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Introduction Recruitment and retention of medical staffing within the NHS workforce are both complex problems, with staff satisfaction falling, and increasing vacancy rates. Conversely, growing evidence shows that effective medical leadership and management have a positive influence on patient outcomes, quality of care and innovation, staff morale, and organisational performance. Aims and objectives of the research project or activity Locally, our same-day emergency care unit (SDEC) has rapidly expanded and doubled in capacity, therefore requiring a new medical workforce to deliver this service. We predicted the workload to be intense, whilst also recognising the aforementioned benefits of early career medical leadership. It is acknowledged that increasingly service-driven jobs provide less opportunity for learning, teaching, innovation and quality improvement. As a result, our aim was to create a role which provided necessary clinical provision, whilst also fostering this culture of leadership, quality improvement, research and education. Furthermore, this abstract aims to contribute to the literature on novel and hybrid leadership roles amongst the junior doctor workforce. Method or approach We implemented a clinical fellow role, modelling the Royal College of Physicians (RCP) Chief Registrar (CR) role. Since 2016, this scheme has provided a leadership role for trainee doctors, following on from the recommendations within the RCP Future Hospital Commission Report. The CR position provides a combination of clinical, and non-clinical, leadership and service development roles. CR's were already employed locally, however in light of the workforce issues and benefits outlined, the concept was replicated and several clinical fellow roles were implemented in 2018. The clinical fellow role purposefully addressed domains set out in GMC guidance, such as quality improvement, leadership, research and education. The role comprised of 60% clinical work within an SDEC, with the remaining 40% as protected, self-directed non-clinical time. The overarching aim of this job plan was to allow clinicians to develop an embedded culture of learning and improvement. Findings Five years later, we have contributed to the professional development of 45 doctors (8 Chief Registrars, 22 registrars, and 15 senior house officers (SHO)), with case examples of two doctors retaining and progressing from SHO up to the eminent CR role. Examples of impactful work can be summarised; Research Numerous publications have contributed to evidence bases, as well as the development of services beyond our hospital. We are a proactive research-involved unit, with more than several research projects recruiting eligible patients from our department Quality Improvement Opt-out HIV screening has been sustained within the unit for more than 3 years. Innovative interface between acute medicine and specialities, with the development of a heart failure and acute oncology virtual ward Organisation-wide quality improvement projects in keeping with the trust's priorities and strategy Leadership Career progression to departmental clinical lead Faculty members for an FMLM accredited leadership programme, contributing to the education of more than 200 healthcare professionals Annual engagement events liaising with key stakeholder groups to improve both staff and patient experiences. Education Procurement of point-of-care ultrasound probes, and the development of an educational programme Key messages GMC leadership guidance outlines the expectations for 'doctors to engage with colleagues, to maintain and improve the safety and quality of patient care, as well as contribute to discussions and decisions about improving the quality of services and outcomes'. As a result, by emulating the chief registrar position and creating this new dynamic role, we have successfully recruited and retained candidates for multiple years. Recruitment is an ongoing challenge within the NHS, therefore services need to adapt to provide innovative job plans to allow personal and professional development leading to the retention of doctors, as well as potential improved patient outcomes and organisational performance.
Bunn et al. (Fri,) studied this question.