Iain Snelling | University of Birmingham (original) (raw)

Papers by Iain Snelling

Research paper thumbnail of UK trainees’ perceptions of leadership and leadership development

Research paper thumbnail of Exploring reasons behind UK doctors leaving the medical profession: a series of qualitative interviews with former UK doctors

Research paper thumbnail of The Chief Registrar role in the UK: leadership capacity and development of hybrid leaders

Journal of Health Organisation and Management, Jan 23, 2020

Research paper thumbnail of Management and leadership

Research paper thumbnail of Are we nearly there yet? A study of the English National Health Service as professional bureaucracies

Journal of Health Organisation and Management, Jun 19, 2017

Research paper thumbnail of The development of regulation of acute hospitals in England: leadership challenges

Leadership in Health Services, May 4, 2010

Research paper thumbnail of Dissecting leadership education and assessment in surgery

Postgraduate Medical Journal, Apr 30, 2021

The importance of leadership is well recognised within surgery owing to the heavily teamwork depe... more The importance of leadership is well recognised within surgery owing to the heavily teamwork dependent nature and uniquely dynamic working environment of the operating room. Teaching and assessment methods of leadership within UK surgical training has arguably lacked credence in comparison to the more tangible technical clinical competencies due to the fact that the daily tasks of surgeons are multifaceted and cannot be simplified into a tick-box exercise. As such, some surgical trainees perceive themselves to be minimally competent in their leadership ability. The new surgical curricula planned to be implemented by the Intercollegiate Surgical Curriculum Programme in August 2021 aims to address this by shifting leadership training and assessment towards an outcome-based approach, rather than a competency-based approach, with an emphasis on the role of the professional judgement of trainers as well as trainee self-reflection. This article explores these proposed changes by framing them within the context of the wider literature pertaining to surgical leadership education.

Research paper thumbnail of 119 Why are there so few medical chief executives in Psychiatry? An exploration of the perceptions of mental health medical directors and consultant psychiatrists

Research paper thumbnail of 8 Clinical leadership mentors – a pilot scheme to improve trainees’ leadership opportunities and development in the workplace

Research paper thumbnail of Liberating the NHS: orders of change?

Research paper thumbnail of 81 An evaluation of the clinical leadership mentors programme in the South West

Research paper thumbnail of Understanding and improving transitions of older people: a user and carer centred approach

Research paper thumbnail of Medical leadership arrangements in English healthcare organisations: Findings from a national survey and case studies of NHS trusts

Health Services Management Research, 2013

This project sought to describe the involvement of doctors in leadership roles in the NHS and the... more This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and suppo...

Research paper thumbnail of Dissecting leadership education and assessment in surgery

Postgraduate Medical Journal, 2021

The importance of leadership is well recognised within surgery owing to the heavily teamwork depe... more The importance of leadership is well recognised within surgery owing to the heavily teamwork dependent nature and uniquely dynamic working environment of the operating room. Teaching and assessment methods of leadership within UK surgical training has arguably lacked credence in comparison to the more tangible technical clinical competencies due to the fact that the daily tasks of surgeons are multifaceted and cannot be simplified into a tick-box exercise. As such, some surgical trainees perceive themselves to be minimally competent in their leadership ability. The new surgical curricula planned to be implemented by the Intercollegiate Surgical Curriculum Programme in August 2021 aims to address this by shifting leadership training and assessment towards an outcome-based approach, rather than a competency-based approach, with an emphasis on the role of the professional judgement of trainers as well as trainee self-reflection. This article explores these proposed changes by framing t...

Research paper thumbnail of Are we there yet? Models of medical leadership and their effectiveness

Helen Dickinson was involved in the design of the study, the collection of data in phase one and ... more Helen Dickinson was involved in the design of the study, the collection of data in phase one and two, data analysis and contributing to the final report writing. Chris Ham was the principal investigator, designing the research project, analysing data, contributing to the writing of the final report, and acting as the editor of the report. Iain Snelling was involved in phase two of the research, collecting and analysing data and contributing to the final report writing. Peter Spurgeon was involved in the design of the research project, took overall responsibility for the performance analysis phase of data collection, undertook data analysis and contributed to the final report writing.

Research paper thumbnail of Liberating the NHS : orders of change ? Policy Paper 11-April 2011 Research that makes a real difference

Acknowledgements About HSMC HSMC has been one of the leading UK centres for research, personal an... more Acknowledgements About HSMC HSMC has been one of the leading UK centres for research, personal and organisational development in health care for nearly 40 years. Commissioning of healthcare and provision of healthcare outside hospitals have become specific areas of expertise in recent years, underpinned by a continuing commitment to issues of quality improvement and public and patient engagement. This reputation has also extended to adult social care, with a growing track record in inter-agency commissioning and provision of health and social care services. HSMC has also developed a national reputation for both organisational and leadership development across all health settings. For further information visit: The following paper has been shaped by the helpful comments, ideas and feedback from a number of HSMC colleagues. Special thanks also go to Robin Miller for his coordination and management of the policy paper series.

Research paper thumbnail of Evaluation of the Wessex Chief Registrar programme

Background a. Following the Future Hospital Commission (2013), the RCP instituted a Chief Registr... more Background a. Following the Future Hospital Commission (2013), the RCP instituted a Chief Registrar programme in 2016, to provide a 'bridge' between senior medical staff and senior managers (on the one hand) and the junior doctor workforce (on the other). b. In 2017, the Wessex Deanery developed a novel approach whereby non-physicians were offered places in the RCP Chief Registrar programme combined with local support. Nine were appointed. The Wessex Deanery commissioned the Health Services Management Centre (HSMC; University of Birmingham) to evaluate this programme. c. The aims of the evaluation were:  To explore the ways in which Chief Registrars are enacting their role;  To assess the effectiveness of the Chief Registrar role, through considering the role of individuals and the contexts in which they work;  To recommend future directions in the Chief Registrar role. 2. Methods a. The evaluation comprised an online survey of all Chief Registrars and case-studies of four Chief Registrars. The latter entailed audio diaries and interviews with the Chief Registrars and their respective role sets. b. All data were transcribed and analysed thematically (using the `Framework approach'). c. Ethical approval was granted by the University of Birmingham's research ethics committee.

Research paper thumbnail of How trainee hospital doctors lead work-based projects

Leadership in Health Services

Purpose The purpose of this study is to explore how trainee hospital doctors led work-based proje... more Purpose The purpose of this study is to explore how trainee hospital doctors led work-based projects undertaken on an accredited development programme in England. Design/methodology/approach This is a case study of a leadership programme for hospital-based specialty trainees. The programme included participants leading work-based projects which were submitted for academic accreditation. Accounts of 35 work-based projects were thematically analysed to explore how participants led their projects. Findings Leadership was often informal and based on a series of individual face-to-face conversations. The establishment of project teams and the use of existing communication processes were often avoided. The reasons for this approach included lack of opportunities to arrange meetings, fear of conflict in meetings and the personal preferences of the participants. The authors discuss these findings with reference to theory and evidence about conversations and informal leadership, highlighting...

Research paper thumbnail of The Chief Registrar role in the UK: leadership capacity and development of hybrid leaders

Journal of Health Organization and Management

PurposeThe purpose of the study is to evaluate the first cohort of the Royal College of Physician... more PurposeThe purpose of the study is to evaluate the first cohort of the Royal College of Physicians' (RCP) Chief Registrar programme in 2016/7. Chief Registrars provide medical leadership capacity through leadership development posts.Design/methodology/approachThe study adopted a mixed methods design, comprising a monthly survey of the 21 Chief Registrars in the first cohort, interviews with Chief Registrars, and six cases studies where Chief Registrars and colleagues were interviewed.FindingsChief Registrars enjoyed high levels of practical, professional, and leadership support from their employing organisations, the RCP, and the Faculty of Medical Leadership and Management. They had high degrees of autonomy in their roles. As a result, roles were enacted in different ways, making direct comparative evaluation problematic. In particular, we identified variation on two dimensions: first, the focus on medical leadership generally, or quality improvement more specifically, and seco...

Research paper thumbnail of Models of medical leadership and their effectiveness: an exploratory study

Research paper thumbnail of UK trainees’ perceptions of leadership and leadership development

Research paper thumbnail of Exploring reasons behind UK doctors leaving the medical profession: a series of qualitative interviews with former UK doctors

Research paper thumbnail of The Chief Registrar role in the UK: leadership capacity and development of hybrid leaders

Journal of Health Organisation and Management, Jan 23, 2020

Research paper thumbnail of Management and leadership

Research paper thumbnail of Are we nearly there yet? A study of the English National Health Service as professional bureaucracies

Journal of Health Organisation and Management, Jun 19, 2017

Research paper thumbnail of The development of regulation of acute hospitals in England: leadership challenges

Leadership in Health Services, May 4, 2010

Research paper thumbnail of Dissecting leadership education and assessment in surgery

Postgraduate Medical Journal, Apr 30, 2021

The importance of leadership is well recognised within surgery owing to the heavily teamwork depe... more The importance of leadership is well recognised within surgery owing to the heavily teamwork dependent nature and uniquely dynamic working environment of the operating room. Teaching and assessment methods of leadership within UK surgical training has arguably lacked credence in comparison to the more tangible technical clinical competencies due to the fact that the daily tasks of surgeons are multifaceted and cannot be simplified into a tick-box exercise. As such, some surgical trainees perceive themselves to be minimally competent in their leadership ability. The new surgical curricula planned to be implemented by the Intercollegiate Surgical Curriculum Programme in August 2021 aims to address this by shifting leadership training and assessment towards an outcome-based approach, rather than a competency-based approach, with an emphasis on the role of the professional judgement of trainers as well as trainee self-reflection. This article explores these proposed changes by framing them within the context of the wider literature pertaining to surgical leadership education.

Research paper thumbnail of 119 Why are there so few medical chief executives in Psychiatry? An exploration of the perceptions of mental health medical directors and consultant psychiatrists

Research paper thumbnail of 8 Clinical leadership mentors – a pilot scheme to improve trainees’ leadership opportunities and development in the workplace

Research paper thumbnail of Liberating the NHS: orders of change?

Research paper thumbnail of 81 An evaluation of the clinical leadership mentors programme in the South West

Research paper thumbnail of Understanding and improving transitions of older people: a user and carer centred approach

Research paper thumbnail of Medical leadership arrangements in English healthcare organisations: Findings from a national survey and case studies of NHS trusts

Health Services Management Research, 2013

This project sought to describe the involvement of doctors in leadership roles in the NHS and the... more This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and suppo...

Research paper thumbnail of Dissecting leadership education and assessment in surgery

Postgraduate Medical Journal, 2021

The importance of leadership is well recognised within surgery owing to the heavily teamwork depe... more The importance of leadership is well recognised within surgery owing to the heavily teamwork dependent nature and uniquely dynamic working environment of the operating room. Teaching and assessment methods of leadership within UK surgical training has arguably lacked credence in comparison to the more tangible technical clinical competencies due to the fact that the daily tasks of surgeons are multifaceted and cannot be simplified into a tick-box exercise. As such, some surgical trainees perceive themselves to be minimally competent in their leadership ability. The new surgical curricula planned to be implemented by the Intercollegiate Surgical Curriculum Programme in August 2021 aims to address this by shifting leadership training and assessment towards an outcome-based approach, rather than a competency-based approach, with an emphasis on the role of the professional judgement of trainers as well as trainee self-reflection. This article explores these proposed changes by framing t...

Research paper thumbnail of Are we there yet? Models of medical leadership and their effectiveness

Helen Dickinson was involved in the design of the study, the collection of data in phase one and ... more Helen Dickinson was involved in the design of the study, the collection of data in phase one and two, data analysis and contributing to the final report writing. Chris Ham was the principal investigator, designing the research project, analysing data, contributing to the writing of the final report, and acting as the editor of the report. Iain Snelling was involved in phase two of the research, collecting and analysing data and contributing to the final report writing. Peter Spurgeon was involved in the design of the research project, took overall responsibility for the performance analysis phase of data collection, undertook data analysis and contributed to the final report writing.

Research paper thumbnail of Liberating the NHS : orders of change ? Policy Paper 11-April 2011 Research that makes a real difference

Acknowledgements About HSMC HSMC has been one of the leading UK centres for research, personal an... more Acknowledgements About HSMC HSMC has been one of the leading UK centres for research, personal and organisational development in health care for nearly 40 years. Commissioning of healthcare and provision of healthcare outside hospitals have become specific areas of expertise in recent years, underpinned by a continuing commitment to issues of quality improvement and public and patient engagement. This reputation has also extended to adult social care, with a growing track record in inter-agency commissioning and provision of health and social care services. HSMC has also developed a national reputation for both organisational and leadership development across all health settings. For further information visit: The following paper has been shaped by the helpful comments, ideas and feedback from a number of HSMC colleagues. Special thanks also go to Robin Miller for his coordination and management of the policy paper series.

Research paper thumbnail of Evaluation of the Wessex Chief Registrar programme

Background a. Following the Future Hospital Commission (2013), the RCP instituted a Chief Registr... more Background a. Following the Future Hospital Commission (2013), the RCP instituted a Chief Registrar programme in 2016, to provide a 'bridge' between senior medical staff and senior managers (on the one hand) and the junior doctor workforce (on the other). b. In 2017, the Wessex Deanery developed a novel approach whereby non-physicians were offered places in the RCP Chief Registrar programme combined with local support. Nine were appointed. The Wessex Deanery commissioned the Health Services Management Centre (HSMC; University of Birmingham) to evaluate this programme. c. The aims of the evaluation were:  To explore the ways in which Chief Registrars are enacting their role;  To assess the effectiveness of the Chief Registrar role, through considering the role of individuals and the contexts in which they work;  To recommend future directions in the Chief Registrar role. 2. Methods a. The evaluation comprised an online survey of all Chief Registrars and case-studies of four Chief Registrars. The latter entailed audio diaries and interviews with the Chief Registrars and their respective role sets. b. All data were transcribed and analysed thematically (using the `Framework approach'). c. Ethical approval was granted by the University of Birmingham's research ethics committee.

Research paper thumbnail of How trainee hospital doctors lead work-based projects

Leadership in Health Services

Purpose The purpose of this study is to explore how trainee hospital doctors led work-based proje... more Purpose The purpose of this study is to explore how trainee hospital doctors led work-based projects undertaken on an accredited development programme in England. Design/methodology/approach This is a case study of a leadership programme for hospital-based specialty trainees. The programme included participants leading work-based projects which were submitted for academic accreditation. Accounts of 35 work-based projects were thematically analysed to explore how participants led their projects. Findings Leadership was often informal and based on a series of individual face-to-face conversations. The establishment of project teams and the use of existing communication processes were often avoided. The reasons for this approach included lack of opportunities to arrange meetings, fear of conflict in meetings and the personal preferences of the participants. The authors discuss these findings with reference to theory and evidence about conversations and informal leadership, highlighting...

Research paper thumbnail of The Chief Registrar role in the UK: leadership capacity and development of hybrid leaders

Journal of Health Organization and Management

PurposeThe purpose of the study is to evaluate the first cohort of the Royal College of Physician... more PurposeThe purpose of the study is to evaluate the first cohort of the Royal College of Physicians' (RCP) Chief Registrar programme in 2016/7. Chief Registrars provide medical leadership capacity through leadership development posts.Design/methodology/approachThe study adopted a mixed methods design, comprising a monthly survey of the 21 Chief Registrars in the first cohort, interviews with Chief Registrars, and six cases studies where Chief Registrars and colleagues were interviewed.FindingsChief Registrars enjoyed high levels of practical, professional, and leadership support from their employing organisations, the RCP, and the Faculty of Medical Leadership and Management. They had high degrees of autonomy in their roles. As a result, roles were enacted in different ways, making direct comparative evaluation problematic. In particular, we identified variation on two dimensions: first, the focus on medical leadership generally, or quality improvement more specifically, and seco...

Research paper thumbnail of Models of medical leadership and their effectiveness: an exploratory study