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The First 500 - A report on London Deanery's Coaching ... - Mentoring

The First 500 - A report on London Deanery's Coaching ... - Mentoring

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<strong>Coaching</strong> and <strong>Mentoring</strong><str<strong>on</strong>g>The</str<strong>on</strong>g> <str<strong>on</strong>g>First</str<strong>on</strong>g> FiveHundredA Report <strong>on</strong> L<strong>on</strong>d<strong>on</strong> Deanery’s <strong>Coaching</strong>and <strong>Mentoring</strong> Service 2008-2010Dr Rebecca VineyProf Elisabeth Paicewww.mentoring.l<strong>on</strong>d<strong>on</strong>deanery.ac.uk


COACHING ANDMENTORING FORDOCTORS AND DENTISTS6L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


<str<strong>on</strong>g>The</str<strong>on</strong>g> L<strong>on</strong>d<strong>on</strong> Deanery’s Approach to<strong>Coaching</strong> and <strong>Mentoring</strong><strong>Coaching</strong> and mentoring have a l<strong>on</strong>g history, in politics, sports andin the workplace, in different professi<strong>on</strong>s and in different countries.No definiti<strong>on</strong>s are universally agreed, but the following have beenmuch quoted in the UK literature:<strong>Coaching</strong> and <strong>Mentoring</strong> PrinciplesUnderlying all forms of coaching and mentoring are certainprinciples which generate its powerful impact.“““COACHINGOff line help by <strong>on</strong>e pers<strong>on</strong> to another inmaking significant transiti<strong>on</strong>s in knowledge,work or thinking.”(Meggins<strong>on</strong> and Clutterbuck, 1995)<strong>Mentoring</strong>To help and support people to managetheir own learning in order to maximize theirpotential, develop their skills, improve theirperformance, and become the pers<strong>on</strong> theywant to be.”(Parsloe, 1992)<strong>Coaching</strong> and mentoringLearning relati<strong>on</strong>ships which help people to takecharge of their own development, to releasetheir potential and to achieve results whichthey value.”(C<strong>on</strong>nor and Pokara 2007)six principles of coachingand mentoringi.ii.iii.iv.<str<strong>on</strong>g>The</str<strong>on</strong>g> client is resourceful<str<strong>on</strong>g>The</str<strong>on</strong>g> coach’s role is to developthe client’s resourcefulness, itis not about giving advice<strong>Coaching</strong> addresses the wholepers<strong>on</strong>, past, present and future<str<strong>on</strong>g>The</str<strong>on</strong>g> client sets the agendav. <str<strong>on</strong>g>The</str<strong>on</strong>g> coach and the client areequalsvi.<strong>Coaching</strong> is about change(Rogers J, 2008)<strong>Coaching</strong> tends to be short-term process that is more taskorientated, whereas mentoring is usually l<strong>on</strong>ger with a moreholistic approach. However, there is a great deal of overlap in theirunderlying principles and the skills required to deliver them (Vineyand McKimm 2010). This overlap is recognised by the European<strong>Mentoring</strong> and <strong>Coaching</strong> Council www.emccouncil.org who haverecommended that the inclusive term of “coaching/mentoring”should be preferred. <str<strong>on</strong>g>The</str<strong>on</strong>g>re should be a clear distinguisi<strong>on</strong> betweencoaching/mentoring from other supportive or developmental roles,such as patr<strong>on</strong>age, therapy, counselling, appraising, educati<strong>on</strong>alsupervisi<strong>on</strong>, line management or teaching.This supports the L<strong>on</strong>d<strong>on</strong> Deanery’s approach of a <strong>Coaching</strong> and<strong>Mentoring</strong> service which is based <strong>on</strong> a holistic approach which isdelivered in a very focused fashi<strong>on</strong>.L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 7


Benefits of <strong>Coaching</strong> and <strong>Mentoring</strong>In many industries coaching and mentoring are well establishedin the organisati<strong>on</strong>al culture, with benefits for the employerby improved company performance and productivity and theemployee in terms of job satisfacti<strong>on</strong>. In a large study of USbusiness school graduates, those experiencing extensivementoring relati<strong>on</strong>ships <str<strong>on</strong>g>report</str<strong>on</strong>g>ed receiving faster promoti<strong>on</strong>, higherincomes, and were more satisfied with their pay and benefits thanindividuals experiencing less extensive mentoring relati<strong>on</strong>ships.(Dreher, Ash 1990).A review of the literature <strong>on</strong> the subject (Garvey B, Garrett-HarrisR, 2005).c<strong>on</strong>cluded that the main advantages for those beingmentored were:• Improved performance and productivity• Career opportunity and advancement• Improved knowledge and skills• Greater c<strong>on</strong>fidence and wellbeing<str<strong>on</strong>g>The</str<strong>on</strong>g>se benefits have been <str<strong>on</strong>g>report</str<strong>on</strong>g>ed in studies of mentoring andcoaching in medicine. <strong>Mentoring</strong> as an undergraduate and asa trainee helped with individuals’ career choice and satisfacti<strong>on</strong>(Ramanan et al 2006). An analysis of six NHS mentoring schemesacross England identified three overarching areas of benefit:professi<strong>on</strong>al practice, pers<strong>on</strong>al well-being and development.Benefits appeared to go bey<strong>on</strong>d a doctor’s professi<strong>on</strong>al role tocross the pers<strong>on</strong>al-professi<strong>on</strong>al interface (Steven et al, 2008).<str<strong>on</strong>g>The</str<strong>on</strong>g> Case For A Bespoke Service ForDoctors And DentistsDoctors currently face numerous uncertainties and challenges:policy initiatives by government to reduce NHS spending, changesin the career structure, reduced hours of work by trainees, betterinformed patients demanding higher standards of care andrevalidati<strong>on</strong>. (Abbasi, 2008). Life as a junior doctor can be stressful,and the increasing intensity of work may leave little time to reflect<strong>on</strong> and discuss c<strong>on</strong>cerns as they arise (Paice et al 2002, Iversen etal 2008). Stress levels am<strong>on</strong>g c<strong>on</strong>sultants also run high (Ramirezat al 1996). Given the benefits identified above, it is not surprisingthat a number of <str<strong>on</strong>g>report</str<strong>on</strong>g>s, papers and royal college websites haverecommended improved access to coaching and mentoring forsome or all doctors, with similar arguments applying to dentists.<str<strong>on</strong>g>The</str<strong>on</strong>g> guidance paper <strong>Mentoring</strong> for Doctors (Department ofHealth, 2004) <str<strong>on</strong>g>report</str<strong>on</strong>g>ed <strong>on</strong> the views of a number of doctorswho had been mentored and c<strong>on</strong>cluded that the process hadreal benefits for both mentees and their mentors. Menteescommented <strong>on</strong> improved reflecti<strong>on</strong> skills; support for dealing withspecific problems; strategies for coping with change or crisis intheir professi<strong>on</strong>al lives; improved self c<strong>on</strong>fidence and more jobsatisfacti<strong>on</strong>. Mentors also <str<strong>on</strong>g>report</str<strong>on</strong>g>ed increased job satisfacti<strong>on</strong>and improved relati<strong>on</strong>ships with patients, colleagues and familymembers. <str<strong>on</strong>g>The</str<strong>on</strong>g> benefits for the NHS as a whole are clear. <str<strong>on</strong>g>The</str<strong>on</strong>g><str<strong>on</strong>g>report</str<strong>on</strong>g> therefore recommended that:• <str<strong>on</strong>g>The</str<strong>on</strong>g>re is a well publicised c<strong>on</strong>tact point forinformati<strong>on</strong> about mentor availability in eachtrust, postgraduate Deanery and medicalroyal college.• Organisati<strong>on</strong>s that do not provide their ownmentoring arrangements should facilitatedoctors’ access to appropriate programmesand schemes.8L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


Doctors as mentees value primarily the“dedicated time for reflecti<strong>on</strong> during whichsome<strong>on</strong>e they trust listens ‘actively,’ challengestheir thinking but does not problem solve <strong>on</strong>their behalf. <str<strong>on</strong>g>The</str<strong>on</strong>g>y work through their problems ina situati<strong>on</strong> of assurance of absolute c<strong>on</strong>fidencebut within the ethical framework accepted byall doctors.”(<strong>Mentoring</strong> for Doctors, Department ofHealth, 2004)A questi<strong>on</strong>naire survey, open to all doctors in the UK, about whatwould most improve their working lives revealed that improvedaccess to mentoring was important to junior doctors, staff andassociate specialist grades, and doctors from black and ethnicminority groups (Dornhurst et al, 2005)Since the L<strong>on</strong>d<strong>on</strong> Deanery service was established, threeimportant <str<strong>on</strong>g>report</str<strong>on</strong>g>s have called for mentoring to be made morewidely and readily accessible within the health service.RECOMMENDATIONS ABOUTMENTORING FROM RECENT REPORTSWomen Doctors: Making a Difference<str<strong>on</strong>g>report</str<strong>on</strong>g> of the Chair of the Nati<strong>on</strong>alWorking Group <strong>on</strong> Women in Medicine,Department of Health, 2009Improve access to mentoring and career“advice. In the next round of c<strong>on</strong>tractnegotiati<strong>on</strong> there should be an explicit facilityfor appropriately trained and skilled doctors(usually c<strong>on</strong>sultants) to undertake mentoringor career counselling as a programmedactivity within their job plan.”Invisible Patients: Report of theWorking Group <strong>on</strong> the health ofhealth professi<strong>on</strong>als, Department ofHealth, 2010<strong>Mentoring</strong> and support can be especially“important at points of career transiti<strong>on</strong>, forprofessi<strong>on</strong>al development and to enableflexible working arrangements. <str<strong>on</strong>g>The</str<strong>on</strong>g> availabilityof mentors and supervisors throughout ahealth professi<strong>on</strong>al’s period of rehabilitati<strong>on</strong>following sickness absence helps to ensurean effective return to work. Those involved inmentoring and supervisory roles need to beappropriately trained and supported.”Time for Training: A review of theimpact of the European Working TimeDirective <strong>on</strong> the quality of training.Sir John Temple, 2010“Newly appointed c<strong>on</strong>sultants requirementoring and support. <strong>Mentoring</strong> andsupport for trainees must be improved.”L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 9


THE CASE FOR A DEANERY-LED SERVICE<str<strong>on</strong>g>The</str<strong>on</strong>g> missi<strong>on</strong> of L<strong>on</strong>d<strong>on</strong> Deanery is to improve the quality ofpatient care by ensuring the supply of doctors and dentistswho are educated, trained and motivated to play a full part in afirst class modern health service. It is therefore a core Deaneryfuncti<strong>on</strong> to develop doctors and dentists to the maximum oftheir potential, as leaders, team players and champi<strong>on</strong>s forlocal quality improvement. This is particularly pertinent at atime of major challenge and financial stringency in the NHS. Analternative means of development is through leadership courseswhich may be enlightening experiences but they do not offerthe individually tailored approach of coaching/mentoring thatsupports the individual in their unique envir<strong>on</strong>ment to enable themost appropriate soluti<strong>on</strong> to be found. It is much more powerfulto experience coaching whilst being in the process of managingchange yourself, than to attend a theoretical course <strong>on</strong> thesame subject.A centrally provided Deanery-led coaching andmentoring service results in many benefits tohealthcare in L<strong>on</strong>d<strong>on</strong> as follows:• Planning a coherent L<strong>on</strong>d<strong>on</strong>-wide approachto the training and development of medicaland dental mentors• Ensuring equality of access for menteesacross L<strong>on</strong>d<strong>on</strong>• Ensuring objectivity and c<strong>on</strong>fidentiality formentees by providing a service outside theemploying organisati<strong>on</strong>• Providing c<strong>on</strong>tinuity of mentoring/coachingfor trainees <strong>on</strong> rotati<strong>on</strong>al programmes• Exercising purchasing power to access highquality training and supervisi<strong>on</strong>• Developing a critical mass of enthusiasm,experience and expertise to drive theservice forward• Providing <strong>on</strong>e voice for coaching andmentoring of doctors and dentists in L<strong>on</strong>d<strong>on</strong>• Supporting L<strong>on</strong>d<strong>on</strong>’s healthcare strategy• Providing a focal point for discussi<strong>on</strong>swith nati<strong>on</strong>al organisati<strong>on</strong>s eg GMC, RoyalColleges, Department of Health<str<strong>on</strong>g>The</str<strong>on</strong>g> benefits to the deanery are also manifold:• Supporting the Deanery’s missi<strong>on</strong> to improvethe quality of patient care by ensuring thesupply of doctors and dentists who areeducated, trained and motivated to play theirpart in a first class modern health service• Enhancing the careers and job satisfacti<strong>on</strong> ofstaff and hence the reputati<strong>on</strong> of L<strong>on</strong>d<strong>on</strong> as aplace to train and work• Helping doctors and dentists to achievework/life balance and avoid dropping out oftraining or burning out• Engaging doctors and dentists in improvingthe quality of educati<strong>on</strong> and service topatients in L<strong>on</strong>d<strong>on</strong>• Enabling doctors and dentists from diversebackgrounds to maximise their potential• Strategies to prevent burnout such assupporting flexible working and work/lifebalance• Encouraging doctors and dentists in difficultyto find strategies to overcome their problems• Developing a culture of active listening,support and encouragement am<strong>on</strong>g agentsof the Deanery• Releasing leadership potential at every level10L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


<str<strong>on</strong>g>The</str<strong>on</strong>g> Deanery believes to run the service optimally the mentoringshould be delivered by appropriately trained and supporteddoctors or dentists. It is c<strong>on</strong>sidered that a shared understanding ofthe c<strong>on</strong>text and values of the medical envir<strong>on</strong>ment will encouragetrust in the service and rapidly enable rapport to be established.C<strong>on</strong>fidentiality is more readily assured by offering mentors fromdifferent specialties and organisati<strong>on</strong>s which will give the menteethe c<strong>on</strong>fidence in the system to share pers<strong>on</strong>al informati<strong>on</strong>. Inadditi<strong>on</strong> the mentor will be likely to bring a fresh light up<strong>on</strong> issueswhich should encourage creative thinking and there should be lesstemptati<strong>on</strong> to offer the Mentee inappropriate advice or soluti<strong>on</strong>s. Itis important that the mentor has the knowledge and understanding<strong>on</strong> accessing other sources of help for the mentee, such ascareers informati<strong>on</strong>, counselling, psychotherapy or medical help.<str<strong>on</strong>g>The</str<strong>on</strong>g> Deanery, with its wide educati<strong>on</strong>al networks, is ideally placedto ensure the availability of experienced mentors from differentspecialties and different organisati<strong>on</strong>s across L<strong>on</strong>d<strong>on</strong>.LESSONS LEARNED FROM OTHERS<str<strong>on</strong>g>The</str<strong>on</strong>g> less<strong>on</strong>s learned by others helped to inform the way theL<strong>on</strong>d<strong>on</strong> Deanery service was set up.• A review of publicati<strong>on</strong>s about mentoringprogrammes for medical students or doctorsc<strong>on</strong>cluded that most offered evidence ofsatisfacti<strong>on</strong> with the programme but failed toprovide a short- and l<strong>on</strong>g-term evaluati<strong>on</strong> ofthe individual successes of the participatingmentors and mentees. (Buddeberg-FischerB, Herta KD, 2006). <str<strong>on</strong>g>The</str<strong>on</strong>g> L<strong>on</strong>d<strong>on</strong> Deaneryprogramme has been designed from the startwith systems to capture feedback from eachencounter between mentor and mentee;reflecti<strong>on</strong> <strong>on</strong> the impact of the experiencesome time after c<strong>on</strong>clusi<strong>on</strong>; and the views ofstakeholders such as medical directors anddirectors of medical educati<strong>on</strong> about anyeffect in the workplace.• Another review of the subject highlights theproblems of having a mentor who is seniorto the mentee and working in the samedepartment “problems exist, such as c<strong>on</strong>flictbetween the mentoring and supervisoryroles of the mentor, c<strong>on</strong>fidentiality breaches,mentor bias, lack of “active listening” androle c<strong>on</strong>fusi<strong>on</strong>.” (Taherian K, Shekarchian M,2008). <str<strong>on</strong>g>The</str<strong>on</strong>g> L<strong>on</strong>d<strong>on</strong> Deanery service matchesmentees to mentors from outside theemploying organisati<strong>on</strong> and specialty.• A successful programme in North EastEngland also described problems with “levelsof c<strong>on</strong>fidence in providing mentoring; culturalfactors, such as juniors not wishing to beseen to need help, and organizati<strong>on</strong>al factors,such as lack of time allocated for mentoring.”(C<strong>on</strong>nor et al, 2000) <str<strong>on</strong>g>The</str<strong>on</strong>g> training andsupervisi<strong>on</strong> of mentors and the assuranceof c<strong>on</strong>fidentiality for mentees are centralto the L<strong>on</strong>d<strong>on</strong> Deanery’s <strong>Coaching</strong> and<strong>Mentoring</strong> Service.L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 11


Establishing THELONDON DEANERYSERVICE12L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


SECURING RESOURCES<str<strong>on</strong>g>The</str<strong>on</strong>g> funding for starting up the service came from the ‘transiti<strong>on</strong>al’m<strong>on</strong>ey made available to deaneries by the Department of Healthto support doctors whose careers had been adversely affected bythe flawed Medical Training Applicati<strong>on</strong> Service (MTAS) recruitmentscheme. In order to help these individuals, the Deanery trained acadre of mentors who then went <strong>on</strong> to provide the nucleus of aservice open to all doctors and dentists working in L<strong>on</strong>d<strong>on</strong>’s NHS.Based <strong>on</strong> discussi<strong>on</strong>s with colleagues who had set up mentoringarrangements in their own organisati<strong>on</strong>s, and looking to the privatesector where successful leadership assumed that new leaderswould be supported in their role by skilled and remuneratedcoaches. It was clear that to sustain the service the mentors mustbe paid and supported to grow their skills. <str<strong>on</strong>g>The</str<strong>on</strong>g> Deanery comparedthe funds paid to GP appraisers and other mentoring schemesbefore deciding to pay £150 for 90 minutes of mentoring. Generallythe mentors provide the meeting rooms and updates, supervisi<strong>on</strong>,forums and training are all unpaid. Those doctors and dentistswho mentor in their working time invoice <strong>on</strong> behalf of theiremploying organisati<strong>on</strong>.<str<strong>on</strong>g>The</str<strong>on</strong>g> facilitators of the supervisi<strong>on</strong> evenings are paid for theevenings, their own supervisi<strong>on</strong> is not funded.Assessing colleagues, matching mentor to mentee, and runningtaster events is paid at similar rates. However some mentors d<strong>on</strong>ot invoice the service.BUILDING A TEAMDr Rebecca Viney was appointed to lead the service in February2008, the service sits within the newly established FacultyDevelopment Unit. One of her early tasks was to build a team.Administrative support was essential and a variety of talents andinnovati<strong>on</strong>s were brought to the service by administrators. Thosementors with the most experience matched mentors to mentees,ran taster sessi<strong>on</strong>s, facilitated the supervisi<strong>on</strong> evenings, ran a bookclub <strong>on</strong> coaching and mentoring, helped to develop strategy andassessed new mentors.A formal <strong>Mentoring</strong> Advisory Group (later to be renamed the<strong>Coaching</strong> and <strong>Mentoring</strong> Advisory Group or CMAG) was setup after the first six m<strong>on</strong>ths, <strong>on</strong>ce the decisi<strong>on</strong> had been madeto c<strong>on</strong>tinue to support the service after the transiti<strong>on</strong> m<strong>on</strong>iesran out. CMAG was set up to provide advice to the service byincluding mentoring experts and the stakeholders; supporting thedevelopment of strategy and policies, and aligning them to thestrategic objectives of the Deanery. <str<strong>on</strong>g>The</str<strong>on</strong>g> membership of the CMAGincludes representatives of the Deanery, local educati<strong>on</strong> providers,trainees, a lay member and external experts in the field. A broadernetwork of support was developed by identifying interestedcolleagues within the Deanery and other educati<strong>on</strong> providers bothin L<strong>on</strong>d<strong>on</strong> and more widely. This wider group proved a valuablesource of practical support and champi<strong>on</strong>ship, helping to spreadthe word about the service am<strong>on</strong>g their colleagues.<str<strong>on</strong>g>The</str<strong>on</strong>g> service appointed a mentoring tutor for 18 m<strong>on</strong>ths, to assistthe lead with matching of mentees to mentors and then morespecifically with doctors in difficulty.L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 13


Principles of the ServiceBased <strong>on</strong> a review of the literature about coaching and mentoringand discussi<strong>on</strong>s with colleagues who had set up mentoringarrangements in their own organisati<strong>on</strong>s, a set of principles for theservice was agreed (Viney and Bhatti, 2010). <str<strong>on</strong>g>The</str<strong>on</strong>g>se included:Voluntary participati<strong>on</strong><str<strong>on</strong>g>The</str<strong>on</strong>g> full benefits of coaching and mentoring are realised <strong>on</strong>ly if bothparties come to the process as willing volunteers, and feel able towithdraw if it is not working out.C<strong>on</strong>fidentialityBoth parties must be able to trust each other and speak openlyand h<strong>on</strong>estly without fear of being quoted. Some mentees mightprefer the very fact that they are being mentored to be keptc<strong>on</strong>fidential. Disclosure of informati<strong>on</strong> to another body will <strong>on</strong>lybe made in those rare circumstances where there is a seriousc<strong>on</strong>cern about the safety of the practiti<strong>on</strong>er-patient, their patientsor the public, or where there is c<strong>on</strong>cern about criminal activity.<str<strong>on</strong>g>The</str<strong>on</strong>g> Mentee would be informed that the disclosure was about tohappen and every effort would be made to gain their c<strong>on</strong>sent first.ExternalityExternality is accessing a mentor who is not from the mentee’sspeciality or place of work .Whilst many organisati<strong>on</strong>s, inhealthcare and outside it, have set up successful internal schemes,there is str<strong>on</strong>g evidence that people benefit in being able to talkto some<strong>on</strong>e outside the employing organisati<strong>on</strong>, and outside thespecialty in which they are working. In this way, the mentorcan remain purely objective and can listen fully to the menteewithout his/her own experience potentially leading to pre-judging.In additi<strong>on</strong>, the outside perspective is often valuable. Wherepossible therefore, mentees should not be matched with mentorsfrom their own specialty or employing organisati<strong>on</strong>. In this wayc<strong>on</strong>fidentiality is ensured and the mentee gains the benefits of anoutside perspective.Choice<str<strong>on</strong>g>The</str<strong>on</strong>g> mentee must have a choice of mentors, with the opti<strong>on</strong>, wherepossible, to have <strong>on</strong>e from the same sex or ethnicity, a similarbackground, or who has had to deal with similar issues. However,the mentee should be discouraged from choosing a mentor <strong>on</strong> thebasis of patr<strong>on</strong>age. This may involve the mentee hoping that thementor may give directive advice that may not be the best soluti<strong>on</strong>to this individual case or use their influence in promoting theinterests of their Mentee.Mentee preparati<strong>on</strong><strong>Coaching</strong> and mentoring are not currently embedded in theNHS culture. Applicants to be mentored may have little previousexperience of the type of service being offered. Informati<strong>on</strong> shouldbe readily available <strong>on</strong> the dedicated website and further detailprovided by the matchers and mentors by teleph<strong>on</strong>e. <str<strong>on</strong>g>The</str<strong>on</strong>g> menteesshould be clearly instructed in their resp<strong>on</strong>sibilities to prepare forsessi<strong>on</strong>s beforehand, to identify problems to work <strong>on</strong> and c<strong>on</strong>cordwith any agreed change from the mentoring sessi<strong>on</strong>s.Trained mentors<str<strong>on</strong>g>The</str<strong>on</strong>g> central plank of the service is that the skills required forsuccessful coaching and mentoring have to be learned and that allmentors in the scheme will have had at least 3 days of hands-<strong>on</strong>training and successfully passed an assessment of competence.This in c<strong>on</strong>juncti<strong>on</strong> with the <strong>on</strong>going support is a means ofensuring uniformity of approach and good practice.Ongoing supportMastery of coaching and mentoring skills involves training,supervised practice and reflective practice facilitated with expertprofessi<strong>on</strong>al support. <str<strong>on</strong>g>The</str<strong>on</strong>g> service should provide these elementsand require its mentors to participate.C<strong>on</strong>tracting<str<strong>on</strong>g>The</str<strong>on</strong>g> Deanery/mentor and mentor/mentee c<strong>on</strong>tracts shouldbe explicit and signed by both parties. <str<strong>on</strong>g>The</str<strong>on</strong>g> ground rules andboundaries were covered in the training of mentors. <str<strong>on</strong>g>The</str<strong>on</strong>g>y will beset out in the written material supplied to mentees who be askedto state that they have read it before their applicati<strong>on</strong>is progressed.Ethics<str<strong>on</strong>g>The</str<strong>on</strong>g> ethical framework within which the service operates will bemade clear to all parties through training and via written guidelinessupplied <strong>on</strong> the website.Avoidance of dependence<str<strong>on</strong>g>The</str<strong>on</strong>g> mentoring should be restricted to 4 sessi<strong>on</strong>s in order to focusminds and discourage an <strong>on</strong>-going dependent relati<strong>on</strong>ship, sincethe aim of the service to foster self-resourcefulness.No blameA mentoring relati<strong>on</strong>ship can be intense and interpers<strong>on</strong>al fricti<strong>on</strong>or lack of rapport may interfere with its effectiveness. Either mentoror mentee will be able to withdraw from a mentoring relati<strong>on</strong>shipat any time without blame or repercussi<strong>on</strong>s. <str<strong>on</strong>g>The</str<strong>on</strong>g> mentee may bere-matched in these circumstances.14L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


M<strong>on</strong>itoring, evaluati<strong>on</strong> and reviewAs with any service funded by public m<strong>on</strong>ey, there must be asystem of quality c<strong>on</strong>trol and quality improvement, with regularfeedback from participants and other stakeholders.Equal opportunitiesAll mentors must have evidence of having undertaken recent equalopportunity training.Website development<str<strong>on</strong>g>The</str<strong>on</strong>g> website was intended to be the shop window for the service.It was important that it should be prominently displayed <strong>on</strong> theDeanery home page to advertise the service and facilitate ease ofaccess. <str<strong>on</strong>g>The</str<strong>on</strong>g> Deanery’s web team with the mentoring lead havedesigned a well-structured home page that clearly presents theservice and enables navigati<strong>on</strong> to relevant informati<strong>on</strong>. Feedbackfrom users has been very positive. Importantly, any<strong>on</strong>e enteringthe keywords “mentoring” and “L<strong>on</strong>d<strong>on</strong>” into Google will find thewebsite www.mentoring.l<strong>on</strong>d<strong>on</strong>Deanery.ac.uk in the first few hits.<str<strong>on</strong>g>The</str<strong>on</strong>g> L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong>Service HomepageL<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 15


Written MaterialsRegular updates, overviews and handbooks for mentors andmentees, have been published explaining the underlying coachingand mentoring c<strong>on</strong>cepts, the service and its boundaries. <str<strong>on</strong>g>The</str<strong>on</strong>g>seresources have proved to be a vital ingredient in the success of theventure. <str<strong>on</strong>g>The</str<strong>on</strong>g>y have helped to ensure that all parties have a sharedexpectati<strong>on</strong> of the mentoring relati<strong>on</strong>ship and the resp<strong>on</strong>sibilitiesof all parties. <str<strong>on</strong>g>The</str<strong>on</strong>g> handbooks, ethical guide, and answers tofrequently asked questi<strong>on</strong>s (FAQs) about the service providethe practical details that help individuals find their way throughthe system with a minimum of misunderstanding, c<strong>on</strong>fusi<strong>on</strong> orfrustrati<strong>on</strong> (Mentor agreement).It makes a huge difference having people come“with a good idea of what to expect and whatthe ground rules are from reading the website –it means we d<strong>on</strong>’t have to spend too much time<strong>on</strong> the preliminaries and can get stuck rightinto the work.”(mentor)<str<strong>on</strong>g>The</str<strong>on</strong>g> written material was based <strong>on</strong> published material (Clutterbuck,1991, Rogers, 2004, C<strong>on</strong>nor and Pokara 2007), and <strong>on</strong> materialsused by colleagues running mentoring in their own organisati<strong>on</strong>s.Mentor agreement• Mentors will fit with the pers<strong>on</strong>specificati<strong>on</strong> and job descripti<strong>on</strong>core competencies.• Mentors will attend 3 day mentoringcourse /unless they have attended anapproved equivalent.• Mentors will be self employed for theirmentoring sessi<strong>on</strong>s except by prioragreement with the Deanery.• Mentors will attend a minimum of 50%of local support group meetings annually.• Mentors will be prepared to take aminimum of <strong>on</strong>e Mentee at any<strong>on</strong>e time.• Mentors will see each new Mentee foran introductory sessi<strong>on</strong>, and if theyagree they will send back a <str<strong>on</strong>g>report</str<strong>on</strong>g> afterfirst meeting sessi<strong>on</strong> and set datesfor further meetings not more than 3m<strong>on</strong>ths apart.• <str<strong>on</strong>g>The</str<strong>on</strong>g> commitment to 4 sessi<strong>on</strong>s needs tobe undertaken within 12 m<strong>on</strong>ths (unlessextensi<strong>on</strong>s have had prior agreementfrom the Deanery).• After each sessi<strong>on</strong> the mentor will returnan invoice and Mentor and Menteerecording sheet to the administrator.<str<strong>on</strong>g>The</str<strong>on</strong>g>y may also choose to complete amentor development reflectivepractice form.16L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


• It is the resp<strong>on</strong>sibility of mentors toretain c<strong>on</strong>tact with the mentee andmake a record of all attempts to c<strong>on</strong>tact.If the appointment is cancelled, thementor should arrange a new date. It isimportant that a signed Mentor c<strong>on</strong>tractis submitted al<strong>on</strong>g with invoices. Pleasesee the Mentor C<strong>on</strong>tract in the nextsecti<strong>on</strong>.• Mentors will tell the administrator whenthe mentoring c<strong>on</strong>tract is completed, sothat an Exit Evaluati<strong>on</strong> Questi<strong>on</strong>naire willbe sent to the departing Mentee.• Mentors should be prepared to travel areas<strong>on</strong>able distance to meet the Mentee.• Mentors should keep a Pers<strong>on</strong>alDevelopment Plan (PDP) in relati<strong>on</strong> totheir own learning needs as mentors.• Mentors will sign the Declarati<strong>on</strong>form for the selecti<strong>on</strong> and reselecti<strong>on</strong>purposes.• Mentors will inform the <strong>Mentoring</strong> Leadshould he/she be involved in a complaintby the Mentee (see declarati<strong>on</strong> form).RECRUITING AND SELECTING MENTORSAwareness of the service was raised through flyers, taster sessi<strong>on</strong>sto the educati<strong>on</strong>al networks in primary and sec<strong>on</strong>dary care, andby word of mouth. Further informati<strong>on</strong> and applicati<strong>on</strong> formswere provided <strong>on</strong> the website. <str<strong>on</strong>g>The</str<strong>on</strong>g> <strong>on</strong>line applicati<strong>on</strong> form wasdesigned to identify which candidates had previous experienceand to capture candidates’ views and expectati<strong>on</strong>s of mentoring .A few applicants argued that they did not require training as theywere working as a mentor, had previous training or their experiencehad already provided them with the required skills. However theprinciples of the service required all applicants to be trained ina c<strong>on</strong>sistent manner and undergo an assessment. Those whostated in their applicati<strong>on</strong> that they were already trained wererequired to attend a “gateway day” to refresh their training and beassessed. Unless the applicant had both passed the assessmentand previously undertaken at least three days of a substantiverecognised training course they were required to undertake theDeanery’s three day training course in mentoring skills. A handfulof applicants with extensive mentoring experience but less than3 days training were allowed to start mentoring after passing theassessment provided they agreed to undertake the three daytraining course within the next year.<str<strong>on</strong>g>The</str<strong>on</strong>g> recruitment process targeted doctors and dentists who hadeducati<strong>on</strong>al roles, and encouraged applicants from a wide rangeof specialties and settings. <str<strong>on</strong>g>The</str<strong>on</strong>g> intenti<strong>on</strong> was to embed a cultureof coaching and mentoring across L<strong>on</strong>d<strong>on</strong>’s NHS. In the sec<strong>on</strong>drecruitment round applicants from over-represented specialitiesand Trusts were not accepted for training while extra efforts weremade to recruit from the under-represented areas.• Mentors will be prepared to appraise amentor colleague.• Where mentors and mentees decideto c<strong>on</strong>tinue with their sessi<strong>on</strong>s afterdeanery funding expires (e.g. with theclient or a trust paying) the arrangementsshould be approved by the Deanery.Mentor Handbook, L<strong>on</strong>d<strong>on</strong> Deanery<strong>Coaching</strong> and mentoring website11 Sep 2010L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 17


TRAINING, SUPERVISION ANDDEVELOPMENT OF MENTORSTraining<str<strong>on</strong>g>The</str<strong>on</strong>g> next step was to make sure the Deanery’s coaching andmentoring service provided excellent training for mentors. Trainingpartners were required who would ensure that all mentors wereequipped with the competence required. See below.EIGHT COACHING/MENTORINGCOMPETENCE CATEGORIES1. Understanding SelfDem<strong>on</strong>strates awareness of own values,beliefs and behaviours, recognises howthese affect their practice and uses this selfawarenessto manage their effectiveness inmeeting the client’s, and where relevant, thesp<strong>on</strong>sor’s objectives.2. Commitment to Self-DevelopmentExplores and improves the standard of theirpractice and maintain the reputati<strong>on</strong> ofthe professi<strong>on</strong>.3. Managing the C<strong>on</strong>tractEstablishes and maintains the expectati<strong>on</strong>sand boundaries of the coaching/mentoringc<strong>on</strong>tract with the client and, whereappropriate, with sp<strong>on</strong>sors.4. Building the Relati<strong>on</strong>shipSkilfully builds and maintains an effectiverelati<strong>on</strong>ship with the client, and whereappropriate, with the sp<strong>on</strong>sor.5. Enabling Insight and LearningWorks with the client and sp<strong>on</strong>sor to bringabout insight and learning.6. Outcome and Acti<strong>on</strong> Orientati<strong>on</strong>Dem<strong>on</strong>strates approach, and uses theskills, in supporting the client to makedesired changes.7. Use of Models and TechniquesApplies models and tools, techniques andideas bey<strong>on</strong>d the core communicati<strong>on</strong> skillsin order to bring about insight and learning.8. Evaluati<strong>on</strong>Gathers informati<strong>on</strong> <strong>on</strong> the effectiveness oftheir practice and c<strong>on</strong>tributes to establishinga culture of evaluati<strong>on</strong> of outcomes.European <strong>Mentoring</strong> and <strong>Coaching</strong>Council, 2009Initially the <strong>Coaching</strong> and <strong>Mentoring</strong> service partnered with MTASto establish a service. To achieve the rapid roll-out of a highquality service, doctors and dentists who were known to be activementors were approached. Selected companies’ training wasdirectly observed; training materials and the training experiences ofmentors were compared. Three potential partners were identifiedand approached to explore a training programme and its costs. Bythe end of the first year, training requirements had been outlinedand tenders sought widely against our specificati<strong>on</strong>s. Based<strong>on</strong> this process Management Futures was selected to be theprovider partner for a three day intensive hands-<strong>on</strong> course with anassessment at the end of it.“What I liked about the course was that it washands-<strong>on</strong> right from the start. You got theopportunity to try things out as so<strong>on</strong> as youlearned about them, and you got immediatefeedback <strong>on</strong> how you were doing.”(GP mentor)18L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


Supervisi<strong>on</strong> and development<str<strong>on</strong>g>The</str<strong>on</strong>g> service has a str<strong>on</strong>g emphasis <strong>on</strong> supervisi<strong>on</strong> and furtherdevelopment of mentors, in line with the c<strong>on</strong>cepts described byHay, Supervisi<strong>on</strong> and development encourages reflective practiceand c<strong>on</strong>tinuous improvement and keeps interest alive (Hay, 2007).Mentors agree in their c<strong>on</strong>tract to undertake a minimum of twosessi<strong>on</strong>s of mentoring development per annum, most undertakec<strong>on</strong>siderably more. Individual annual reviews of all mentors takesplace to quality assure the pool of mentors and to plan their furthermentoring development. Mentors are invited to attend quarterlysupervisi<strong>on</strong> evenings, half day skills boosters and forums <strong>on</strong>specific topics through the Deanery. In additi<strong>on</strong> NHS L<strong>on</strong>d<strong>on</strong> hasoffered some teleph<strong>on</strong>e supervisi<strong>on</strong>.All mentors are actively encouraged to undertake the Instituteof Leadership and Management (ILM) Certificate or Diploma inExecutive <strong>Coaching</strong> and Leadership <strong>Mentoring</strong>. An additi<strong>on</strong>albenefit of the ILM programme is that participants have access to apeer mentor and pers<strong>on</strong>al supervisi<strong>on</strong> by teleph<strong>on</strong>e.<str<strong>on</strong>g>The</str<strong>on</strong>g> importance of supporting trained mentors with <strong>on</strong>goingsupervisi<strong>on</strong> was recognised from the start. <str<strong>on</strong>g>The</str<strong>on</strong>g> Tavistock Clinic,which already provided training in clinical supervisi<strong>on</strong> for theDeanery, agreed to facilitate group supervisi<strong>on</strong> at a centrallocati<strong>on</strong>. Four supervisi<strong>on</strong> groups (<strong>on</strong>e for each geographicalquarter of L<strong>on</strong>d<strong>on</strong>) were run by psychotherapist facilitators <strong>on</strong>ceevery eight to ten weeks. At the start <strong>on</strong>ly <strong>on</strong>e facilitator was adeanery mentor. Over time five of the facilitators became trained asmentors.After about six m<strong>on</strong>ths, mentors requested that the groups meetnearer their homes. Two Deanery mentors from the MaudsleyHospital in south L<strong>on</strong>d<strong>on</strong> offered to facilitate the two South L<strong>on</strong>d<strong>on</strong>groups , supported by a professi<strong>on</strong>al coach and a highly skilledmedical director. However the attendance was patchy and somementors missed the c<strong>on</strong>necti<strong>on</strong> with other mentors andthe Deanery.Since then supervisi<strong>on</strong> has been provided approximately every 2m<strong>on</strong>ths at a central locati<strong>on</strong> chosen for its accessibility. As well assupervisi<strong>on</strong>, the mentors and facilitators have the opportunity t<strong>on</strong>etwork over a light meal, join in with a coaching and mentoringbook club and catch up <strong>on</strong> Deanery news. <str<strong>on</strong>g>The</str<strong>on</strong>g> aim is to enhancereflecti<strong>on</strong> and develop skills rather than review “cases”, - alwaysremembering that the mentee is resourceful and is not a patient.‘Mentor Forums’ were also provided, their purpose being tointroduce the mentors to techniques and issues that were notaddressed in the initial training. <str<strong>on</strong>g>The</str<strong>on</strong>g>y were also an opportunityto provide an update <strong>on</strong> the development of the service. <str<strong>on</strong>g>The</str<strong>on</strong>g>seevents have included themes such as;• Helping the doctor in difficulty• Leadership skills and coaching andmentoring• Emoti<strong>on</strong>al intelligence and the tools tomeasure itMARKETING THE SERVICEL<strong>on</strong>d<strong>on</strong> Deanery is the largest Deanery in the country, resp<strong>on</strong>siblefor commissi<strong>on</strong>ing and managing the postgraduate educati<strong>on</strong>of over 12,000 doctors and dentists. It also has resp<strong>on</strong>sibilityfor supporting the c<strong>on</strong>tinuing professi<strong>on</strong>al development of staffand associate specialist grades (SASGs), GPs and c<strong>on</strong>sultanteducators. An important initial c<strong>on</strong>siderati<strong>on</strong> related to which ofthese should be eligible for the service, given our finite resources.From the start it was agreed that all doctors and dentists workingin the NHS in L<strong>on</strong>d<strong>on</strong> were eligible to apply to be mentoredthrough the service, though not necessarily funded by the Deanery.Funding eligibility initially included <strong>on</strong>ly those doctors and dentistswho were in training or in the first two years after completi<strong>on</strong> oftraining, and also GPs <strong>on</strong> the Inducti<strong>on</strong> and Refreshment Scheme.After a few m<strong>on</strong>ths, in resp<strong>on</strong>se to demand and because fundingwas available, SASGs were added. It did not seem appropriate tooffer the service to doctors not working in the NHS or in L<strong>on</strong>d<strong>on</strong>.Start-up funding had been made available to provide trainedmentors for doctors in career difficulty following MTAS, and thosewere the first group targeted. Once the decisi<strong>on</strong> was made toextend the service, the challenge was to rapidly publicise it to thepeople who would most benefit hear about it quickly, enablingthe mentors to put their new skills into practice without delay.However, the level of uptake of the service by mentees wasuncertain, and the Deanery did not want to leave applicantsdisappointed or disillusi<strong>on</strong>ed by stimulating demand bey<strong>on</strong>d thecapacity to meet it. <str<strong>on</strong>g>The</str<strong>on</strong>g> initial marketing strategy was therefore toadvertise <strong>on</strong> the Deanery website and send flyers out through theeducati<strong>on</strong>al networks, ie a soft launch to test the water. Once itwas agreed that all SASGs would be eligible, individual invitati<strong>on</strong>swere sent to their email addresses and the service was promotedvia the flyers to medical directors. Further promoti<strong>on</strong> was achievedthrough presentati<strong>on</strong>s given by the mentoring lead, mentors andmembers of CMAG at a range of educati<strong>on</strong>al events aroundL<strong>on</strong>d<strong>on</strong>, including the Deanery’s SASG websitewww.fr<strong>on</strong>tier.l<strong>on</strong>d<strong>on</strong>Deanery.ac.uk and through SASG tutors.New c<strong>on</strong>sultants and GPs were reached through the deanery’sannual c<strong>on</strong>ferences. Taster sessi<strong>on</strong>s at which people couldexperience a brief mentoring encounter were organised at severaleducati<strong>on</strong>al events, most notably as part of the 2009 BMJCareers Fair.L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 19


Matching Mentees to MentorsAs the principle of choice is important, it was decided to offerpeople applying to be mentored a choice of mentors. All mentorssuccessfully completing the assessment.Are asked to write a brief ‘pen portrait’ of themselves, includingbrief details of their background, specialty and interests. <str<strong>on</strong>g>The</str<strong>on</strong>g>Deanery keeps a register of trained mentors, the number ofmentees they are working with, where they prefer to meet menteesand any other preferences. Applicants to be mentored are advisedbefore applying to familiarise themselves with the material <strong>on</strong> thewebsite. Once the applicati<strong>on</strong> is received, it is checked againstthe GMC or GDC website and the mentee’s funding eligibility isc<strong>on</strong>firmed. <str<strong>on</strong>g>The</str<strong>on</strong>g> administrator then passes the applicati<strong>on</strong> to the<strong>Mentoring</strong> lead and <strong>Mentoring</strong> Tutor who c<strong>on</strong>tact <strong>on</strong>e of the smallteam of ‘matchers’ - experienced mentors who undertake thisadditi<strong>on</strong>al work <strong>on</strong> behalf of the Deanery. <str<strong>on</strong>g>The</str<strong>on</strong>g> matcher teleph<strong>on</strong>esthe applicant and referring to the mentee’s applicati<strong>on</strong> exploreswhat the issue is that they want to work <strong>on</strong> and what they canexpect to get out of being mentored. <str<strong>on</strong>g>The</str<strong>on</strong>g> nature of mentoring isexplored, and distinguished where necessary from advice-giving,informati<strong>on</strong> provisi<strong>on</strong>, patr<strong>on</strong>age or therapy. This discussi<strong>on</strong> servestwo purposes, first in managing the expectati<strong>on</strong>s of those whogo <strong>on</strong> to be mentored and sec<strong>on</strong>d in identifying those for whomcoaching and mentoring will not meet their needs. In such casesthe applicant may be directed towards a more appropriate sourceof support, locally or via other Deanery services such as MedNetwww.l<strong>on</strong>d<strong>on</strong>Deanery.ac.uk/var/support-for-doctors/MedNetor the Careers Unit www.l<strong>on</strong>d<strong>on</strong>Deanery.ac.uk/var/careers-unit<str<strong>on</strong>g>The</str<strong>on</strong>g> pen portraits of 3-5 mentors that would seem to suit theirpreferences are then emailed across and the applicant has time toc<strong>on</strong>sider and make a choice. <str<strong>on</strong>g>The</str<strong>on</strong>g>y are reminded of the ‘no blame’policy and that they can decide that they would prefer anothermentor if issues arise. <str<strong>on</strong>g>The</str<strong>on</strong>g> matcher gently reminds potentialmentees to resp<strong>on</strong>d and is able to gauge the level of commitmentto being mentored. <str<strong>on</strong>g>The</str<strong>on</strong>g> matcher with the deanery may agreenot to pursue further <strong>on</strong>ce a certain level of n<strong>on</strong>-resp<strong>on</strong>se hasbeen reached.Feedback and Evaluati<strong>on</strong>Feedback about the service was encouraged from the start, fromboth mentors and mentees. Evaluati<strong>on</strong>s are an intrinsic part ofeach of the training and supervisory events provided for mentors,and the comments have been used to improve the c<strong>on</strong>tent andsetting of these events. Regular meetings to discuss feedbackwith the training and supervisi<strong>on</strong> partners ensured the quality andc<strong>on</strong>text of the training improved over time. Records are kept of thetraining and supervisi<strong>on</strong> accessed by each mentor. At the simplestlevel, records are kept of how many mentees each mentor hasand how many sessi<strong>on</strong>s have occurred. Evaluating the successof the relati<strong>on</strong>ship is necessarily more difficult. While what goes<strong>on</strong> in the sessi<strong>on</strong>s is c<strong>on</strong>fidential, the Deanery team are awareof who is being mentored and by whom, and can reas<strong>on</strong>ablyask for feedback <strong>on</strong> the success of the mentoring in its closuredocumentati<strong>on</strong> and also by teleph<strong>on</strong>ing individual mentors andmentees to hear how they are getting <strong>on</strong>. This feedback is regularlydiscussed at meetings of CMAG in order to encourage c<strong>on</strong>tinuousquality improvement.A formal evaluati<strong>on</strong> of the first year of the service was carried outbetween January and July 2009. <str<strong>on</strong>g>The</str<strong>on</strong>g> evaluati<strong>on</strong> was carried outby the <strong>Coaching</strong> & <strong>Mentoring</strong> Research Unit at Sheffield BusinessSchool. <str<strong>on</strong>g>The</str<strong>on</strong>g>y carried this out by interviewing stakeholders withinthe Deanery and CMAG; surveying mentors and mentees;c<strong>on</strong>ducting case studies with 8 mentor:mentee pairings andreviewing the Deanery’s documentati<strong>on</strong> relating to the governanceand management structures, processes and procedures of theservice. <str<strong>on</strong>g>The</str<strong>on</strong>g> results of this evaluati<strong>on</strong> were the subject of a <str<strong>on</strong>g>report</str<strong>on</strong>g>(Chadwick-Coule and Garvey, 2009) available <strong>on</strong> request fromthe Deanery. In brief, stakeholders were very positive about theleadership, the training, the service and the way it was organised.Both mentors and mentees <str<strong>on</strong>g>report</str<strong>on</strong>g>ed that their expectati<strong>on</strong>s weremet or exceeded. Mentors and to a lesser extent mentees, noteda beneficial impact <strong>on</strong> their listening skills, their management of selfand others, and their resp<strong>on</strong>se to a challenging situati<strong>on</strong>.20L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


THE PARTICIPANTS21L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


MISSING<str<strong>on</strong>g>The</str<strong>on</strong>g> MentorsCHART 1 AGE 1% GROUPING OF MENTORSOVER 6030-40A mentor does not give advice, rather helps“ 8%11% MISSINGthe mentee to weigh up situati<strong>on</strong>s, through a1%process of reflecti<strong>on</strong>, questi<strong>on</strong>s, challenge andOVER 6030-40feedback allowing the mentee to come to a8%11%decisi<strong>on</strong> themselves. It is crucial to remember50-60that in any mentoring relati<strong>on</strong>ship it is the30%mentee who drives the agenda, notthe mentor. 50-60”30%(L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and<strong>Mentoring</strong> website)<str<strong>on</strong>g>The</str<strong>on</strong>g> success of a coaching and mentoring service depends heavily<strong>on</strong> having a cadre of capable mentors who are approachable, wellinformedand skilled at helping their mentees think through howbest to achieve their goals. <str<strong>on</strong>g>The</str<strong>on</strong>g> Deanery was fortunate in attractinga str<strong>on</strong>g group of mentors, with a sufficient range of pers<strong>on</strong>alities,styles and backgrounds to present mentees with a real choice. ByMarch 2010, 140 had completed the initial training programme and104 were actively mentoring.Demographics of mentorsWomen made up 55% of those trained, and 60% of thoseactively mentoring. 68% of mentors were white and the remainderwere from a wide range of ethnic backgrounds, reflecting thedemographics of L<strong>on</strong>d<strong>on</strong>’s GPs and c<strong>on</strong>sultants. Nearly halfof the trained mentors were GPs. <str<strong>on</strong>g>The</str<strong>on</strong>g> rest were from a widerange of specialties (Chart 2). Almost all the mentors were GPsor c<strong>on</strong>sultants. At this stage trainee groups were not targeted.SASGs were targeted, and 8 undertook the training, of whomfour were actively mentoring. <str<strong>on</strong>g>The</str<strong>on</strong>g> mentors came from 58 differenthealthcare organisati<strong>on</strong>s in L<strong>on</strong>d<strong>on</strong>.40-5050%40-5050%CHART 2 SPECIALTY OF MENTORSTRAINEDO&G2%PHM EMO&G1% 3%2%GPDENTAL PHM EM46%5% 1% 3%GP PSYCH DENTAL46% 7% 5%ANAESTHPSYCH7%7%ANAE7%22L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> ServiceMEDICINE13%SURGERY8%PAEDS8%MEDICINE13%SURG8%PAEDS8%


Previous experience of mentoringApplicants to become a mentor in the service were asked abouttheir previous experience or training. While <strong>on</strong>ly 39/152 (26%) hadbeen <strong>on</strong> some form of formal training in mentoring, most felt thatthey had carried out a mentoring role, formal or informal, usuallywith junior colleagues or students at their place of work. After thethree day training many recognised that their previous ‘mentoring’largely related to patr<strong>on</strong>age or advice giving and this differed, fromthe model of mentoring promoted within the Deanery’s service.I have not d<strong>on</strong>e any official mentoring training“up do date but as a senior doctor in my trustand having finished my training a while ago Ialways find myself in a positi<strong>on</strong> of giving careeradvice and help to other people.”(C<strong>on</strong>sultant)Motivati<strong>on</strong> to become a mentorWhen asked <strong>on</strong> the applicati<strong>on</strong> form to give their reas<strong>on</strong>s forwanting to become a mentor almost every<strong>on</strong>e referred to theirdesire to help others, give something back, make a difference.Several saw this as an extensi<strong>on</strong> of their role as a doctor -improving patient care through supporting colleagues. Somecommented <strong>on</strong> the help they had themselves received at difficulttimes, or they wished they had received. <str<strong>on</strong>g>The</str<strong>on</strong>g>re was a str<strong>on</strong>gsense of empathy with younger colleagues facing careercrossroads, making important career transiti<strong>on</strong>s, or coping withorganisati<strong>on</strong>al change.I would like to be a “Yoda” or “Mr Miyagi” to an“aspiring or young c<strong>on</strong>sultant, hopefully passing<strong>on</strong> what experience I can impart in guiding/developing some<strong>on</strong>e else’s career. Professi<strong>on</strong>all<strong>on</strong>eliness or lack of guidance can be a problemin senior positi<strong>on</strong>s.”(C<strong>on</strong>sultant)I think general practice can be a very isolating“job and the more we can do to bring in formalnetworks to decrease this the better, peoplebecome very set in their ways, even in largegroup practices as partners, and often d<strong>on</strong>’tlook at their way of work.”(GP)A few made the point that they expected the relati<strong>on</strong>ship would beenriching for them too.I have always enjoyed supporting my colleagues“and peers in their pers<strong>on</strong>al and professi<strong>on</strong>aldevelopment and the development of theirpractices. This aspect of my work has enrichedmy own pers<strong>on</strong>al/professi<strong>on</strong>al developmentover many years.”(GP)That the mentors’ own performance might benefit initially came assomething of a surprise to mentors. However during the trainingsessi<strong>on</strong>s it was clear that mentors were struck by the differencein impact between a problem solving, advice-giving approachand an actively listening, questi<strong>on</strong>ing approach, and readily madec<strong>on</strong>necti<strong>on</strong>s to the way they dealt with their own staff and patients.Doing mentoring has changed the way I talk to“people – patients, juniors, colleagues. Even myfamily has noticed!”(C<strong>on</strong>sultant)<str<strong>on</strong>g>The</str<strong>on</strong>g> benefit to mentors was c<strong>on</strong>firmed in a questi<strong>on</strong>naire surveysent to active mentors during the sec<strong>on</strong>d year, of whom 49resp<strong>on</strong>ded. (Charts 3 and 4)L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 23


CHART 3. BENEFIT TO MENTOR INMANAGING SELFENCOURAGE OTHERS TO FIND WAYS OF DEALINGWITH PROBLEMS AND/OR ANXIETIESCAREFULLY MANAGE MY OWN RESPONSESAND REACTIONS WHEN FACED WITH ADEMANDING SITUATIONTAKE CONSCIOUS STEPS TO MANAGEMY EMOTIONS AND PRESSURESPACE MY EFFORTS FOR THE LONG HAUL,SEEKING SUPPORT AS NECESSARY0 10 20 30 40 50 60 70 80 90 100% AGREEING0CHART 10 4. 20BENEFIT 30 40TO 50 MENTOR 60 70 IN 80 90 100MANAGING CHALLENGING % AGREEING SITUATIONSLISTEN TO THE VIEWS OF OTHERS0 10 20 30 40 50 60 70 80 90 100% AGREEING0 10 20 30 40 50 60 70 80 90 100% AGREEINGFEEL COMFORTABLE INVOLVING OTHERS INSUPPORTING MEDRAW ON MY OWN EXPERIENCES AND AMOPTIMISTIC THAT I WILL ACHIEVE GOALSHAVE CONFIDENCE IN MY OWNCAPABILITIESRELISH THE CHALLENGE AND FEEL ABLETO SUCCEEDBE PREPARED TO CHALLENGE THE STATUS QUOIN ORDER TO ACHIEVE SERVICE IMPROVEMENTMANAGE MY OWN ANXIETY ANDAPPEAR CONFIDENT24L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


<str<strong>on</strong>g>The</str<strong>on</strong>g> MenteesDemographics of menteesFemales made up 62% of applicants for mentoring. 52% werewhite and the remainder from a variety of ethnic backgrounds;75% were aged 40 or less. Just under half the applicants weretrainees, distributed fairly evenly across the grades (Chart 5).<str<strong>on</strong>g>The</str<strong>on</strong>g>y came from a wide variety of specialties and employingorganisati<strong>on</strong>s across L<strong>on</strong>d<strong>on</strong>.Reas<strong>on</strong>s for applying to be mentoredApplicati<strong>on</strong> reas<strong>on</strong>s were dominated by dilemmas over careerdecisi<strong>on</strong>s, progressi<strong>on</strong> and development. <str<strong>on</strong>g>The</str<strong>on</strong>g>y ranged from thevery general to the very specific. In a few cases the main or <strong>on</strong>lyreas<strong>on</strong> given was that they had been referred, ie some<strong>on</strong>e else hadrecommended they apply, whether a friend, supervisor, trainingprogramme director or even the GMC (Charts 6 and 7).I recognise not <strong>on</strong>ly in myself but in colleagues“that there are currently many questi<strong>on</strong>s aboutmotivati<strong>on</strong> with regards to our vocati<strong>on</strong>, andbelieve str<strong>on</strong>gly in the mutual need for supportam<strong>on</strong>g doctors.”(New c<strong>on</strong>sultant)I am at the point in my training where I have to“decide what path I want my career to take. I amfinding this decisi<strong>on</strong> very challenging and I’vebeen struggling with it for some time. I’d likea mentor as an objective sounding board so Ican work through my opti<strong>on</strong>s. C<strong>on</strong>versati<strong>on</strong>swith c<strong>on</strong>sultants in my field always end up withadvice rather than what I actually need.”(Specialty trainee)I would like advice <strong>on</strong> issues surrounding“c<strong>on</strong>sultati<strong>on</strong>s, and patient doctor relati<strong>on</strong>s.”(GP trainee)CHART 5. CAREER LEVEL OF APPLICANTSCONSULTANT8%GP24%NOT WORKING4%FOUNDATION13%SAS GRADEHIGHER SPECIALTY16% 21%CHART 6. REASON FOR APPLYINGCAREER ENHANCEMENT44%NO ANSWER1%WORK/LIFE BALANCE6%REFERRED6%CORE SPECIALTY14%PROBLEM OR HURDLE12%CRISIS OR CHANGE13%CAREER DECISION18%L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 25


CHART 7. REASON FOR APPLYING,BY GRADE%1009080706050403020100NOT WORKINGFOUNDATIONCOREHIGHERSASGPCONSULTANTREFERREDWORK/LIFE BALANCECAREER ENHANCEMENTCAREER DECISIONPROBLEM OR HURDLECRISIS OR CHANGE26L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


Outcome of applicati<strong>on</strong>As of March 2010, just over half of the applicants had embarked<strong>on</strong> mentoring or completed it and another 20% were goingthrough the matching process. Of the rest, 13% failed to resp<strong>on</strong>dto attempts to make c<strong>on</strong>tact, 9% withdrew their applicati<strong>on</strong> and4% were ineligible for Deanery funding and unable to alternativefunding. 3% were ineligible because they were not working in theNHS or in L<strong>on</strong>d<strong>on</strong> - we had a handful of applicants from the rest ofthe country or abroad. (Chart 8).CHART 8. OUTCOME OF APPLICATION TOBE MENTOREDCOMPLETED14%IN MENTORING37%INELIGIBLE3%NO RESPONSE13%NO FUNDING4%IN PIPELINE20%WITHDRAWN9%Feedback from menteesC<strong>on</strong>fidential feedback from every mentee was sought after theirmentoring was completed. This has been very positive, whereavailable, though getting the evaluati<strong>on</strong> pro-formas completedand returned has proved a challenge. Below are some typicalemail quotes:It was very valuable to be able to discuss some“difficulties with some<strong>on</strong>e outside my departmentand specialty and enabled me to re-find myfeet <strong>on</strong> a training rotati<strong>on</strong> at a point where I wasfinding things very difficult.”I felt although brief and <strong>on</strong>ly 2 sessi<strong>on</strong>s I felt“an amazing sense of support and enjoyedthe chance to discuss career progressi<strong>on</strong>and decisi<strong>on</strong> making with a n<strong>on</strong> anaesthetistincredibly useful. I would like to find out moreinformati<strong>on</strong> <strong>on</strong> becoming a mentor myself inthe future when I have settled into my newc<strong>on</strong>sultant post.”She provided me reflective space in a n<strong>on</strong>“threatening manner to c<strong>on</strong>sider my careeropti<strong>on</strong>s and to examine and challenge my prec<strong>on</strong>ceived ideas about the obstacles in mycareer path.”Topics discussed in sessi<strong>on</strong>s<str<strong>on</strong>g>The</str<strong>on</strong>g> topics discussed during the mentoring sessi<strong>on</strong>s reflectedthose the applicants said they wanted help with, though with moreemphasis <strong>on</strong> work/life balance (Gabbard G 1985) and less <strong>on</strong>technical and professi<strong>on</strong>al knowledge. <str<strong>on</strong>g>The</str<strong>on</strong>g> views of mentors andmentees of the topics discussed did not diverge significantly. <str<strong>on</strong>g>The</str<strong>on</strong>g>mentors’ views are presented here, based <strong>on</strong> 49 resp<strong>on</strong>dents toan early survey (Chart 9).L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 27


CHART 9. MENTORS VIEWS OF TOPICSDISCUSSEDCAREER PROGRESSIONPLANNING LEARNING/DEVELOPMENTWORK-LIFE BALANCEDECISION-MAKINGCURRENT WORK PROBLEMSCPDTIME MANAGEMENT ISSUESREHEARSING ARGUMENTSPERSONAL/DOMESTIC ISSUESRELATIONSHIP WITH TEAMLEADERSHIP ISSUES/SKILLSRELATIONSHIP WITH MANAGEROWN PERFORMANCE ISSUESPERFORMANCE OF COLLEAGUESTECHNICAL/PROFESSIONAL KNOWLEDGE0 10 20 30 40 50 60 70 80 90 100% SAYING A FAIR BIT OR A LOT28L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


C<strong>on</strong>siderati<strong>on</strong>s forthe Future29L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> ServiceL<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 29


Less<strong>on</strong>s learned<str<strong>on</strong>g>The</str<strong>on</strong>g> first two years of the service have proceeded to plan and theservice has recruited and trained its full capacity of mentors whichhas kept pace with mentee applicants. A number of less<strong>on</strong>s werelearnt regarding what went well, and what requires improving thatwill guide the planning for the future.Planning ahead<str<strong>on</strong>g>The</str<strong>on</strong>g> transiti<strong>on</strong>al funding to support those affected by MTASprovided the opportunity to kickstart this programme. However,uncertainty over the availability of further funding made planningahead difficult. It is c<strong>on</strong>sidered that funding for a minimum of threeyears is required to enable c<strong>on</strong>structive forward planning.Keeping recordsCommunicati<strong>on</strong> between the Deanery mentoring team and thementors and mentees has mostly been via email and the website.<str<strong>on</strong>g>The</str<strong>on</strong>g> website c<strong>on</strong>tains a number of useful downloadable forms thatprovide a structure for c<strong>on</strong>tracting, recording sessi<strong>on</strong>s, reflectingand feeding back. Mentors are expected to sign and get thementee to sign, a brief record about the themes of the sessi<strong>on</strong>and any acti<strong>on</strong> points agreed, and to return this to the mentoringoffice. This is important as it forms the basis for invoicing forthose mentors, e.g. GPs, who are self-employed and paid by theDeanery directly for their time. Retrieving this paperwork has notalways been easy and participants have expressed discomfort withreturning notes that may have sensitive informati<strong>on</strong> <strong>on</strong> them. Adecisi<strong>on</strong> has now been taken to exclude any record about themesand acti<strong>on</strong>s agreed. However mentor and mentee may keep thisan<strong>on</strong>ymised informati<strong>on</strong> if jointly agreed as helpful in the process.Marketing<str<strong>on</strong>g>The</str<strong>on</strong>g> service was deliberately given a relatively soft launch, so asnot to create demand bey<strong>on</strong>d capacity. After about 18 m<strong>on</strong>ths itbecame clear that there were insufficient mentees for the numberof mentors trained, and marketing of the service was stepped up.Mailshots to trainee groups through their specialty schools, to newGPs through the Deanery database of recent trainees, throughtheir PCTs, the LMC, their trainers and programme directors andto new c<strong>on</strong>sultants via their medical directors have been effectivein increasing demand. For example a recent mailshot to a largecohort of new c<strong>on</strong>sultants, via the Deanery database, yielded over50 applicati<strong>on</strong>s in a week.Data collecti<strong>on</strong> and analysisIn times of ec<strong>on</strong>omic stringency services will be scrutinised closelyfor delivering value for m<strong>on</strong>ey. It is vital that accurate records arekept <strong>on</strong> an electr<strong>on</strong>ic database to enable regular review and audit.Data collecti<strong>on</strong> and recording, including feedback and evaluati<strong>on</strong>,should be an explicit resp<strong>on</strong>sibility in the job descripti<strong>on</strong> ofadministrative staff.30L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> ServiceCommunicati<strong>on</strong>sEffective communicati<strong>on</strong>, through an attractive user friendlywebsite, group emails and newsletters are essential. Support fromthe Deanery communicati<strong>on</strong>s team made an important c<strong>on</strong>tributi<strong>on</strong>to the success of the service. It was also important to have anumber of mentors who had high profile ‘day jobs’ and were ableto be influential ambassadors for the service.Future decisi<strong>on</strong>sCentralised vs DevolvedBased <strong>on</strong> the size of L<strong>on</strong>d<strong>on</strong>’s NHS, it would be reas<strong>on</strong>able to planfor the service to expand year <strong>on</strong> year for the foreseeable future,so that every doctor or dentist can access a mentor during timesof challenge or change. Although larger hospital trusts may beable to develop in-house services, based <strong>on</strong> similar principles it isviewed that a high quality service would be impossible to deliverfor the following reas<strong>on</strong>s. <str<strong>on</strong>g>First</str<strong>on</strong>g>ly, it would be difficult to reassurementees <strong>on</strong> c<strong>on</strong>fidentiality and prevent prejudgement of issues bymentors. In additi<strong>on</strong>, there is str<strong>on</strong>g evidence that people benefit inbeing able to talk to some<strong>on</strong>e outside their employing organisati<strong>on</strong>and from a different specialty. This separati<strong>on</strong> of functi<strong>on</strong> assiststhe mentor in remaining purely objective, c<strong>on</strong>centrating <strong>on</strong> thementee’s story without their own experience prejudicing the issues.In additi<strong>on</strong>, an outside perspective is often invaluable.<str<strong>on</strong>g>The</str<strong>on</strong>g>re are str<strong>on</strong>g reas<strong>on</strong>s for having a centrally organised servicesince this enables equity of provisi<strong>on</strong>, enables effective promoti<strong>on</strong>of the service and minimises any negative influence from individualorganisati<strong>on</strong>s who may not perceive the benefits to their trust. Itpermits the service to be more resp<strong>on</strong>sive to change and take <strong>on</strong>new roles such as focusing <strong>on</strong> leadership skills in coaching andmentoring. It enables quality improvements to be implementedwidely and c<strong>on</strong>sistently.TrainingIn the future it may be possible as medical and dental mentorsbecome more experienced and acquire recognised qualificati<strong>on</strong>s,to provide mentor training in house.Individual vs. Teams<str<strong>on</strong>g>The</str<strong>on</strong>g> coaching skills can be utilised in team building and teamcoaching. Current mentors would require little additi<strong>on</strong>al trainingto deliver this. <str<strong>on</strong>g>The</str<strong>on</strong>g> ultimate aim of mentoring is to improve patientcare. <str<strong>on</strong>g>The</str<strong>on</strong>g> proposed changes as outlined in the White Paper willrequire highly effective team working across the health service andit is anticipated that team coaching will have a valuable c<strong>on</strong>tributi<strong>on</strong>to make.Team leaders whether established or recently appointed willbenefit from coaching as they face the challenges ahead which areunprecedented in the NHS.


Poor performance vs High performanceTargeting the service at poor performance or at enabling highperformance requires careful c<strong>on</strong>siderati<strong>on</strong>. Although these are ac<strong>on</strong>tinuum, and the same skills are likely to be helpful to both, itis important to have a service that is aspired after. If a service isseen to provide support for poor performance <strong>on</strong>ly, high-fliers, whomay gain the most benefit from input as they may be more ableto carry out change, will not apply. It is important that participatingis perceived as a mark of success and an essential part of furtherprofessi<strong>on</strong>al development.Fees vs FreeHistorically those schemes that have not paid their mentors havewithered over time. <str<strong>on</strong>g>The</str<strong>on</strong>g> time mentors invest in order to work for theL<strong>on</strong>d<strong>on</strong> Deanery is c<strong>on</strong>siderable since it includes not <strong>on</strong>ly the faceto face mentoring time but additi<strong>on</strong>al travelling time, administrativework, as well as fitting in supervisi<strong>on</strong> and refresher sessi<strong>on</strong>s.Most mentors are working full time and deliver the service in theirown time at evenings or weekends. This highly skilled work isdevalued if the time and effort to acquire and deliver these skillsis not recognised. <str<strong>on</strong>g>The</str<strong>on</strong>g> provisi<strong>on</strong> of free coaching and mentoringplaces the mentor and mentee <strong>on</strong> an unequal power base, withthe Mentee indebted to the mentor for their c<strong>on</strong>tributi<strong>on</strong> to theprocess. This tends to encourage ineffective mentoring techniquessuch as paternalism, patr<strong>on</strong>age and advice giving disempoweringthe mentee further.Sustaining and embedding theservice<str<strong>on</strong>g>The</str<strong>on</strong>g> challenge for the service is to encourage and embed a cultureof coaching and mentoring across L<strong>on</strong>d<strong>on</strong>’s NHS. Initiatives thatthe service will be pursuing to promote this aim include:• Training in mentoring and coaching forteams of senior staff from the same NHSorganisati<strong>on</strong>• Training for multi professi<strong>on</strong>al groupsincluding Human Resources, MedicalEducati<strong>on</strong> Managers and Nurse Practiti<strong>on</strong>ers• Forming partnerships with other organisati<strong>on</strong>sencouraging coaching and mentoring suchas royal colleges and medical schools• Training of some mentors in team buildingand team coachingImproved working practices - Leanand GreenLeanIn keeping with L<strong>on</strong>d<strong>on</strong> Deanery’s drive to encourage Leanworking, the CMAG and the mentors will c<strong>on</strong>sider how theprocess of applicati<strong>on</strong>, choosing a mentor and arranging meetingscan be simplified and made more efficient for mentees and howc<strong>on</strong>tracting, documentati<strong>on</strong> of sessi<strong>on</strong>s and seeking feedback andbe made more efficient for mentors.GreenPaperless communicati<strong>on</strong> will be the norm either by teleph<strong>on</strong>e orelectr<strong>on</strong>ic, unless an individual specifically requests a paper copy,and records will be stored electr<strong>on</strong>ically. Catering for coursesand meetings will be kept modest and healthy, using eco-friendlysuppliers wherever possible.L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service 31


Resp<strong>on</strong>se to the White Paper Equityand Excellence: liberating the NHS<str<strong>on</strong>g>The</str<strong>on</strong>g> recent white paper, Equity and Excellence: liberating the NHShas called for new leadership and better integrati<strong>on</strong> of learning andworking. L<strong>on</strong>d<strong>on</strong> Deanery’s <strong>Coaching</strong> and <strong>Mentoring</strong> Service hasresp<strong>on</strong>ded by:• Raising awareness of the service with medicaldirectors and encouraging new c<strong>on</strong>sultantsand GPs to apply• Funding coaching and mentoring for anydoctor or dentist in a new leadership role - atany stage of their career• Planning to develop a select cohort ofmentors with the skills to coach teams andhelp them work more effectively together• Encouraging ARCP and RITA panels to offercoaching and mentoring to trainees who arestruggling for any reas<strong>on</strong>• Offering funded coaching and mentoring tothose with leadership roles in educati<strong>on</strong> andtraining• Attended nati<strong>on</strong>al coaching c<strong>on</strong>f• Exploring new models and training32L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


C<strong>on</strong>clusi<strong>on</strong><str<strong>on</strong>g>The</str<strong>on</strong>g> first five hundred mentees have c<strong>on</strong>firmedour c<strong>on</strong>victi<strong>on</strong> that this service is needed andappreciated by a significant number of doctorsand dentists. This is c<strong>on</strong>firmed by the feedbackthe service has received from both mentors andmentees. It is expected that demand will c<strong>on</strong>tinue togrow as pers<strong>on</strong>al recommendati<strong>on</strong>s spread the wordand the benefits accrue from the new competenciesgained. This should drive even higher standards ofteam working and patient care, whilst delivering aholistic approach that reduces the risk of burnout.<str<strong>on</strong>g>The</str<strong>on</strong>g> Deanery’s <strong>Coaching</strong> and <strong>Mentoring</strong> service iswell prepared to help deliver the changes describedin the White Paper Equity and Excellence: liberatingthe NHS.What is needed is not just a handful of allocated“or even fully trained mentors but an overallparadigm shift to a culture of coaching, with rolemodels, positive c<strong>on</strong>structive feedback, andgood staff management principles.”(Hutt<strong>on</strong> Taylor, 1999)33L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service


REFERENCES1.2.3.4.5.Abbasi K. <strong>Mentoring</strong> and the meaning ofsoul. J R Soc Med 2008;101:523Buddeberg-Fischer B, Herta KD. Formalmentoring programmes for medicalstudents and doctors-a review of theMedline literature. Medical Teacher, 2006;28:248-257Chadwick-Coule, Tracey and Garvey,Bob. L<strong>on</strong>d<strong>on</strong> Deanery <strong>Mentoring</strong>Service: A Formative and DevelopmentalEvaluati<strong>on</strong> of Working Practices andOutcomes. <strong>Coaching</strong> & <strong>Mentoring</strong>Research Unit, Sheffield Business Schoolat Sheffield Hallam University 2009Clutterbuck D (1991) Every<strong>on</strong>e needs amentor:fostering talent at work. Instituteof Pers<strong>on</strong>nel and Development, L<strong>on</strong>d<strong>on</strong>C<strong>on</strong>nor M, Pokora J (2007) <strong>Coaching</strong> and<strong>Mentoring</strong> at Work: Developing EffectivePractice. Open University Press,Milt<strong>on</strong> Keynes8.9.10.11.12.Dreher, George F.; Ash, R<strong>on</strong>ald A.A comparative study of mentoringam<strong>on</strong>g men and women in managerial,professi<strong>on</strong>al, and technical positi<strong>on</strong>s.Journal of Applied Psychology. 1990;75:539-546www.dh.gov.uk/en/Publicati<strong>on</strong>sandstatistics/Publicati<strong>on</strong>s/Publicati<strong>on</strong>sPolicyAndGuidance/DH_117353Garvey B, Garrett-Harris R (2005) <str<strong>on</strong>g>The</str<strong>on</strong>g>Benefits of <strong>Mentoring</strong>: A LiteratureReview, A Report for East mentors Forum.<str<strong>on</strong>g>The</str<strong>on</strong>g> <strong>Coaching</strong> and <strong>Mentoring</strong> ResearchUnit, Sheffield Hallam University, SheffieldGabbard G. <str<strong>on</strong>g>The</str<strong>on</strong>g> role of compulsivenessin the normal physician. JAMA 1985;254:2926-2929Hay J. Reflective practice and supervisi<strong>on</strong>for coaches. Open University Press,Maidenhead, 20076.7.C<strong>on</strong>nor MP; Bynoe AG; Redfern N;Pokora J; Clarke J. Developing seniordoctors as mentors: a form of c<strong>on</strong>tinuingprofessi<strong>on</strong>al development. Report of aninitiative to develop a network of seniordoctors as mentors: 1994-99. MedicalEducati<strong>on</strong>, 2000; 34: 747-53Dornhurst A, Cripps J, Goodyear H,Marshall J, Waters E, Boddy S-A.Improving hospital doctors’ working lives:<strong>on</strong>line questi<strong>on</strong>naire survey of all grades.Postgrad Med J, 2005;81:49-5413.14.15.16.Hutt<strong>on</strong>-Taylor S. Cultivating a coachingculture. BMJ, 1999;318: Career FocusInvisible Patients: Report of theWorking Group <strong>on</strong> the health of healthprofessi<strong>on</strong>als, Department of Health,2010Ivers<strong>on</strong> A, Rushforth B, Forrest K. <str<strong>on</strong>g>The</str<strong>on</strong>g>Competent Novice: How to handle stressand look after your mental health. BMJ2009;338:b1368<strong>Mentoring</strong> for Doctors34L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Service17.www.dh.gov.uk/en/Publicati<strong>on</strong>sandstatistics/Publicati<strong>on</strong>s/Publicati<strong>on</strong>sPolicyAndGuidance/DH_4089395 Department of Health, 2004


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AppendixFeedback and soundbites[My mentor] built up a rapport with me with“ease whilst maintaining a real objectivity. I foundthat this enhanced our sessi<strong>on</strong>s by allowing meto talk and think freely. She gave me time tothink and organize my thoughts. I felt that shemaintained a good momentum in our sessi<strong>on</strong>swith a soluti<strong>on</strong> based method that targeted myproblems specifically. [My mentor] is instantlylikeable and fair. I think that she balanced outthe sessi<strong>on</strong>s nicely whilst adding a reassuringsense of realism with regards to my objectives.[My mentor] also made me feel empoweredby the sessi<strong>on</strong>s by allowing me to vocalize myc<strong>on</strong>cerns with ease. I looked forward to oursessi<strong>on</strong>s because I did not feel that I was in ahighly pressured situati<strong>on</strong>. Our sessi<strong>on</strong>swere positive.”H<strong>on</strong>esty and a keen sense of empathy is at the“forefr<strong>on</strong>t <strong>on</strong> reflecti<strong>on</strong> during these sessi<strong>on</strong>s.[My mentor] gave me a steady desire to facemy issues head <strong>on</strong>, and now rather than later.More clearly, during these sessi<strong>on</strong>s I was giventhe opportunity to initiate breaking the cycle oflearned negative behaviours. This stands outthe most. [My mentor] was particularly good atproviding a framework to initiate positive change– so that I could c<strong>on</strong>tinue to make progressoutside of these sessi<strong>on</strong>s. I felt receptive duringour sessi<strong>on</strong>s and most importantly I felt that [mymentor] showed a genuine interest in my lifewith a view to making it better.”I h<strong>on</strong>estly feel that my sessi<strong>on</strong>s with [my“mentor] suited me completely. It’s difficult to saywhere she could improve apart from c<strong>on</strong>tinuingto harness her skills as a great communicator.”I think that [my mentor] could <strong>on</strong>ly add in a“positive sense to <strong>on</strong>e’s life experience. It’s thetruthful objectivity which stuns me – and asense that soluti<strong>on</strong>s often lie within theso-called problem.”I think that my coaching experience has“affirmed what I suspected already, that is, forcertain individuals it clarifies life. I feel settled,and more assured. Sometimes you need36L<strong>on</strong>d<strong>on</strong> Deanery <strong>Coaching</strong> and <strong>Mentoring</strong> Servicethat voice of objectivity to help organize yourthoughts and understand your emoti<strong>on</strong>s. I thinkthat coaching has helped to focus <strong>on</strong> areas ofmy life that can be improved. This makes theday to day problems change into challengeswhere soluti<strong>on</strong>-based thinking allows for apositive outcome. <strong>Coaching</strong> helps to simplifyevery day life challenges for me.”My mentor has helped me work through a“few c<strong>on</strong>cerns I had about my training as wellas helping me understand more about myself– how I learn and how I like to work. Insteadof feeling I’m just <strong>on</strong>e of many trainees, I’vefelt the advice and support has been verymuch centered around me and my needs. I’ddefinitely recommend others to give [mentoring]a try, especially if they have a work or trainingdilemma that they’ve been wrestling with or justwant to try and make the most of theircurrent opportunities.”Although I have mentored several other doctors,“I reached the tender age of 52 without everhaving been a mentee. <str<strong>on</strong>g>The</str<strong>on</strong>g> L<strong>on</strong>d<strong>on</strong> Deaneryprovided me with the opportunity, which Iseized. I <strong>on</strong>ly had a vague idea of what I wantedto achieve from the 4 sessi<strong>on</strong>s <strong>on</strong> offer, buthave always had the str<strong>on</strong>g feeling that I couldachieve more. <strong>Mentoring</strong> enabled me to reflect<strong>on</strong> my career, both the positive points and thosethat needed addressing since I was not satisfiedwith them. To my surprise, the mentoring wasnot just limited to the traditi<strong>on</strong>al careers model,but explored all the facets of my life examiningwhich aspects I was c<strong>on</strong>tent with and thosethat were unsatisfactory. Various points cameout of the discussi<strong>on</strong>s, most of which I’d alreadyidentified for myself but due to time pressureshad not put into place. <str<strong>on</strong>g>The</str<strong>on</strong>g> mentoring enabledme to break down aims into achievable goals.Sessi<strong>on</strong>s ended with agreements <strong>on</strong> whatshould be undertaken before the next sessi<strong>on</strong>.<str<strong>on</strong>g>The</str<strong>on</strong>g>se were negotiated between my mentor andmyself in order to meet the objectives I had setwhilst still keeping the workload in reas<strong>on</strong>ablelimits. I am now working a few additi<strong>on</strong>al hours,1 to 2 per week, in order to meet my aims,but I am more c<strong>on</strong>tent and satisfied now that


I am addressing my training and educati<strong>on</strong>alrequirements. In additi<strong>on</strong>, points wereaddressed outside my working life, these werecritical for me in order to achieve a balancedhome/work balance despite voluntarily doingfurther unpaid hours.”<strong>Mentoring</strong> has given me peace of mind since I“now have a plan to tackle areas where I haveless c<strong>on</strong>fidence in my abilities.”<strong>Mentoring</strong> has enabled me to create pers<strong>on</strong>ally“targeted learning objectives.”<strong>Mentoring</strong> has refreshed the aims of my“medical career.”<strong>Mentoring</strong> has helped me address issues in my“pers<strong>on</strong>al life that have impacted my medicalcareer and my pers<strong>on</strong>al well-being.”This has been a very useful and creative“reflective space. It has allowed me to reflect <strong>on</strong>what is happening in our practice, what couldand should change, and how to facilitate this.It has also helped me decide <strong>on</strong> aspects of myown career development.”[Camden GP]I think that appraisal and revalidati<strong>on</strong>“procedures should make mentoring free andavailable at the point of need in keeping withNHS principles to those professi<strong>on</strong>als who needit, which is probably a lot more thanrecognise it!”I think that this was an appropriate use of my“trainers CPD grant and have recommended theprocess to other GP trainers and colleagues.”[L<strong>on</strong>d<strong>on</strong> GP][<strong>Mentoring</strong>] has made a significant difference to“my professi<strong>on</strong>al development.”[L<strong>on</strong>d<strong>on</strong> FY2 trainee]<strong>Mentoring</strong> is all about the applicati<strong>on</strong> of“comm<strong>on</strong> sense, guided by experience andwisdom, and applied to an individual’s owncircumstances.”[GP, Kent]<strong>Mentoring</strong> sessi<strong>on</strong>s have helped to improve“knowledge and skills, regain c<strong>on</strong>fidence andwellbeing, improve performanceand productivity.”[GP, Kent]When asked whether the mentee wouldrecommend their mentor to other clients?“ Absolutely ”What stands out for you in [your mentor’s]coaching?Ability to get to the point and understand the“detail of the problems.”“ Empowering approach. ”[Associate Specialist in Paediatric Dermatology]What are your views <strong>on</strong> coaching now?Should be offered to most people in“their training.”[Associate Specialist in Paediatric Dermatology]Although I <strong>on</strong>ly had two sessi<strong>on</strong>s, I found these“extremely useful, as they gave me a frameworkfrom which to approach problems. <str<strong>on</strong>g>The</str<strong>on</strong>g>yencouraged me to self-reflect, which I havefound invaluable.”I would c<strong>on</strong>sider a mentorship programme“again in the future. It has given me invaluableskills, that need c<strong>on</strong>stant development, butthat I have found useful to practice in day today life.”[ACF in Public Health]This is an excellent & prompt service that the“deanery is offering and my best wishes for a1000th applicant so<strong>on</strong>!”[C<strong>on</strong>sultant Paediatrician]I felt although brief and <strong>on</strong>ly 2 sessi<strong>on</strong>s I felt“an amazing sense of support and enjoyedthe chance to discuss career progressi<strong>on</strong>and decisi<strong>on</strong> making with a n<strong>on</strong> anaesthetistincredibly useful. I also talked about my fearsand social discriminati<strong>on</strong> of being dyslexic in themedical professi<strong>on</strong> and pertinently at interview.I felt utterly supported and respected thec<strong>on</strong>fidentiality enormously. I would like to findout more informati<strong>on</strong> <strong>on</strong> becoming a mentormyself in the future when I have settled into mynew c<strong>on</strong>sultant post. Thank you <str<strong>on</strong>g>The</str<strong>on</strong>g> L<strong>on</strong>d<strong>on</strong>Deanery for this opportunity.”

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