................................................31.Introduction........................................................................................................................................41.1.DefinitionsofLeadership.............................................................................................................41.2CPFLProjectTeamandSteeringGroup........................................................................................5

2.Scopingofthechallengestoinformprogrammedevelopment.........................................................62.1Scoping-Theseniorstakeholderview..........................................................................................62.2Scoping–theJuniorClinicalPsychologist(JCP)survey.................................................................72.3Scoping–JCPFocusCohortInterviews.........................................................................................8

3.Whatwasdeliveredandhowitwasreceived..................................................................................113.1aTheWebsite..............................................................................................................................113.1bFeedbackrethewebsite...........................................................................................................123.2aMonthlyDevelopmentOpportunities&OnlineLearningLinks................................................133.2bFeedbackreMonthlyDevelopmentOpportunities&OnlineLearning....................................143.3aSeminarProgramme.................................................................................................................153.3bFeedbackreSeminarProgramme.............................................................................................153.4aMentoringScheme....................................................................................................................173.4bFeedbackonMentoring............................................................................................................18

4.ImpactonLeadershipactivity...........................................................................................................194.1Follow-upSurvey........................................................................................................................194.2Progressoffocuscohorttowardstheirspecificleadershipgoals...............................................24

5.ConclusionsandRecommendationsforthefuture.........................................................................265.1Recommendations/IssuesforTrustandServiceManagers.....................................................265.2RecommendationsforSupervisorsofJCPs................................................................................265.3RecommendationsforClinicalTrainingCoursesandTrainingSupervisors................................275.4RecommendationsforProfessionalBody...................................................................................275.5RecommendationsforCommissionersofTrainingandtheProfessionalBody..........................28

ExecutiveSummary

1. TheCPFLprojectwassponsoredbyHENCELinordertotrialwaysofincreasingtheleadershipactivityofjuniorclinicalpsychologists(JCPs).TheprojectranbetweenJune2015andMarch2016andwasoverseenbyasteeringgroupmadeupoftheclinicaldirectorsofthesixLondonDoctorateinClinicalPsychologytrainingcourses.

2. Theprojectcollecteddatafromseniorstakeholdersandrecentalumnaeofthesixtrainingcoursesviabothsurveysandin-depthinterviewsoncurrentanddesiredleadershipactivityandbarrierstotake-upofleadershiproles.

3. Keybarrierstogreaterleadershipactivityincludeda)externalandstructuralbarriersaroundemploymentandresources,b)internalfactorssuchasconfidenceandviewsastothedesirabilityofaleadershiprole,aswellasthemoreobviousc)accesstoongoingleadershipdevelopmentskillsandseminars.

4. TheCPFLprogrammewasdevelopedtoaddressthefactorsthatcameoutoftheabovescopingexercises,andJCPcontributorstothebaselinedatawereinvitedtotakepartintheprogram,formingourexperimentalCPFLcohortof46JCPs.

5. ThepilotprogramavailabletotheCPFLcohortcomprisedaccesstoawebsiteprovidinglinkstoonlinelearningoptionsaswellasinformationabouttherestoftheprogramme,monthlyemailshighlightingdevelopmentopportunities,aseriesofworkshopsexperientiallyaddressingkeyleadershiptopics,andamentoringprogramme.

6. Feedbackwasreceivedfrom72%ofthecohortfollowingcompletionoftheprogramme,andwasoverwhelminglypositive.

7. Therewasahightake-upoftheopportunitiesoffered–thewebsitehadover800pageviews,overhalfofthecohorttookpartinonlinelearningordevelopmentopportunitiessignpostedviathewebsite,two-thirdsofthecohorthadattendedatleastoneworkshopwithaquarterhavingattendedfourormoreoftheworkshops,andoverhalfhadalreadymadecontactwithamentorwithinthefirsttwomonthsofstartingthementorshipprogramme.

8. Satisfactionwithallelementswashigh–96%reportedfindingthewebsiteuseful,85%reportedfindingtheworkshopsgoodorexcellent,and100%feltpositiveabouttheirinitialmentoringcontacts.

9. Impactoftheprogrammeonleadershipactivityappearspromising,withpositivemovementfrombaselineinallkeyareasandtheinterviewedfocuscohorthavingmettwothirdsoftheirpersonalleadershipgoalsfortheyear.

10. RecommendationsaremadeforTrustandservicelevelmanagementonaddressingstructuralbarrierstoleadershipactivity,aswellasrecommendationsforclinicalsupervisorsofjuniorpsychologistsandtrainingcoursesonaddressingcognitiveandemotionalaswellasknowledge-relatedbarrierstoleadershipactivity.

11. Recommendationsarealsomadefortheprofessionalbodyregardingroll-outofanationalversionofthescheme,andsettingupofnationalmonitoringofleadershipcontributionsbypsychologists.

1.Introduction

1.1.DefinitionsofLeadershipTheClinicalPsychologistsasFutureLeaders(CPFL)projectwasacrossLondonresponsetoHENCEL’srequestforaprogrammeofprofessionaldevelopmentinleadershipforqualifiedclinicalpsychologistsintheregion.HENCELhadstatedthattheywantedto:

• Improvetheleadershipskillsofqualifiedclinicalpsychologistsinorderthattheycanshapethebroaderpsychologicalworkforceeffectively

• Usebotheducationandthedevelopmentofnetworkstosustainimprovementsinleadershipskills.

Thisreportfeedsbackonthesettingup,runningandoutcomesoftheproject,andprovidesrecommendationsforkeystakeholdersonincreasingtheleadershipcontributionofjuniorclinicalpsychologistsinthefuture.FormoredetailsonthesteeringgroupandagreeddeliverablesseeAppendix.TheNHSHealthcareLeadershipModel,describes9dimensionsofleadership(seebelow).

Priortothebroadadoptionofthismodel,theBPSin2010publishedaClinicalPsychologyLeadershipDevelopmentFramework,andMichelleBrownandSarahDexter-SmithlastyearappraisedtheNHSLeadershipModelintermsofwhatitmeantforclinicalpsychologistsateachNHSband.Whatisinterestingaboutalltheseframeworksisthattheyfocusmoreonthehowthanthewhat,thatistheydescribewhatapersonwouldbedoingiftheywereprovidinggoodleadership-‘howtodoit’,ratherthanwhat‘it’(leading)is.TheWebstersDictionarydefinitionofleadershipis“thepowerorabilitytoleadotherpeople”,andthedefinitionoftheverb‘tolead’isgivenas:

• Tocause(apersonoranimal)togowithonebyholdingthembythehand,ahalter,arope,etc.whilemovingforward

• Tobearouteormeansofaccesstoaparticularplaceorinaparticulardirection.

InourdiscussionswithJuniorClinicalPsychologists(JCPs),wehaveusedthisunderlyingconceptofleadingasmovingotherpeopleforward,whetherbydirectguidance(suchasactingasasupervisor),orviaprovidingtheroutethatallowssomeonetomoveforward(e.g.publishingresearch),andsoughttounderstandfromtalkingtoJCPsandotherstakeholderswhatthefacilitatorsandchallengesaretothem‘leading’inanyoftheseways.

1.2CPFLProjectTeamandSteeringGroupTheproject’sSteeringGroupwasmadeupoftheClinicalDirectorsofthesixDoctorateinClinicalPsychologytrainingcourseswhichcoverLondonandtheSouthEast:Dr.HelenPoteRoyalHolloway,UniversityofLondonProfessorTonyRoth,UniversityCollegeLondonProfessorMargieCallanan,Salomons,CanterburyChristChurchUniversityMs.SueRutter,InstituteofPsychiatry,KingsCollegeLondonDr.NeilRees,UniversityofEastLondonMs.MaryJohn,UniversityofSurreyTheCPFLProjectTeamwasmadeupof:ProjectLead: Dr.JennyTaylor,ConsultantClinicalPsychologistAdministrativeSupport: Ms.AnnetteLock(RoyalHolloway)AsstPsychologistsupport: MsHaniehToussiandMs.SamMcCulloughTheProjectLeadworkedwiththeSteeringGrouptoagreethefollowingoverarchingmethodology–scopingactivitytoclarifystakeholderviewsondesirableoutcomesfortheprojectandbaselinedataoncurrentleadershipactivityandbarriersfromjuniorpsychologistalumnaeoftheuniversitiestakingpart,developmentofthepilotprogramme,evaluationofsatisfactionwithandimpactoftheprogramme,andprovisionofrecommendationsbasedontheworkoftheproject.

2.ScopingofthechallengestoinformprogrammedevelopmentScopingofthechallengeswascarriedoutusingthreeconnectedapproaches.Westartedwithidentifyingkeyseniorstakeholdersandaskingthemwhatwouldbedifferentinthefutureifjuniorclinicalpsychologistswerebetterdevelopedintermsoftheirleadershipskills.Secondly,wecarriedoutanonlinesurveyofDoctorateinClinicalPsychologyalumnaeregardingtheircurrentengagementinleadershipactivities.Thirdly,weundertookin-depthinterviewswithafocuscohortfromwithinthatgroupofalumnae,togainamoredetailedunderstandingoftheircurrentrolesandleadershipactivities,andthechallengestheyfelttheywerecurrentlyfacing.

2.1Scoping-TheseniorstakeholderviewWeinterviewed12seniorstakeholders,includingHeadsofPsychologicalTherapies,CourseDirectors,andtheChairoftheLondonRegionalAdvisoryGroup.Therewerefivemainareasthatseniorstakeholdersidentifiedwheretheywouldliketoseefurtherdevelopmentintheleadershipabilitiesofjuniorpsychologists.Examplesaregivenforeachareas–formoredetailseeSupplementaryData.

FutureLeaders

Responsibility&Risk:

“JCP’swouldbeconfidentinassessingandmanagingriskANDsupporPngteamsto

managerisk”Inihahve&

Entrepreneurial:“JCPswouldunderstandbudgetsandtenderingprocesses,knowhowtohelpkeeptheirservicesafloatusinginformaPon/

markePng/audit/businesscasesetc.”

OutwardFacing:“JCPswouldbebigpicturethinkers,

awareofchanges/developmentsintheNHS/understandingofthelegalcontexte.g.MHA,capacity.”

Involved,effechvecommunicators:“JCPsasgood

communicatorsofpsychologicalideas-beabletoputacrossideassuccinctly,notjustin1000wordreports”

Confidentintheirskillsandroles:

“JCPswouldbeconfidentinthemselvesasseniorhighlypaid

professionals”

UCL34%

UEL20%

Salomon16%

Surrey12%

RHUL10% IOP

8%

SurveycohortbyUniversity

2.2Scoping–theJuniorClinicalPsychologist(JCP)surveyAlumnaeofthesixLondonClinicalPsychologyTrainingcourseswhoqualifiedbetween2010-2012wereemailedbytheiruniversitiesandinvitedtotakepartintheprogramme.67alumnaeresponded,ofwhom51wereeligiblefortheresearchaspect(i.e.werecurrentlyworkingforaLondonTrust,werecurrentlyinworknotonleave).Ofthese51whowereeligible,46signeduptotakepartintheCPFLprogrammeandcompleteourinitialbaselinesurvey.These46areour‘CPFLcohort’,andincludedalumnaefromacrossthe6universities,butwiththegreatestnumbersbeingfromUCLandUEL,inkeepingwiththelargercoursesizesoftheseuniversities.Thecohortworkedinarangeofspecialities,thelargestofwhichwereAdult,thenChild,thenHealth.

TheentireCPFLcohortwereasked8questionswhichwereconsideredtobeindicatorsofleadershipactivityinjuniorpsychologistsbasedonthesurveyofseniorstakeholders:

1. Whatareyourcurrentresponsibilitesintermsofchairingmeetings?2. Whatareyourcurrentresponsibiliteisintermsofmanagingstaff?3. Whatareyourcurrentresponsibilitiesintermsofclinicallysupervisingstaff?4. Intermsofserviceriskmanagement,doyoucurrentlyprovideconultationtootherstaffon

riskmanagement,takepartinanA&Eassessmentrotawithinhours,takepartinanyoutofhoursrotas?

5. Howconfidentareyouinindependentlyassessingself-harm,suicidality,andrisktoothers?6. Whatareyourcurrentresponsibilitiesintermsofservicedevelopment/management?7. Doyoucurrentlyholdanynationalroles?8. Haveyouhadanyengagementwiththemediainthelastyearasapsychologist?

All46ofthecohortansweredallquestions.15%regularlychairedameetingwithintheirservice,withafurther46%beingonarotaforchairingameeting.

Adult39%

Child23%Older

Adults4%

Learningdisability10%

Health18%

Neuro4%

Unknown2%

SurveyCohortbySpeciality

Themajoritywerenotprovidingmanagementorsupervisiontoanyqualifiedstaff-61%notlinemanaginganyqualifiedstaff,72%notclinicallysupervisinganyqualifiedstaff.Encouragingly,72%saidthattheydidprovidesomelevelofconsultationtootherqualifiedstaffonissuesofriskmanagement,althoughonly11%tookpartinanysortofselfharmoroutofhoursriskassessmentrota.Inkeepingwiththeabove,72%saidtheyfeltconfidentaboutindependently(thiscouldincludediscussioninclinicalsupervision,butthentakingresponsibilityforthedecisionratherthanitbeingateamdecision)assessingriskofsuicide,butinterestinglyonly63%saidtheyfeltconfidentaboutassessingriskofself-harm,andonly37%wereconfidentintheareaofassessingrisktoothers.Intermsorservicedevelopmentandqualityimprovement,aboutathird(37%)weretheirservice’sleadforaparticularareaofqualityimprovement,suchasauditing,andagainlessaboutathird(37%)hadsetupanewelementofservicedelivery.Afifth(20%)wereonaTrustcommitteeregardinganareaofqualityimprovement/servicedevleopment,butonly4%hadbeendirectlyresponsibleforsettingupanewservice.Themajoritywerenotinvolvedinoutward-facingprofessionalactivitiesoutsidetheirownTrust–only11%hadhadanationalrole(suchasinvolvementintheBPS,NICEcommitteesetc),andonly9%hadengageedwiththemediainaprofessionalcapacityinthelastyear.Theirresponses(seeSupplementaryDataformoredetails)bothprovidedabaselinemeasureandalsoenabledustofocusourprovisionovertheyearahead.

2.3Scoping–JCPFocusCohortInterviewsOfthe46JCPswhosigneduptotakepartintheCPFLprogramme,12wereselectedtobepartoftheFocusCohort,totakepartinmorein-depthqualitativeinterviewstohelpunderstandwhatspecificleadershipaimsindividualjuniorpsychologistshaveinmindforthemselves,whattheyseeasthebarrierstoachievingthoseaims,andwhattheywouldideallyaccessinaleadershipprogramme,tohelpfurtherfleshoutwhatwouldbemosteffectiveoverthecomingyear.ThefocusgroupwasselectedtoprovidetwoalumnaefromeachuniversityandtogiveusarangeofclinicalspecialitiesandTrusts.Theclinicalspecialitiesareasbelow,andtheTrustsrepresentedinclude:CentralLondonCommunityHealthcare,WestLondonMentalHealth,CentralandNorthWestLondon,SouthLondon&Maudsley,Oxleas,SouthWestLondon&St.George’s,Camden&Islington,UniversityCollegeLondonHospital,andNorthEastLondon.Therewasonemanandelevenwomeninthefocuscohort,onepersonofAsianheritage,ninewhitepeopleandtwoblackpeople.

Aftercompletingthefocusinterviews,thefocuscohortweretheninvitedtoproceedinthesamewayastherestofthecohort,thatistheyhadaccesstothewholemenuofevents,andwereinvitedtocompletethesurveyagainattheendoftheprogramme.

QualitativeanalysisoftheseinterviewshighlightedarangeofbarrierstoleadershipdeliverybeingreportedbytheseJCPs.Thebarrierscouldbeseenasfallingintothreemaintypes–externalorstructuralbarriers(NHSstructure/resourceissues,lackofmanagementencouragement),internalemotionalorcognitivebarriers(lackofconfidence,ambivalenceaboutleadership),andlastly,butperhapsnotmostimportantly,accesstotrainingandknowledge.

Adult33%

Child17%

OlderAdult17%

IntellectualDisability17%

Health8% Neuro

8%

Focuscohortbyspeciality

Adult

Child

OlderAdult

IntellectualDisability

Health

Neuro

Percievedbarriers

NHSstructure/resourceissues:

“Theredon'tseemtobeany8bposts-therewerealltheseJCPsreporPngtoan8d.”

Lackofmanagmementencouragement:

“Ithinkpeopledon’tinvestthatmuchPmein

thinkingaboutyoutakingonotherroles…thefocushasbeenmore

onclinical.”

Lackofconfidence:"ButIdon'thaveenoughtraining"

Ambivalenceaboutleadership:

“Ithinkit’sfindingthatbalance..wanPngtobe

part-PmeversuswanPngtomoveupandusealltheskillsthatIdo,thinkIhavetogive-

uponwork-lifebalance.”

Accesstoleadershiptraining:

“Idothinkthetrainingpsychiatristsgetismuchmorearoundleadershipandaboutbeingmanagersofteams..,andwearenotsetupforthat.”

3.WhatwasdeliveredandhowitwasreceivedFollowingthescopingexercisesdescribedabove,itbecameclearthatabalanceneededtobefoundbetweenprovisionoffurthertraining/educationonleadership,andfocussingonaddressingtheemotionalandcognitivefactorsimpactingontake-upofleadershiprolesbyJCPs.External/structuralissueswereseenasoutsidethescopeofthiscurrentproject(butareconsideredintheRecommendationssection),sothefocusofprogrammedeliverywasonaddressingcognitive/emotionalbarriersandaccesstoleadershipknowledge.Intermsofthedeliveryofseminarsandworkshops,thisunderstandingofthefactorsimpactingonleadershipaffectedthestyleofdelivery,withafocusonsmaller,longer,workshopevents,withopportunitiesfordiscussionandplanningof‘take-home’ideas,ratherthanafocusontheory,inordertoprovidespacefordiscussionofattendeescognitive/emotionalresponsestotheideaofprovidingleadershipinthisdomain.Inadditionwehadaspecificworkshoponconfidenceinpublicspeaking,andseminarswithleadersinvariousfieldsaswellasdevelopingamentoringprogramspecificallyfortheJCPs.TheaccesstoknowledgeprovidedintermsofcontentoftheworkshopsandwhatwasavailableviatheCPFLwebsitewasshapedbythegapsinknowledgeindicatedbytheseniorstakeholderinterviewsandinitialfocuscohortinterviews-seebelowforfurtherdetails.AttheendofMarchtheentireCPFLcohortwerecontactedandaskedforfeedbackretheiruseofandviewsaboutthevariouscomponents–feedbackhasbeenreceivedtodatefrom33/46originalparticipants(72%).

3.1aTheWebsiteACPFLwebsitewassetup,tofosterasenseofcommunityandtoprovideaccesstoinformationaboutonlinetrainingopportunities,upcominglivetrainingevents,andotherdevelopmentopportunities–websitehttp://www.cpfl.org.uk.ThewholeCPFLcohortwasemailedandinvitedtomakeuseofthewebsite,whichalsobecamethehomeofthementoringscheme.Thewebsitewasaccompaniedbyregularemailsdirectingparticipantstoupdatesonthewebsite.Theadjacentisascreenshotofthehomepage:

3.1bFeedbackrethewebsiteThewebsitewaswell-usedbytheparticipants,withclearspikesinviewswheneveremailsweresentouttothecohort.

96%ofCPFLParticipantsthoughitwasfairlyusefulorveryimportanttohaveawebsiteforaleadershipprogrammesuchasthis,and46%oftherespondentshadvisiteditseveral(4ormore)timesovertheyear.FormoreinformationseeSupplementaryData.

“Itfeelsveryimportanttohaveacentralresourceforleadershipopportunities/resources,tocontinuewithavailablementors,aFAQpage/forum” -CPFLparticipant

3%

47%50%

FeedbackonWebsite

Didn'tthinkitwasuseful

Fairlyuseful

Veryimportant

3.2aMonthlyDevelopmentOpportunities&OnlineLearningLinksFunctionsofthewebsiteincludedprovidingideasfordevelopmentopportunitiesthatparticipantscouldtakepartinintheirowntime,andsignpostingtootheronlinelearningopportunities.Themonthlydevelopmentopportunitiesincludedsuggestionssuchasthebelow:GetinvolvedwiththeBritishPsychologicalSocietyThisincludedinformationabouttheBPS,it’sroleasaprofessionalbody,anditsrelationshiptoregulatorybodiesandunions,aswellasinformationand‘how-to’detailson:

• Beingamemberofyourprofessionalbody(andwhyyouwouldbe)• BecominganelectedofficialofaDCPFacultyCommittee• ContributingtopolicyviatheBPS• Beoneofthepublicvoicesofpsychology

EncouragementtospendtimelookingaroundtheirownTrustWebsite“DoyouknowwhotheChiefExecutiveofyourTrustis,orwhotheothermembersoftheBoardare?Doyouknowwhattheirbackgroundsorinterestsare?HowaboutyourTrust'soverallbudgetortotalnumberofstaff,orhowitfaredinit'slastinspection?MuchofthisinformationwillbeavailableonyourownTrust'swebsite,justhaveapokearoundinyourlunchbreak-it'salegitimateuseofTrustresourcesandwillhelpyougetasenseofwhatmightbemotivatingthoseatthetop,whattheyarehavingtoconsider,andthereforewhatopportunitiestheymightbeinterestedin.YoushouldalsobeabletofindthedateofthenextTrustBoardmeetingheldinpublic,whichyoucanattendtogetabettersenseofwhat'sontheagendawhereyouare.Wecan'tdirectyoufromhere,aseachwebsiteisdifferent,butmosthaveasectionalongthelinesof'Whoarewe',or'TheBoard',andyoucanalsoexternallygooglethenameofyourTrustand'BoardMeeting'andthatwillusuallygetyouthereaswell.Youmightwanttohavealookatthepapersofthepreviousmeeting,andmaybediscussthemwithyoursupervisor,totrytogetagriponwhat'sgoingonbeforeyougoalong..Intermsofinspections,youcanalsogodirectlytotheCareQualityCommission'swebsiteandlookupyourTrust'sfacilitiestoseeiftherehavebeenrecentreviews.HappyHunting!”TheonlinelearningpageincludedlinkstoNHSandotheronlineleadershipcourses.

3.2bFeedbackreMonthlyDevelopmentOpportunities&OnlineLearning64%ofourfeedbackrespondentshadtriedatleastoneofthemonthlydevelopmentopportunities,andallwhohadusedthemreportedfindingthemuseful,with48%describingtheas‘Great,woulddefinitelywantthesetocontinue’

55%hadtriedatleastoneoftheonlinecoursessignpostedonthewebsite.FormoredetailedinformationseeSupplementaryData.

52%

48%

0%

FeedbackonMonthlyDevelopmentOpportuniEes

Fairlyuseful,gavemeideas

Great,woulddefinitelythesetoconhnue

Notuseful

3.3aSeminarProgrammeSixfreeafternoonseminars/workshopsfocussingontheareasidentifiedaspartoftheearlierscopingprocessesweredeliveredinsmallinteractivegroupsfromtheAutumntermonwardsincentralpremises–seebelowfortheeventsandpresenters.Oct2015 WorkingwithServiceUserstoimproveServiceDelivery

Nov2015 DevelopingConfidenceinPublicSpeaking

Dec2015 EngagingwiththeMedia

Jan2016

AlternativeLeadershipRoutes-Careersinclinicaltraining/academia-ClinicalPsychologistsasResponsibleClinicians

Feb2016 TwoTalkAfternoon–NHSStructures&Commissioning-NHSTrustStructures-Understandingthecommissioningcontext

March2016

AssessingandManagingRisk

3.3bFeedbackreSeminarProgrammeTwothirdsofourrespondentshadattendedatleastoneseminar,withaquarterhavingattended3ormore.Thosewhohadn’tattendedanycitedamongsttheirreasonsfornon-attendancedifficultyintakingtimeoffwork(theseminarswereWednesdayafternoons),andsuggestionsincludedeveningseminarsandfilmingseminarssotheycouldbewatchedonline.

33%

43%

24%

HowmanyCPFLseminarsdidyouaMend?

None

1-2seminars

3ormore

Attendanceperseminaraveraged11participants(outofthe46ontheprogramme).Combinedfeedbackfromthe6events(92%feedbackrate-59responses)hasbeenverypositive

Commentsonwhattheparticipantslikedabouttheseminarsincluded:“Networking,meetinglike-mindedcolleagues.Sharingideas/experiences.Goodsizeofgroup–nottoobig/toosmall,goodfordiscussions.Likedtheinformalnatureofsharingideas”“Spacetodiscuss‘real’lifeissues”“Brilliant!Reallygoodstrategiestotryandverygoodtips”“Practicalexercisestofocusonandmakingsurewetakeitawaywithus”“Confidence-building”

Ideastheyhadforimprovingtheseminarsincluded:“Longer–aday’ssession?”“Involveajournalistorsomeoneinthemediatohelpteachusfromtheinsideout”“Afollowupworkshop?Toseehowskillshavebeenused?”“Iwouldhaveliketohearalittlebitmoreaboutthepresenter’scareerpaths–concreteexamplesofstepstheytookoropportunitiesthatcametheirway”

Ideasforfutureseminars/seminarstheywouldlikerepeatedincluded:

• Riskmanagement

0

5

10

15

20

25

30

35

1(Poor) 2 3 4 5(Excellent)

Num

bero

fRespo

nses

ResponseRaEngScale

OverallFeedbackforLeadershipEvents

PresentahonStyle(audability,pace,manner)

UseofTeachingAids(overheads,videosandhandouts)

AppropriateLevel

PercievedUsefulness

• Publicspeaking• Leadershipinnon-NHSstructures• Engagingwiththemedia• Workinginamedicallydominatingenvironment–negotiatingtheenvironment• Applying/preparingfor8a/8bposts/interviews• Makingabusinessplan• Facilitatingconsultationgroupstootherstaff

3.4aMentoringSchemeAsadirectresponsetotheinterestinmentoringfromtheCPFLfocuscohort,amentoringschemewassetupwhichwentliveinJanuary2016.ThementorswererecruitedviatheBPSandotherprofessionalnetworks.TheschemeaimedtoprovidetheJCPswithanopportunitytodiscussideasaboutcareerprogressionandleadershipwithaseniorcolleaguespecificallyfromoutsidetheirimmediatemanagement/supervisorystructures,toaddresstheneedexpressedbyJCPsforaspacetodiscussmanagementofworkpoliticsandtheircareeraspirationswithseniorcliniciansnotdirectlyinvolvedinmanagingandappraisingthem

Whatdiditinvolve?Therequestwasforseniorpsychologistswhowouldbepreparedtoofferquarterlymeetings/phoneconversationstoamenteeoverayear-longperiod.Theaimwouldbeforthementortousethefirstconversationtolearnaboutthementee,theircurrentsituation,theirskillsandinterests,andtheiraspirations,andtothenthinktogetheraboutgoalsthementeemightwanttofocusonovertheyearahead,andstepstheymighttaketoattainthosegoals.Thethreeadditionalmeetings/conversationswouldbetofollowuponprogresstowardsthosegoals,andshareexperienceandideastohelpthementeeintheirprogression.

Howdiditwork?MentorsprovidedbasicinformationaboutthemselveswhichwasusedtocreateanentryforthemonourCPFLMentoringWebsite,wherejuniorpsychologistscanseewheretheyarebased,whattheirareasofworkare,andapproachthemdirectlytorequestbeingtheirmentee(seeexampleentrybelow).SampleMentorEntry-SusieConnorsSusieiscurrentlytheLeadPsychologistforPeoplewithLearningDisabilitiesinSouthamNHSTrust.SusiehasworkedforvariousNHSTrustsduringhercareer,andalsohasanindependentconsultancyprovidingtrainingtoresidentialhomesaroundtheneedsofpeoplewithLD.Asablackpsychologist,Susieisparticularlyinterestedinsupportingmenteesfromminoritybackgroundstothinkabouthowthisimpactsontheirprofessionalpathway.SusiecanbecontactedatSusie.connors@southam.nhs.uk.

Mentorswerethenfreetoacceptordeclinethoserequests,dependentontheircurrentavailability,andweaskedthemtoletusknowiftheywantedustotakedowntheirentryif,forexample,theyalreadyhadamenteeorwouldn’tbeabletotakeonamenteeforasignificantperiodoftime.OurCPFLcohortwereallemailedaboutthementoringprogrammeandinvitetoviewthelistofmentorsandmakedirectcontact.

3.4bFeedbackonMentoringAsthementoringpageonlywentliveinJanuary,wehavelimitedfeedbackasyetonitsimpact.Intermsoftake-up,55%ofthefeedbackrespondentshavealreadymadecontactwithamentor,andnearlyhalfofthosehavehadaninitialmeeting/callwiththeirmentor.Thosewhohadn’tmadecontactwithamentoreithercitedalreadyhavingsimilarformalorinformalopportunitiesinplacealready,orsaidthattheydidn’tseeanyoneamongstthecurrentlistofmentorswhoseareasofworkoverlappedwiththeirssufficientlytomakeitlikelytoseemmeaningful.Thosewhonowhaveamentorareeitherfeelingverypositiveaboutthis(50%)orarecautiouslyoptimistic:

“Thelistofmentorswasreallygood.ThereweretwoontherethatimmediatelyjumpedouttomeandIcontactedthemquicklyandwasluckyenoughtosecurethemboth.Havingthatlistmadeitmucheasiertofindamentorandaccessthem.““FormethiswasthemosthelpfulelementoftheCPFLprogramme”“IfeltlikemymentorgavemeadvicethatIhavenotheardfromotherpeoplewhichwasveryhelpful”Asthementoringcomponenthasbeenrunningfortheshortestperiodoftime,afullreviewofimpactwilltakeplacelaterintheyear.

0%

50%50%

Whatdoyouthinkofthementoringsofar?

Notimpressed

Thinkitmaybehelpful

Feelingreallyposihveaboutthishelpingmydevelopment

4.ImpactonLeadershipactivity

4.1Follow-upSurveyWehada72%responserateinourfollow-upsurveyregardingwhatleadershipactivitiesthegroupwereengaginginattheendoftheproject.Theresultsshowslightincreasesacrosstherangeofleadershipactitvitiesandalthoughthenumbersaresmall,theyareallinthedirectionofincreasedleadershipactivitiy/responsibility,sometimesviasubtleshiftssuchassupervisinglessunqualifiedstaffbutmorequalifiedstaff,lessJCPsbeingtherepresentativiesenttoacommitteebutmoreleadingonaservicearea.Thesechangesmayofcoursebetheresultofnaturaldevelopmentovertheninemonths,butitisencouragingthatallthemovesareinapostivedirectioneveninthisrelativelylimitedamountoftime.

Q.1Doyouregularlychairmeetings?Atfollow-uptherewasaslightincreaseinthepercentagereportingbeingtheregularchairsofmeetings(from15%-18%),andadecreaseinthosechairingmeetingsonarotatingbasisornotchairingmeetingatall.

0 20 40 60 80 100

RegularChair

RotaChair

NoChairing

Follow-up Baseline

Q.2Doyoulinemanagestaff?Thereseemedtobeashiftfrommanagingunqualifiedstafftomanagingqualifiedstaff(11%originallygoingupto18%atfollow-up)butnosignificantdifferenceinthosewhodidn’tmanageatallandthosewhomanagedwholeteams.

Q.3Doyouclinicallysupervisestaff?Therewasanincreaseinthereportsofthepercentageclinicallysupervisingqualifiedstaff,from28%to36%,andareductioninthosesupervisingno-one.

0 20 40 60 80 100

Imanageateam

Ilinemanagesomequalifiedstaff

Ilinemanagesomeunqualifiedstaff(e.g.trainees)

Nollinemanagementresponsibilihes

Follow-up Baseline

0 20 40 60 80 100

ClinicalSupervisorofqualifiedstaff

ClinicalSupervisorofunqualifiedstaff

NoClinicalSupervisionresponsibilihes

Follow-up Baseline

Q.4Intermsofriskmanagement,whichofthefollowingformpartofyourrole?Therewasanincreaseinthepercentageprovidingconsultationtootherstaffregardingriskortakingpartinoutofhourscrisismanagementrotasfrom74%to83%(althoughinterestinglyadecreaseinreporteddaytimeriskrotainvolvement).

Q.5Howconfidentdoyoufeelaboutassessingeachofthefollowingindependently?Therewasincreasesinthepercentagereportingfeelingconfidentinallareasofriskassessmentwithconfidenceinassessingsuicidalityincreasingfrom71%to82%.

0 20 40 60 80 100

Consultahontootherstaff

DayhmeA&Eassessment

Outofhourscrisis/A&Eassessment

Follow-up Baseline

0 10 20 30 40 50 60 70 80 90

Selfharm

Suicidality

RisktoOthers

Follow-up Baseline

Q.6Whatareyourcurrentresponsibilitesintermsofservicedevelopment/improvementGeneralengagementinserviceimprovementdidn’tchangesignifciantly-therewasadecreaseinthoseleadingonanareaofserviceimprovementorsittingonacommittee,butanincreaseinthepercentagewhoreportedhavingsetupanewelementofservicedeliveryoranewclinicalservice(4%to12%)

Q.7Doyoucurrentlyholdanynationalroles?Therewasasmalloverallincreaseinthepercentagereportinganysortofnationalrole(from11%to16%),andinterestinglyinparticulartherewasanincreaseinthepercentagereportinghavingaroleonaBPScommittee(2%to13%).

0 20 40 60 80 100

Serviceleadforanimprovementarea,e.g.audit

OnaTrustCommiseeregardinganaspectofserviceimprovement

Havesetupanewelementofservicedelivery

Havesetupanewclinicalservice

Follow-up Baseline

0 20 40 60 80 100

OnaBPSCommisee

Othernahonalrole

Nonahonalrole

Follow-up Baseline

Q.8Whatengagementhaveyouhadwiththemediaoverthelastyear?Lastly,whilstwehaven’tasyetseenanincreaseinthepercentagereportingbeinginterviewedontheTV/Radioorhavingaprofessionalinternetpresence,wedidhaveareportedincreasefrom2%to6%intermsofhavingbeenpublishedorquotedinthepress.

0 20 40 60 80 100

Interviewedonradio/TV

Publishedorquotedinpress

Professionalinternetpresence

Follow-up Baseline

4.2ProgressoffocuscohorttowardstheirspecificleadershipgoalsThe12membersoftheFocusCohortwereallencouragedtosetthemselvesleadershipgoalsforthenexttwelvemonths,andtodiscussthesewiththeirmanagersintheirnextappraisal,inordertohavethemaspartofadevelopmentplanreviewedandsupportedbytheirlinemanagement.Theywereinvitedtosendcopiesofthegoalstheydevelopedintotheprogramme,whichnineofthetwelvedid.InApril2016,thefocuscohortwerere-contactedandaskedabouttheirprogresstowardstheirindividualleadershipgoals,andwhatfactorshadhelpedorhinderedprogress.Sixoftheoriginalninerepliedbyemail,andtwoofthemofferedtohaveaphonefollow-upinterview.Theirgoalshadincluded:takingonclinicalsupervisionofothers,publishingapaper,increasedconfidenceinspeakinginteammeetings,gettingan8aor8bpost,beingonaBPScommittee,gettingabookcontract,engaginginresearch,providingconsultationtoastaffgroup,impactingonclinicalKPIsintheirworkplace(reductionofchallengingbehaviourontheward,writingabusinesscasetosetupanewelementofservice,negotiatingandmanagingabudget.Theyreportedonaveragethattwo-thirdsoftheirgoalshavingbeenmetovertheyear.Obstaclestoreachingtheirgoalsappearedtobemainlyexternal/structuralandincludedservicesnotbeingsupportiveoftakingontraineesduetolackofphysicalspace,non–psychologistmanagersnotseeingtraineesasavaluableresource,andsomeJCPsbeinginpart-timerole,andthisbeingseenasreallyhamperingtheirabilitytobringevidenceofsupervisiontoapplicationsformoreseniorroles.OtherobstaclestomeetinggoalsaroundBPSmembership/committeeinvolvementincludedthelackofperceivedvalueforthefeesinvolvedinjoiningtheBPS,anddifficultiesinaccessingotherBPSmemberstosupportaBPSmembershipapplication(onerespondentsayingshedidn’tknowofanyoneinherservicewhowasamember).Thebiggestobstacleseemedtobegainingsupporttofocusonactivitiesotherthanface-to-faceassessmentsandtherapysessionsinservicesthatwereunderconsiderableclinicalpressure.Recommendationsforimpactingonexternal/structurallimitingfactorsarediscussedinSection5.Intermsofwhathadhelpedthemreachtheirgoals,theycitedspecificCPFLseminars,accessingamentorviaCPFL,themonthlyemailsfromtheprojectwhichservedasreminderstothinkabouttheirLeadershipCPD,theirinitialfocuscohortinterviewswhichonedescribedas‘givinghertheconfidencetotryforan8arole’,andanotheras‘justhavingthatdedicatedtimetothinkaboutyourcareerandhavesomeoneaskcuriousquestionsaboutthejobyouareinwasveryhelpful’.ExternalfactorsthathadsupportedthemincludedhavinganappraisalshortlyaftertheinitialCPFLinterview,andusingthattodiscusstheirCPFLgoalsandworkouthowtoactionthemintheworkplace,andhavingasupervisorsupportthemintryingoutaleadershiprole(inthiscaseprovidingconsultancytoastaffgroup)whichtheywereanxiousabout,andprovidespecificsupportarounddoingso.Unsurprisingly,particularstridesweremadewhenJCPswereabletomobiliseincreasedengagementintheirleadershipdevelopmentfromtheirin-workseniorstaffasaresultoftheCPFLprogramme:[FollowingdiscussionofthegoalsetaspartoftheCPFLprogramme]…mymanagersuggestedthatIcouldpitchanotherbusinesscasetoseeifIcouldgetontothenationaltrainingprogrammeforthe

NHS-QSIR.Iwrotethebusinesscasearoundmakingthedepartmentpaperless(inlinewithrecentNHStargetstobecomepaperlessby2020)...Itookbaselinemeasures,implementedaninterventionandthentookoutcomemeasures.Theprojectwasasuccessnotonlyinreducingpaperwasteinthedepartmentbutalsospeedingupthetimefromreferraltoofferingapatientanappointment.Ithensubmittedtheprojecttoa"GreenWards"environmentcompetitionruninternallyatUCLH.Iwasluckyenoughtowin!Wehaveatrophyinthedepartmentnowandhave£500ofprizemoney...Allveryexcitingandinspiring.”“[AttendingtheCPFLtrainingevents}..ledtoinformaldiscussionswithleadcolleaguestodiscussthebusinesssideofclinicalleadership.Allofthishelpedsomuchandhasresultedinmesubmittinganapplicationforan8bLeadPsychologistpostandIhavebeeninvitedtointerviewforthis.”Overall,thefocuscohortinterviewsindicatedthataconsiderableboosttoconfidence,focusandengagementwithexistingsupportstructureswasgainedbyhavinganindividualgoal-settinginterview(asisnowbeingofferedbyourmentors)followedbyongoingcontactandopportunitiessuchasweredeliveredviatheCPFLprogramme:“IhavejoinedtheCYPFFacultyCommitteeandI'mnowPRandSocialMediaRep,andinvolvedinvariousprojectsonthebackofthis.ThiswouldnothavehappenedwithoutthesupportoftheCPFLProgramme.IhavealsoattendedMediatrainingthroughbothCPFLandthroughmynewroleintheBPS.IwroteareviewforthePsychologist–theinvolvementwiththeprogrammehasgivenmeanumberofexperiencesformyCV,whichI'msureplayedapartingaininganinterviewforan8bpost.”Anotherwrotetous:“Thankyousomuchforalltheupdatesandemails..Justourfirstinterview,wherewemappedoutgoals,talkedaboutorganisationaldynamicsandthat"theskiesthelimit"feelingyougave......It'sthe"whynot""goget'em"leadershipmentalitythathasgivenmetheenthusiasmtotry.Iamthereforeofferinglotsofconsultationonthewards.YouremailsaboutBPSopportunitieshavealsoreallygivenmefocus-althoughIprobablygetBPSeventsemails,Ihadn'tseenMonday'sfreeconferenceonresearchdevelopment,(untilyoure-sentit)whichIamreallylookingforwardto,asIdoalotofresearchinmy"sparetime"...So,Ihadthree8ainterviews,monthaftermonth,afterwemet,andIwassuccessfulwiththelastone!“

5.ConclusionsandRecommendationsforthefutureWearegratefultoHENCELforprovidingtheopportunitytounderstandingreaterdetailthefactorssupportingandhinderingthedevelopmentofleadershipamongstclinicalpsychologists.Wehopetousetheinsightsfromthisworktoimpactonleadershipactivityinthefutureinlinewiththerecommendationsbelow.Overall,itisclearisthatthereisarealappetiteforleadershipdevelopmentamongstJuniorClinicalPsychologists,andthattheprovisionofarangeofdevelopmentstrategies,includingbutnotrestrictedtoformalleadershipcourses,islikelytoincreasetheextenttowhichJCPshelpotherstomoveforwardindeliveringthesortofcarethatwewouldallliketoreceive.

5.1Recommendations/IssuesforTrustandServiceManagers

• UsingJCPspurelyasfrontlinecliniciansisnotanefficientuseoftheinvestmenttheNHShasmadeintheirtraining–JCPsshouldbeusedinprovisionofsupervisionandconsultationtootherstaff,anddeliveryofteaching,trainingandresearch,aswellasfrontlineclinicalwork.

• Incorporationofassistantandtraineeclinicalpsychologistpostsintoserviceplanningbothincreasesthecapacityofqualifiedpsychologistsbutalsoimportantlyprovidesthetrainingofthenextgeneration.SupervisionofassistantsandtraineesalsoprovidesaninitialstepinthedevelopmentofsupervisorandmanagementskillsinJCPs.

• InordertomaximisetheleadershipcontributionofJCPsacrosstheNHS,itisimportantthatindividualTrustsseesupportingthedevelopmentofJCPsinlocumorpart-timepostsasofequalprioritywithsupportingthoseinfulltimesubstantivepostsintermsofanequitableandwhole-NHSstrategy.

• Inclusioninthejobplansofseniorstafftimeformentoringofjuniorstaff,inlinewiththerecommendationsformentoringofmedicalstaff(BMA).

5.2RecommendationsforSupervisorsandLineManagersofJCPs

• JCPsneedregular(atleastmonthly)supervisionfromqualifiedclinicalpsychologists,thatincludesafocusonleadershipdevelopment,iftheyaretofullydevelopasseniorNHSleaders

• Appraisalsshouldclearlyincludegoalsintermsofleadershipdevelopmentaswellasclinicaldelivery–ideasregardingappropriategoalscanbesourcedviatheBPSLeadershipFrameworkoftheadaptedNHSLeadershipModelforAppliedPsychologists(http://www.nelacademy.nhs.uk/downloads/276)

• Attentionshouldbepaidtothecognitiveandemotionalbarriersthatimpactonengagementinleadershipactivity,aswellasanytrainingneeds,andappropriateinterventionsco-developedwiththeJCPstoaddressthese.

5.3RecommendationsforClinicalTrainingCoursesandTrainingSupervisors

• Continueworkwithclinicalsupervisorsoftraineesonprovisionofleadershipopportunitiesinplacements,especiallymakingthesecontemporaneouswithleadershipteachingwherepossible,toavoidleadershipteachingbeingexperiencedasunrelatedtoplacementwork

• Greaterfocusinsupervisortrainingonhowsupervisorscanprovideleadershipopportunitieswithinplacements,andproblem-solvinganybarrierstodoingso

• Leadershipcomponentsofclinicaltrainingdeliveredinawaythataddressesinmoredepththecognitiveandemotionalbarrierstoleadershipactivitye.g.seminars/workshopswherespecificaspectsofleadership(e.g.consultingtoagroup,advisingonrisk,supervisinganassistant)arediscussedandthenroleplayed,ratherthanafocusonleadershiptheory

• Exploringandaddressingcognitive/emotionalbarrierstoleadershipviaindividualmeetingswithcoursetutors/existingappraisalsystems,

• CourseSupervisorstoencouragetraineestoconsiderspecificgoalsforleadershipactivityintheirfirsttwoyearspost-qualificationaspartoftheirfinalappraisal,andthinkwiththetraineesabouthowtheymightbringthesegoalsintotheirworkplaceappraisalspost-qualification.

• Ensurethatfinalyeartraineeshaveabetterunderstandingofthedifferingrolesthatunions,professionalbodiesandregulatorswillplayintheirpost-qualificationprofessionallives.

• Talentmanagement-providesignpostingtorelevantexternalleadershipprogramsandmentoringopportunitiesforthoseshowingstrongleadershippotential.

5.4RecommendationsforProfessionalBody

• ThattheDCP’sLeadership&ManagementCommitteetakeforwardtheproposedroll-outofanationalCPFLscheme,engaginglocalbranchesandTrustsandmakinguseoftheinfrastructureandresourcesdevelopedinthisCPFLproject

• ThattheDCPengageswith3rdyearclinicaltraineesintermsofprovidinginformationontheroleoftheprofessionalbody(e.g.anonlineinfovideo/presentationwhichtraineescanbesignpostedto),easyaccesstomembershipregistration,andinformationaboutthenationalCPFLschemeifrolled-out.

• ThattheDCPmonitoratanationalleveltheengagementofpsychologistsinseniorleadershipresponsibilities,including,butnotlimitedto:- Trustdata–numbersofpsychologistsleadingteams,psychologistsatBoardlevel,as

Directors,ChiefExecs- Number/proportiononApprovedClinicianregister- Number/proportionofNICEcommitteesrelatedtomentalhealthchairedby

psychologists- Number/proportionofLondonCCGmembers/chairswhoarepsychologists

5.5RecommendationsforCommissionersofTrainingandtheProfessionalBody

• Reviewofthestructuresthatsupportthetransitionofmedicaldoctorstoconsultantgradeandthepotentialtransferabilityofelementsofthesestructurestosupportingthetransitionofpsychologicaldoctorstoconsultantgradeinamoresystematicfashion.