Retention Charter action 4.1

Action 4.1: Supporting existing medical leaders to remain motivated and deliver their best.

Action 4.1 is part of Domain 4 of the RCPsych's Retention Charter for employers - which relates to developing medical leadership.

What stage is your organisation at?

Use this maturity matrix to assess what stage your organisation is at, in terms of Action 4.1.

  • Policies relating to job planning include clear recognition of medical leadership roles and responsibilities in clinical, educational, and academic work. Supported professional activity (SPA) time allocated to such roles is regularly reviewed as workload and responsibility changes.
  • Appraisal processes include specific recognition of medical leadership performance and competencies within clinical, educational, and academic work.
  • The organisation has networks in place where medical leaders regularly come together to share learning and support one another.
  • Continuing professional development activities relating to building and maintaining leadership competencies exist within the organisation.

  • Existing medical leaders have equitable access to 1:1 mentorship and/or coaching opportunities within the organisation or by facilitating their access to such opportunities externally.
  • The organisation actively supports medical leaders in completing specialist leadership programmes and/or qualifications external to the organisation to further their development.
  • Provisions are in place for medical leaders to routinely discuss and reflect on the emotional challenges of their work with peers such as through Balint groups, reflective practice sessions, Schwartz rounds or similar initiatives.
  • The views, experiences, and achievements of medical leaders are routinely collated by the organisation through formal feedback and appraisal processes.

  • The organisation demonstrates regular appreciation of medical leaders through formal mechanisms such as letters, certificates, events, and awards to promote and celebrate leaders excelling in their work.
  • Mechanisms exist to share good practice in medical leadership both within and outside of the organisation.
  • Responsible Officer (RO) training is offered for all psychiatrists in senior medical leadership positions so that decisions regarding referral to the regulator are taken proportionately and equitably.
  • The organisation demonstrates, with appropriate evidence, that it routinely acts on feedback from medical leaders and enhances leadership experience at all levels, linking this to improved patient care.

Advice and recommendations

  • Standardise and review job planning templates for leadership roles (including clinical, educational, and research leadership), ensuring that expectations of these roles are clearly delineated and there is sufficient allocated time and resource for psychiatrists to perform them effectively. Current medical leaders should be involved in this review process and the unique demands of balancing leadership roles with clinical responsibilities should be clearly recognised and support given to manage this balance.
  • Include recognition of leadership performance in organisation-wide staff recognition and reward systems and consider nominating medical leaders excelling in their roles for regional/national awards.
  • Ensure that regular 360-degree feedback is collated for medical leaders and that this is used to recognise positive practice, inform their development, and set future objectives. 
  • Create coaching and/or mentoring opportunities for those in leadership positions by offering coaching or mentorship training, creating a database of coaches/mentors with their contact details, and routinely offering this to new clinical leaders.
  • Advertise external leadership development courses, schemes, and qualifications to medical leaders and ensure that there is sufficient funding available to support them in these endeavours. Ensure that these courses, schemes and qualifications are tailored towards leadership at various levels.
  • Implement weekly peer supervision, support, and/or mentoring to support the development of medical leaders. In addition, encourage ‘reverse mentoring’ where senior medical leaders can learn from, as well as teach and support, their junior colleagues.
  • Establish medical leaders networks, leadership development days, and good practice events where peers can come together to share positive practice, discuss challenges and concerns, and provide mutual support. This includes reflections on managing the practical and emotional demands of clinical work alongside formal leadership roles.
  • Ensure that leadership competencies and opportunities are discussed in medical appraisals by including this in appraisal paperwork/checklists, standardising appraisal processes, and offering appraisal training. There should be recognition that medical leadership is unique and requires significant expertise juggling clinical and leadership commitments. 
  • Collate regular feedback from medical leaders about facilitators and challenges to them achieving success in their roles, working with them and wider networks to identify solutions to challenges.
  • Organise regular training and development opportunities for medical leaders, supporting their development of system leadership skills, understanding of the broader determinants of health, and the development of leadership within wider relevant systems across the four nations. This training should include effective onboarding as people begin leadership roles and continued training and development opportunities as they progress. For example, courses for clinical directors and aspiring clinical directors could include access to peer-support and action learning sets based on their area of work.

    Links and resources

    Examples of good practice

    Solent NHS Trust worked with NHS Shared Business Services (SBS) to offer comprehensive telephone interviews with an independent HR specialist for those leaving the organisation.

    This resulted in significantly increased engagement in exit interviews and the collation of detailed data which enabled the organisation to identify priority areas for improvement and take positive action.

    They subsequently achieved reductions in employee turnover and 94% of leavers who completed exit interviews with NHS SBS rated them positively.