Case study: Clinical Directors Programme

Using a co-design approach to develop a national leadership programmes for executive clinical directors and consultant leaders in Ireland.

Context and background

This study describes how a co-design approach was used to develop the Clinical Director Programme for clinical director leaders, the first of its kind in Ireland. The aim of the programme was to enhance individual clinical leadership and management competencies while supporting strategic organisational development.

Strategy for improvement

The programme also supported the Irish health system reform agenda and the strategic recommendations of the Irish Government 'Sláinte Care Report' on future health which will promote improved services and better patient outcomes.


The programme was co-designed following feedback from clinical directors’ leaders working front line by the Health Service Executive (HSE) and the Institute of Leadership in RCSI. The programme was available to current and aspiring clinical director leaders from across the Irish health system.


The programme ran from November 2017 to April 2018 with 32 participants. The programme was nine days consisting of 3x3 day modules. Programme inputs included HSE subject matter experts, psychometrics/coaching, case studies and action learning sets which we facilitated by hospital CEOs.


The objectives of this study were to co-design and develop a leadership programme which:

  1. was tailored to meet specific learning needs of executive clinical directors and consultant leaders;
  2. responded to current and emerging strategic changes in healthcare policy and service delivery;
  3. supported personal and professional leadership practice and enhanced management skills; and
  4. enabled building relational capital (peer to peer) and strategic networks nationally.

Measurement of improvement and impact

The end of programme evaluation (April) reported a 100% satisfaction both with the programme with a recommendation for their colleagues. A three-month post programme evaluation was conducted by the HSE, the main findings are listed below:

  • Clinical directors identified their greatest learning as gaining an insight into the world of senior executives – specifically understanding their mind-sets, how senior executives manage change and as leaders how they 'get the job done'. The power of positive leadership approaches and theory was identified by the participants as helpful in enhancing their own leadership practice.
  • Clinical directors also stated that their greatest leadership stretch included “courage”, “self-belief”, and dealing with peer conflict “knowing that I will revert to being simply a consultant again”. The action learning sets provided the space for this critical reflection “adopting the learning set process to come up with complex solutions”
  • Clinical Directors reported that the greatest impact back at work were the following: “inclusive decision making”; “confidence in my leadership role”,“connections and networks and "understanding the limits of the organisation, locally and nationally”.

Overall results and findings

Through a consultative and co-design process the participants, programme sponsors and academic providers co-designed their programme outcomes, content, structure and learning methodologies. They identified the specific contexts in which they were working and prioritised their own learning mapping them against a leadership competency development framework. Sponsors set criteria for strategic leadership projects and engaged with participants continuously.

Lessons to date

The co-design enabled the creation of multifaceted programmes each with its own unique ‘signature’. The competency framework, psychometrics assessments, and robust theoretical models provided rigor. Teams used action learning to model new ways of working.

Main messages

Success of this leadership development programme is attributed to the co-design process by engaging participants and sponsors as adult learners and partners. It provided us with sufficient flexibility in meeting participants current and emerging development needs whilst ensuring a sound pedagogical underpinning. Co-design approaches to leadership development enable discovery of what really matters to consultants and clinical directors and their development.

This submission addresses issues of enhancing leadership and management skills for consultants and clinical directors and aspiring clinical directors.