Developing leaders, strengthening systems: evaluation of a multidisciplinary healthcare leadership programme

PURPOSE: Evaluations of healthcare leadership development programmes often rely on short-term self-report and rarely examine organisational impact. This study aims to evaluate four cohorts of the multidisciplinary emerging leaders programme (ELP), using a theory-informed mixed-methods design with longitudinal follow-up across all four Kirkpatrick levels (reaction, learning, behaviour and results). DESIGN/METHODOLOGY/APPROACH: The programme consisted of seven or eight full-day workshops and included team quality improvement (QI) projects as the experiential learning element. Ninety-four participants from multidisciplinary backgrounds within Oxford University Hospitals NHS Foundation Trust completed the programme. Qualitative data included 39 reflective essays and 21 semi-structured interviews conducted 3-4 years post-programme. These data were analysed using Braun and Clarke's approach to thematic analysis. Quantitative data included workshop ratings, pre/post affective commitment scale (ACS), turnover intention scale (TIS-6) and an adapted medical leadership competency framework questionnaire (MLCFQ). 86 (91%) completed pre- and 72 (77%) completed post-programme questionnaires, resulting in 55 (58%) paired questionnaires. Results were compared using Wilcoxon signed-rank tests, adjusted for multiple comparisons. FINDINGS: Participants reported improvements in leadership knowledge, confidence and emotional intelligence. There were significant improvements across all MLCFQ domains (median change + 0.6 to + 0.9; adjusted p < 0.005 for each). Participants reported application of QI tools, stakeholder engagement, conflict management and distributed leadership. The ACS and TIS-6 showed no significant pre/post changes. Participants described sustained service improvements and system contributions, including redesigned patient pathways, team processes, externally funded innovations and initiatives that maintained service continuity. ORIGINALITY/VALUE: This study demonstrates an evolving and sustained impact of the ELP, with outcomes extending beyond individual capability gains to behavioural change and organisational benefits.