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Using PDSA to Show Real Leadership in the NHS
When people hear the word “leadership”, they often picture formal titles: clinical directors, matrons, managers. But in the NHS, leadership is just as much about what you do on a busy ward at 3 pm on a Tuesday as it is about what happens in the boardroom.
One of the most powerful – and underrated – ways to show everyday leadership is through Quality Improvement (QI), especially when you use a structured method like PDSA cycles. This isn’t just good for patients and teams. It’s also gold dust for NHS consultant interviews, where you’ll almost certainly be asked to talk about a time you showed leadership, improved a service, or dealt with a problem.
Lets look at how using PDSA doesn’t just make your project better, it also shows you as an organised, thoughtful leader.
What is PDSA, really?
PDSA stands for:
- Plan: Understand the problem and design a change
- Do: Test the change on a small scale
- Study: Look at the data and feedback to see what happened
- Act: Decide whether to adopt, adapt, or abandon the change
On paper, it’s a simple cycle. In practice, it’s a mindset:
- Don’t guess. Test
- Don’t blame. Learn.
- Don’t jump to huge changes. Start small and build.
And that mindset is exactly what good leadership looks like.
How PDSA Shows Organised Leadership
When you say, “We used PDSA cycles” or “We did an audit and re-audit”, interviewers immediately hear:
This person understands how improvement is supposed to be done in the NHS.
You’re not just complaining about problems or throwing random solutions at them. You’re:
- Defining the issue clearly
- Setting a specific aim
- Planning deliberately instead of reacting emotionally
In leadership terms, that says:
“I don’t just notice problems , I approach them in a structured, professional way.”
A lot of projects fail because they try to fix everything at once.
PDSA pushes you to do the opposite:
- Start with small, low-risk tests, one bay, one clinic, one ward round
- Learn what works in real life, not just in theory
- Fix the issues early, when changing course is still easy
- Only scale up when the idea is proven and staff are on board
This shows leadership because it proves you can:
- Manage risk
- Respect the realities of clinical work
- Lead change with people, not to people
In an interview, lines like these land well:
- “Rather than changing everything at once, we tested a small change in one area first.”
- “After each PDSA cycle, we reviewed the data and staff feedback and refined the intervention.”
- “Once we saw consistent improvement, we spread the change to the rest of the ward.”
Traditional audit can sometimes feel like:
“You’re doing it wrong. Do it better.”
PDSA shifts the tone to:
“What’s getting in the way, and how can we make it easier to do the right thing?”
That’s a big leadership move.
Using PDSA means you:
- Look for system issues instead of blaming individuals
- Treat each cycle as an opportunity to learn, not prove someone wrong
- Make it safe for staff to be honest about barriers
In an interview, you might say:
“We used PDSA cycles so we could learn from the process rather than expecting perfection straight away. When something didn’t work, we saw it as feedback, not failure.”
That signals emotional maturity and a supportive leadership style.
Leadership isn’t just about having a vision. It is about showing whether your ideas actually worked.
PDSA nudges you to:
- Collect baseline data, what was happening before?
- Measure again after each cycle
- Use numbers, not just feelings, to judge progress
For example:
- “Documentation completion increased from 40% to 80%.”
- “Average time to discharge paperwork decreased from 3 hours to 1.5 hours.”
- “Missed observations incidents dropped from 5 per month to 1.”
This shows interviewers that you:
- Care about outcomes
- Can handle basic data
- Follow through, rather than losing interest halfway
A Mini Example: PDSA in Action
Imagine this as your interview story:
On our ward, I noticed that VTE risk assessments were often incomplete on admission, which had clear patient safety implications and put us out of line with Trust policy. I took the initiative to lead a small QIP on this.
Plan: I carried out a baseline audit and found only 55% of patients had a completed VTE assessment within 24 hours. With our ward team, we set a clear aim to increase this to 90% over three months.
Do: For our first PDSA cycle, we added a simple prompt to the admissions proforma and reminded doctors at the morning handover.
Study: After two weeks, re-audit showed improvement to 70%, but junior doctors said they often forgot during busy on-calls.
Act: We adapted the plan – in the next cycle, we added a reminder to the electronic handover list and asked nurses to check completion as part of their admission checklist.
After two more cycles, compliance improved to 92%, and we embedded the change by adding the reminder into the ward induction pack for new doctors. For me, using PDSA cycles showed that structured, small tests, with regular feedback, are far more effective than just telling people to “do better.”
That’s not just a QIP. That’s a leadership story.
How to Talk About PDSA in Interviews
You don’t need to give a lecture on QI. Just weave in a few key lines:
- “We used PDSA cycles to structure the project.”
- “We started with a baseline audit to understand the problem properly.”
- “We tested small changes, reviewed the data, then refined the approach.”
- “We repeated the audit to show objective improvement.”
- “This taught me that leadership is about learning and adapting, not having all the answers from the start.”
If you can combine that with:
- A clear Situation
- Your Task/role
- Your Actions (especially PDSA and involving the team)
- The Results (with data)
…you’ll have a strong, credible example of organised leadership using QIP.
Let’s discuss about your interview preparation needs to succeed
How Career4Doctors Can Help
At Career4Doctors, we specialise in helping you secure your NHS consultant job and Ace your IMT interview faster and with confidence. Our expert services include:
- One to one Interview Coaching
- Realistic Mock Interviews
- Presentation Coaching and Feedback
- Books
- Video lectures
- Weekly Master classes
- Award winning coach
Whether your interview is six days, six weeks or six months, we’ll help you become the best version of yourself on the day that matters the most.
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