Designing safe, effective, efficient, equitable, and person-centred services normally takes some time and a great deal of stakeholder engagement and shared understanding to gain traction. This year has seen a significant acceleration of these activities plus new organisational and clinical collaborations and rapid cycle learning systems as a result of the challenges associated with the COVID-19 pandemic response. Whether it is a WhatsApp group where clinician's share their real-time understanding of a new disease or a collaboration of manufacturing organisations and clinicians to develop new/more equipment, change and innovation are working at an accelerating pace. We have built upon the NHS leadership guide we used in the College's leadership development programme and 2019 webinars, Developing People, Improving Care. We explain how using the guide and new evidence in support of the approach along with the learning from 2020 could ensure that excellent innovations and ways of working remain while others are adapted as the crisis evolves to a new normal. Our intention is to provide a road map and personal and team strategies that will deliver ongoing and strong clinical leadership as well as improved quality of care.

IntroductionMassive open online courses (MOOCs) offer a flexible approach to online and distance learning, and are growing in popularity. Several MOOCs are now available, to help learners build on their knowledge in a number of healthcare topics. More research is needed to determine the effectiveness of MOOCs as an online education tool, and explore their long-term impact on learners’ professional practice. We present a protocol describing the design of comprehensive, mixed-methods evaluation of a MOOC, ‘QualityImprovement (QI) inHealthcare: the Case for Change’, which aims to improve learner’s knowledge and understanding of QI approaches in healthcare, and to increase their confidence in participating, and possibly leading QI projects.Methods and analysisA pre-post study design using quantitative and qualitative methods will be used to evaluate the QI MOOC. Different elements of the RE-AIM (reach, effectiveness and maintenance) and Kirkpatrick (reaction, learning and behaviour) models will be used to guide the evaluation. All learners who register for the course will be invited to participate in the QI MOOC evaluation study. Those who consent will be asked to complete a presurvey to assess baseline QI knowledge (self-report and objective) and perceived confidence in engaging in QI activities. On completion of the course, participants will complete a postsurvey measuring again knowledge and perceived confidence. Feedback on the course content and how it can be improved. A subset of participants will be invited to take part in a follow-up qualitative interview, 3 months after taking the course, to explore in depth how the MOOC impacted their behaviour in practice.Ethics and disseminationThe study has been approved by the University of Bath Human Research Ethics Committee (reference: 2958). Study findings will be published in peer-reviewed journals, and disseminated at conference and departmental presentations, and more widely using social media, microblogging sites and periodicals aimed at healthcare professionals.

Doctors have a central role in managing patients across a multitude of clinical environments, which places them in the ideal position to identify systemic issues. Traditional medical training focuses on the knowledge and technical skills required; rarely are doctors trained in leadership, management or how to analyse and understand systems so as to design safer, better care. Quality improvement methodology is an approach that is known to enable improvement of the systems in which healthcare professionals work in order to provide safe, timely, evidence-based, equitable, efficient and patient-centred care. To address the current disparity, the Royal College of Physicians (RCP) has launched a Quality Improvement Hub, which will aim to support physicians to face the challenges of improving medical care, enabling them to navigate the tools with more confidence and share and implement the learning more swiftly.