Eligibility criteria You will need to identify a sponsor partner from your local health community.

. This could be your line manager, a clinical leader or the improvement lead of your healthcare community. The sponsor should open to the learning on this programme and with their additional experience coach and mentor you through this programme. You need to identify a business critical project linked to your organisations QIPP priorities that you and your sponsor partner will work on together over the course of the programme. Both you and your partner sponsor should commit to share this learning with at least 40 colleagues across your local health region and demonstrate how you achieved this via a case study. You will need to be Agenda for Change Bands 6-8a or a specialist registrar. You, your sponsor partner and your organisation must commit to fully completing the course.

Section 1: Contact details of applicant

Name (and title) Profession Job title Organisation name Contact address Telephone (mobile preferred) Email

Section 2: Partner/Sponsor details

Name (and title) Profession Job title Organisation name Contact address Telephone (mobile preferred) Email

Section 3: Curriculum vitae of emerging leader

3.1 Current Post

Job title and role summary Department Type of organisation Date of appointment 3.2 Key responsibilities/objectives

Please provide an overview of your role within the context of your organisation, including your responsibilities such as size of budgets (if appropriate) and number of direct reports. Please also describe your current involvement in leading improvement (300 words max).

3.3

Previous posts held (last three roles or earlier if specifically relevant to this programme) Position Organisation

Dates

3.4

Qualifications (degrees, diplomas, professional qualifications etc.) Qualification & Class College/University Date

Subject

Other developmental training completed

Section 5: Motivationwhy should we select you?

Please tell us why you are applying for this programme (750 words max). You may wish to consider: a) b) c) d) e) what interests you about this programme how you expect to benefit from participating in this programme what benefits your organisation is likely to get from your participation how would you like to spread your learning to colleagues how will you benefit from the support of your sponsor during the programme.

Section 6: Your business critical project

Identify one significant improvement you would like to lead in your organisation and describe why you would like to lead this (750 words max). Please include: a) a brief description of the improvement you would like to lead b) the aims and scope of the work c) who would need to be involved d) the potential impact of the improvement and how this will be measured e) how the Vanguard Programme will benefit your project f) your plans to develop a case study that captures the learning and outcomes. g) what key strengths your partnership with your programme sponsor will add to the success of your project.

Section 7: Compact
The applicant I have read, fully understand and commit to: completing the full course which will involve a time commitment of 10 days delivery of QIPP project in partnership with your sponsor demonstrating the spread of this learning to 40 colleagues in your health region Name Date

The partner/sponsor The organisational sponsor (at the organisation at which the applicant is currently employed) must sign the following declaration. I have read, fully understand and commit to: completing the full course which will involve a time commitment of five days delivery of QIPP project in partnership with my emerging leader partner demonstrate the spread of this learning to forty colleagues in my health community I undertake to actively support the applicant with his/her participation in this leadership development as outlined in this document and the supporting information, including: his/her release for the time required to participate fully in the scheme participation in events as required I have the authority to make the above commitment and undertake to provide internal organisational support during the period of the programme. By signing this commitment as sponsor partner you are also signing on behalf of your organisation to ensure full attendance and completion of this programme that has been funded by the Emerging Leaders Network. If your programme places are not fully utilised then your organisation will be invoiced the full cost of the places. Name Position Date