Creating clinical leaders, transformation pioneers and innovation specialists: because change starts from the ground up

Those of us in the room have the power we need to fundamentally improve the quality of multiple sclerosis (MS) care in the UK, reduce variation and offer consistent care at the level we want everywhere, in the next 3 years.

In July, 85% of 120 healthcare professionals agreed with this statement (‘Raising the Bar’, MS Academy, 2019).

There are many ways to try and change healthcare, whether it is by influencing the policy-makers, collaborating with commissioners, or making clear business cases to management. However, the changes needed are often too nuanced, condition-specific, or have a return of investment too far in the future to gain the necessary attention in these circles. It can be difficult to gather the impetus needed for change to really be felt by those people directly experiencing the services. In order to effect real change in health services, often that change must be led by those delivering the services on the ground.

Navigating the landscape of service provision to meet the changing needs of a local population is challenging, and the overwhelming view of the task ahead can sometimes be too daunting to begin. As those challenges continue, they can see increasingly unsurmountable – something Jerry Clough of OPTUM describes as the ‘catch 22’.

Professor Gavin Giovannoni, chair of the ‘Raising the Bar for MS’ steering group, encouraged clinicians at ‘Raising the Bar’ (2019) saying: ‘If we break down everything we can think of that goes into MS care and improve it by 1% we can make a huge difference to MS as a whole’.

However, whilst many healthcare professionals want to be part of this 1% improvement goal locally, they often feel unequipped to lead that change, or are unsure of how to begin.

The Leadership MasterClass

Recognising this critical training gap, MS Academy has launched a 6-month multifaceted leadership programme tailored to MS experts. ‘Leadership is, simply put, influencing someone for the common good’, said Professor Gabriele de Luca, a clinician-scientist in Clinical Neurology at Oxford who has developed the new Leadership MasterClass alongside Barbara Hoese, President of Pentecore Coaching LLC.

The MasterClass will:

  • Identify and develop future leaders from the MS field who have little leadership experience
  • Develop and implement a mentoring program between participants and established leaders
  • Enhance skills of those who have already assumed or are about to assume leadership roles within their Institutions, the MS field, and, more broadly, the field of neurology

Leadership has lately become far more in favour than ‘management’ and the concept of effective leadership in the workplace is commonly understood. So how is leading for change different? Gabriele and Barbara note three rules, or principles, of change leadership: Change is constant, takes energy and requires coalitions.

Within the Leadership MasterClass, attendees will consider a range of concepts over the six-month programme, through face-to-face retreats, learning calls and a group project:

  • Leading oneself, and building effective relationships (fig 1)
  • Leading in a VUCA world (VUCA: ‘volatile, uncertain, complex, ambiguous’)
  • Negotiation, navigating conflict and performance management
  • Managing personal energy to lead change (fig 2)

Figure 1: Form and self – leading from within. Effective change requires authenticity and integrity – aligning of your essence (who you are) and your form (what you do)

Figure 2: With change, leaders need people to ‘get on board’ and devote their energy to implementing change. Effective leadership requires awareness of the energy continuum in colleagues to maximise their potential.

This energy continuum (fig 2) applies to the individuals going through the change as much as the leaders themselves. Gabriele noted that ‘altering 5-8% of a person’s job can make them feel like their whole role has changed.’ As a leader, assessing the impact of the change and peoples’ attitudes towards it, and helping a team cope with the change by ‘stewarding the constants’ – noticing and encouraging the things that work well as they are and do not need to alter – is key.

‘Change starts with us’

This entire leadership programme has come about because of the national drive to tackle unwarranted variation in MS services – a drive itself led by clinicians and those delivering care on the ground. When the subject of variation in UK services for MS was first broached in 2018, the take home messages from the opening event were: ‘change starts with us’ and ‘we need to do things differently’. Having developed a three-year plan across five workstreams (fig 3), the aim is that every local MS centre or service seeks to advance that plan in their area. Supporting clinical leadership through this MasterClass, sharing best practice, mentoring and peer support was seen as a key enabler to bringing the ambitious plan to fruition.

Figure 3: The five workstreams and their goals this year, each moving towards the ultimate vision: ‘To improve MS services for all people with MS and their families, and to make delivering these services for all involved a rich and rewarding experience.’

The Leadership MasterClass is selective, with each course supporting just eight delegates, and at present it is prioritising leaders in MS service provision. However, with the changing healthscape and the growing number of people living with long-term or neurological conditions coinciding with an increasingly aging population, there is no doubt that ‘doing things differently’ and ‘leading for change’ from the ground up will be essential components of our NHS going forward.

Neurology Academy is committed to supporting our healthcare professionals to deliver the services that people living with neurological conditions need to live the life they want. This is one way of doing that, and they hope to replicate the course for clinicians from other disease backgrounds in the future.

Find out more about the MasterClass and the background to both its creation and the wider ‘Raising the bar for MS’ programme at