We recently spoke with Christopher Lewis, operations learning development manager for the Greater Manchester Training Hub (GMTH).
GMTH is part of the Health Education England (HEE) Training Hub model, designed to meet educational needs of multi-disciplinary primary care teams; they aim to provide opportunities to enter, enhance and expand careers, assisting in the creation of a sustainable solution to the challenges that primary care is facing through inspiring positive change through learning.
Chris talked to us about the educational projects he has been involved in, the ways in which his varied background has benefitted him in a healthcare setting, his thoughts on ICS integration and more.
Chris’s background
I am ex-military – I served in the Royal Air Force where I specialised in operational fast jets, helicopters and was initially deployed as a survival systems specialist. I was promoted to work as part of a leadership development team at RAF Cosford for several years, and then I moved onto work for RAF careers. I focused on leadership and team development, working with communities, colleges, and universities to highlight that the RAF was a good career of choice.
I set up my own training company for several years after leaving the service, worked for a veteran’s charity for a year, and I also became a primary school teacher through the Troops for Teachers programme. Then I moved to my current NHS role at Greater Manchester Training Hub.
I remember them asking me in the interview, “Why have you applied for this job?” I said: “It’s like Slumdog Millionaire – it’s very rare you get a job description where you’ve done everything on that list.” Between my various roles from different industries, I met all the criteria – it was such a good fit. I joined the team in August 2021. Initially I was the learning and development manager, using my knowledge from previous backgrounds to support the team, and it grew from there.
Projects with the Greater Manchester Training Hub
The remit for us is to support all the roles across primary care, to make it a career of choice and improve retention. Given my background, I lead the development of the leadership, coaching and mentoring support we offer.
We work with a variety of partners and organisations to help develop the skills people need to deliver primary care services and to meet the future demand for these services. For example, we deliver the NHSE GP Fellowship Programme which is a two-year programme for newly qualified GPs who have recently completed their CCT. The first year has a clinical and practitioner focus, developing networks, key skills and helping them to integrate into PCNs, whilst the second year is more about leadership, team management development and developing people centred skills whilst enhancing the skills they’ve developed in the first year. I joined the team as they were developing the second year of the course; I designed and deliver the leadership/coaching and mentoring strands of our work.
Last spring, we added a two-day coaching skills course to the programme, which we had quality assured by City and Guilds and the Institute of Leadership and Management. It’s great as our GPs can support patients with a developed coaching skillset and understand what support health coaches can offer for additional guidance, where that role support is available. It’s a brilliant learning opportunity and helps support patients with the skills they’ll need to take ownership of their own health journey and empower them to be part of their own health outcomes.
I also deliver the GP Supporting Mentoring course which supports the GP Fellowship programme and provides GP support from experienced mentors across Greater Manchester. The feedback from mentees and mentors has been very strong and the courses are in high demand. We’ve gone from holding quarterly courses to holding two a month which has necessitated recruiting more course delivery staff.
Then there is a developing project around supporting the GP Nurse Fellowship in a similar way, focusing on building leadership and clinical skills in future cohorts. Other training hub commitments include our Practice Education Facilitators (PEF), who support learners across Greater Manchester. Our PEFs work with nursing students in Primary Care and Social Care settings, which further enhances our commitment to training and managing the future workforce.
On the need for support
We’ve got lots of people coming into primary care currently because of the new ICS structure, so it’s about providing them with the right support and training so that they can hit the ground running and are equipped with a variety of essential skills.
There’s an accredited Wider Workforce Clinical Supervision course which GMTH deliver once a month. There’s a need for everyone in the practice to receive additional training and support. Traditionally, it tends to be GP and nurse led because they’re the ones that receive role specific CPD funding, but we’ve been working on developing funding for front of house staff and practice team as well. They’re often the people communicating directly with patients and are the people who run the risk of getting the brunt of any possible anger or frustration. We want to deliver support for dealing with challenging behaviour, to ensure that everyone in the practice is being fully supported, thus improving staff wellbeing and retention.
That’s something I feel strongly about – I’m now a lead trainer for the Royal Society of Public Health’s Making Every Contact Count for Mental Health programme and I also share resources and support links via social media to support this work. It’s a project running across the north of England focusing on up-skilling healthcare professionals around mental health promotion – it’s about integrating mental health conversations into everyday practice and really addressing that need for wellbeing support.
New to Primary Care project
After joining the team, I immediately realised that Primary Care has its own language – if you’re new to it, or even if you’ve previously worked in another healthcare sector like secondary care, it’s a lot to take in, and on a communication level, even to understand.
We recently launched the New to Primary Care (N2PC) scheme. For the open day, we had two consecutive days involving over sixty people, and we focused on roles and responsibilities – it was very interactive and allowed people to gain information about the various roles within primary care, share insight and ultimately establish a foundation of knowledge of clinical frameworks.
The next part focused on leadership development. You get some people who have worked in healthcare for a long time but haven’t done any leadership training. Leadership is so important – healthcare professionals need these skills to give them the confidence to take control of difficult situations and to have a skillset to support the people and teams they work with every day. Our staff get promoted for being great at their jobs, and leadership development is often overlooked. We work with people, so an understanding of the leadership process is a key, essential skill that we hope is being developed across our programmes and will equip us for the daily challenges ahead.
This training is about understanding the values and behaviour of all people in our teams, be it task, process or people centred. It’s also about highlighting why we do what we do, and about finding the value. For me, it goes back to my time in the military – it’s about looking at what you are great at and what needs improvement and acting from there. We’ve got masterclasses planned for the summer and beyond which will develop this further.
Following the success of the first cohort, we are looking to launch again after August as the feedback from everyone involved has been brilliant; people feel they are integrating better because of the skills they’ve learned on the course which can only build a more confident and secure workforce.
Ultimately, the emphasis of much of the training I work on is all about survival skills. You’re a human being, you’re trying to do your job in a high-pressure environment. Primary care is not that dissimilar to my operational role in the RAF, with the work pressures and high standards we place upon ourselves. It’s important to have the skills that are going to help you understand why people are talking to you in a certain way or why they might act in a particular way – we should all have this knowledge and understanding. We can layer those interpersonal skills up and integrate them with the professional skills. It’s almost like a first aid approach, and the feedback from this work has been amazing.
Key areas of need in primary care
I think the key areas of need are core competencies training and clinical updates. A lot of these programmes understandably stopped/paused during COVID which meant people weren’t getting the training that they needed. We work tirelessly with a variety of organisations across Greater Manchester to help equip our people with the skills they need day-to-day which we hope are delivered as quickly and efficiently as possible.
The amount of pressure and demand currently facing the workforce is another key area of need. At the Hub I think we are very good at outlining the strategy for change and improvement by concentrating more on the needs of the individual which in turn supports the key strategies and demands on our services. It is important to consider the areas of improvement and the skills required of the individual first to be able implement a cogent strategy.
I would say that scenario-based training, self-awareness, and psychological strategies are equally as important as they provide useful skills and tactics for conflict resolution and realistic training opportunities as opposed to purely digital-based learning. The training we offer ensures people have hands-on practical experience which they can apply in clinical situations and begin using the moment they leave the training room.
We also recognise that support networks are so important across all multi-disciplinaries and we’re trying to secure additional funding to build a wider support network that is sustainable and supports staff throughout their whole career.
Integration across the ICS
Integration is an essential, driving facilitator of change within primary care. This is something that I found working in teaching too – the need for improved access to information across sectors. Tapping into that ‘bigger picture’ thinking is crucial to success.
One of the great benefits of the ICS is that it breaks down that traditional silo style of thinking and facilities the connection between roles, which is needed to improve efficiency and better healthcare. It is very comparable to my work as a military leader in the sense that you need to know your role, your boss’s role, and the people either side of you (mission command) to allow you to step across when required and reduce pressure in difficult situations.
Integration has allowed people like me, from outside the NHS, to come in with a skillset that is highly useful and can bring new insights, strategies, and ideas across to help innovate the Primary Care structures. It has illustrated that we are very similar, and people have been very welcoming of my experience.
People are now stepping across boundaries and moving out of these insular schools of thought. They are realising that the new way of thinking can often be more efficient and can take the pressure off.
The formation of ICSs has increased networking opportunities across various sectors too; for example, GMTH has been approached by the Dentistry School to run coaching and mentoring support for dentists. We’ve got four learners joining one of our programmes in the Spring as a pilot, which will hopefully open up to a new specialism.
The creation of ICSs has also opened new pathways which has made accessibility and efficiency of care much better, as well as identifying overlaps in the system. This has enabled similar roles and processes to be streamlined, therefore reducing costs whilst improving healthcare. Continued interconnection will change the face of primary care by creating a more cohesive system and we are seeing that happen more and more.
Hopes for the future
Health Education England supports GMTH in connection with NHS England on several projects, including the GP Retention Scheme. GMTH is also hosted by the Greater Manchester GP Federation. We are integrated with them now and have contacts with a lot of their associations which is important for our future commitments and development.
Our programmes have developed a lot and will continue to evolve; the team is very open-minded, identifying themes in feedback so that we can determine solutions and ultimately better healthcare outcomes.
The skills we are teaching around self-awareness, conflict management, leadership and so on are immediately applicable within a clinical setting and can be deployed right away, but feedback shows that these skills are also transferrable in everyday life. They become embedded and are consistent for people as they move forwards with their careers, which is great.
We will continue to provide follow-on support and development training, maintaining long-term connections with multiple healthcare organisations and working with them to deliver exceptional patient care.
Thank you, Chris, for sharing your journey with us.
