AB069. SOH24AB_085. Leadership in healthcare: a nationally representative mixed methods analysis of the perceptions and experiences of non-consultant hospital doctors

Background: Perennially non-consultant hospital doctors (NCHDs) move between hospitals and specialities. With this broad exposure, NCHDs are uniquely positioned to offer insight into the current leadership within the Health Service Executive (HSE). Change can only be instituted successfully and embedded in the culture with inclusive buy in by all staff. Furthermore, it is not possible to analyse leaders in the absence of followers or context. Therefore, it is imperative to assess this from the NCHDs perspective. Hitherto, there is little known about how junior doctors conceptualize leadership, this is important as perception impacts overall behaviour. Methods: Purposeful sampling of lead NCHDs was undertaken and continued in a snowball fashion. NCHDs were continually recruited until saturation of themes from data generation. After piloting of questions, a peer-to-peer semi-structured interview and quantitative survey was conducted by two interviewers. Notes were transcribed and thematic analysis undertaken. Results: A total of 14 NCHDs of different grades and specialty undertook an interview. All hospital groups of the Republic of Ireland were represented. Attributes felt to best encapsulate good leaders included authenticity, communication, and teambuilding. NCHDs felt characteristics of ineffective leaders included egotism, a lack of culpability, and misplaced priorities. NCHDs experience of leadership styles, hospital culture, and motivations was also explored. Several methods of improving the leadership within the HSE was postulated by NCHDs. Conclusions: Utilising qualitative and quantitative metrics, this study highlights the importance placed on the domain of leadership by NCHDs, how they interpret current practices of leadership within the HSE, and their proposals of methods to improve clinical and executive leadership.