Our recent publication on collective leadership talks about the need for leadership at every level and the need to be strategic with it – with proper succession plans to enable leaders to deliver services both today and in the future. This leadership strategy must be guided by a vision from the top, and it must be led by those who commission, deliver and use the service, those close enough to the needs of patients, carers and families in a collective endeavor to drive up the quality of care
This all sounds sensible and obvious, but at the conference I was saddened to hear many stories of failures in the leadership and compassion shown to staff. I heard from women leaders who still find it hard to be taken seriously or treated as an equal, and there was a mood of fear among many leaders to do the right thing in case they faced top-down sanctions. A junior female manager told us how, when asked to sit on an interview panel, she was tasked by the HR lead to ascertain which of the female applicants were likely to have children in the near future. Showing her sense of outrage she said, ‘I suddenly realised that my career could be affected in a similar way, what can I do about this?’
At both the NHS Confederation conference and our Leadership Summit in May there was evidence that we still have a long way to go, including Kate Granger’s powerful story about her experience as a patient and the results of numerous staff surveys that show high levels of bullying, stress in the workplace, and that some staff feel that boards are more interested in targets, financial balance and regulatory frameworks than in improving the quality of care and investing in supporting the teams providing their service.
On a positive note, the conversations seemed far more focused and forward-looking than at the same conferences last year, and there was widespread recognition of the need to support and enable staff to deliver and lead high-quality care. I was left with the sense that the new regime at the top, led by new NHS England Chief Executive Simon Stevens, shares this view, with a less top-down approach from the centre, a more flexible workforce strategy and a welcome commitment to diversity in leadership positions, as set out in Simon’s recent speech at The King’s Fund.
So are the days of the heroic pace-setting leadership of the NHS really behind us? Are we seeing the emergence of a culture that will support and enable staff to innovate, improve and lead change from within the system? Our recent paper, Reforming the NHS from within, shows that a shared culture, a patient-centred vision, and investment in leadership and quality improvement are more important than structural reforms in driving up quality of care.
I was struck by Simon Steven’s quote ‘Think like a patient, act like a tax payer’ and his commitment to stop the diagnosis of what is wrong, stop structural re-organisations and just get on with it. Do we need to see a new era of leadership for the NHS?
- Read our reports: Developing collective leadership for health care, Delivering a collective leadership strategy for healthcare and Reforming the NHS from within
- Catch up with highlights from our annual NHS leadership and management summit
- Find out more about our leadership development work