The Clinical Fellows came from different professions, organisations, backgrounds and leadership experiences. Whilst they shared a commitment to improving healthcare, they were often working on complex projects, navigating unfamiliar systems and stepping into leadership roles that stretched their confidence and capabilities.  

Many of the challenges they faced did not have straightforward answers. Fellows needed support to work through issues related to influence, stakeholder engagement, team dynamics, organisational politics and personal leadership development. Creating a space where participants felt able to discuss these challenges openly required trust, psychological safety and a shared commitment to learning rather than judgement.  

Collaborate Out Loud was commissioned to design and facilitate an introduction to Action Learning and five structured Action Learning Sets across the fellowship year. The programme was designed to help fellows understand the principles of action learning and develop the skills needed to support one another through open questioning, reflection and constructive challenge.  

The introductory session explored the history and principles of action learning, how the process works and how participants could get the most from it. Together, the group co-created a set of ground rules that shaped how they would work together throughout the year. These included respecting all perspectives, asking open and helpful questions, being willing to explore challenging issues and recognising that every participant’s experience mattered.  

Across the five facilitated sessions, fellows were given dedicated airtime to present real leadership challenges from their work. Rather than providing advice, participants used coaching-style questions and reflective discussion to help one another explore options, gain new perspectives and identify actions they could take forward. Each session revisited previous actions and encouraged ongoing reflection and accountability.  

The facilitation approach focused on creating a supportive peer environment where fellows could think aloud, challenge assumptions and develop confidence in their own leadership judgement.  

The Action Learning Sets provided a consistent and trusted space for reflection throughout the fellowship year. Fellows were able to step back from the pressures of day-to-day project delivery and focus on their own development as leaders.  

The process strengthened peer relationships across the cohort and created a supportive network of clinicians facing similar leadership challenges. By working through real-life situations together, participants developed a deeper understanding of different perspectives, leadership styles and approaches to influencing change within complex systems.  

The sessions also helped fellows move from problem identification to action. Participants were encouraged to leave each discussion with greater clarity about the steps they would take, while the structured review process ensured that learning was carried forward between sessions.  

Beyond supporting individual fellows, the programme contributed to the wider aims of the Clinical Leadership Fellow Scheme by developing reflective practitioners who were better equipped to lead, collaborate, influence and navigate complexity within the NHS.  

We learned that some of the most valuable leadership development happens when people have permission to pause, reflect and learn alongside peers facing similar challenges. 

We saw that creating psychological safety is essential for meaningful learning. When clear ground rules are established and participants know their experiences will be respected, they become much more willing to share uncertainties, test ideas and explore difficult issues.  

We also learned that leaders do not always need answers from others. Often, what they need is a structured process, thoughtful questions and the space to think more deeply about the situation they are facing. The Action Learning approach proved particularly powerful in helping participants develop confidence in their own judgement and leadership capability.  

Most importantly, we learned that leadership development is strengthened when it combines reflection, challenge and peer support. By creating a space where fellows could learn with and from each other, the programme helped develop not only individual leaders but a connected community of future NHS leadership talent.