Abstract
The Royal College of Physicians (RCP) Chief Registrar Programme (CRP) emerged from the RCP Future Hospital Commission Report (2013) and aimed to address development of clinical leadership and quality improvement to maintain high standards of patient safety and experience. The 2016 pilot created a new senior leadership role recruiting doctors in training committed to quality improvement and leadership development to champion delivering change in trusts, supported by a year-long bespoke development programme designed and delivered by the RCP. Following validation of the pilot's impact, the CRP has evolved to become a 'flagship' programme for the RCP with increasing penetrance across the UK to maximise impact for chief registrars to lead and deliver quality improvement in trusts. The longer-term goal is that enthusiastic early leaders will deliver sustainable and impactful change regionally and in the wider NHS. This article seeks to explore the CRP development themes and reflects on the learning from the programme and the experiences of chief registrars. The CRP has evolved during a time of significant healthcare challenge with the programme delivering a future generation of medical leaders to navigate these challenges, deliver improvement and innovation across the health sector. We show how chief registrars and alumni can continue to drive forward widespread impact on individuals, organisations and the wider NHS, providing a strategic solution to meet current and future challenges in the NHS.