Darzi Clinical Leadership Fellows: an activity theory perspective.

PURPOSE: The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services, and to secure quality healthcare in the NHS beyond the lifetime of the programme.

DESIGN/METHODOLOGY/APPROACH: A longitudinal empirical investigation of clinical leaders ( n=80) over an eight-year period was framed through an activity theory (AT)-driven research methodology using a mixed-methods approach.

FINDINGS: AT illuminated how change was sustained in the NHS in London through the Darzi Clinical Leadership Fellowship. By any reasonable measurement, this programme excels, with learning and positive behavioural change sustained after the Fellowship across the NHS. Further recognition is needed of the continuing development needs of fellows as they take on more responsible leadership roles in their careers.

RESEARCH LIMITATIONS/IMPLICATIONS: Darzi fellows are a hard-to-reach group. The sample represents a response rate of 34 per cent. In total, 77 per cent of respondents emanated from cohorts 5 to 8 programmes.

PRACTICAL IMPLICATIONS: The investment in a clinical leadership programme focused on systems leadership for quality generates value for the NHS.

SOCIAL IMPLICATIONS: Countless interventions flowed through London's healthcare community and beyond as a result of the Fellowship. This research exposed how Darzi fellows continue to lead innovation for alternative healthcare outcomes. Many proactive fellows employ a suite of learned skills and capabilities to lead systemic change.

ORIGINALITY/VALUE: This research is the first known longitudinal clinical leadership development study undertaken. The Darzi programme has created a unique clinical network of mutually supportive, team-centric systems thinkers and doers, with an evidence-based approach to systems change. Many fellows are catalysing sustainable change in the healthcare environment.