No more heroes: a lesson for our future leaders?

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At the launch of our new report, The future of leadership and management in the NHS: No more heroes, the subtitle certainly caused some comment, with one blogger wondering if someone at The King's Fund is a Stranglers fan.

So what do we mean by this subtitle? The Commission found that while public services have recently focused on leaders as 'superheroes' – 'super-heads' in schools, elected local mayors, or 'turnaround' chief executives in the NHS – the way in which the NHS is changing requires a different model.

NHS leaders, whether commissioners or providers, have to influence others as much as they lead heroically – a model requiring additional, if not entirely different, skills. Health care and prevention has to be delivered through both co-operation with a wide range of bodies outside the NHS and the ability to work across boundaries within the NHS. Engaging and persuading others over the right course of action are becoming more important than leading the work of a single institution or organisation.

As Keith Grint and Clare Holt of Warwick Business School argue in a paper prepared for the commission, leaders must understand that leadership involves a relationship and can’t be understood without 'followership' – that is taking people with them and building a culture of leadership throughout teams and systems, not through top-down command and control.

Another inspirational speaker at our event last week, Wai-yin Hatton, Chief Executive of NHS Ayrshire and Arran, expressed it in this way, 'when the best leader's work is done, the people say "we did it ourselves".'

But what does this mean in practice? Here at the Fund we think it implies a focus on developing organisations and teams – not just individuals – with effective leadership across systems of care – not just institutions.

It was clear from the buzz at the conference itself and also on social media and in the news, that we touched a nerve with our report expressing our findings on both the future leadership of the NHS and also the value of good management. The popular view that NHS managers are bureaucrats who get in the way of, rather than support, front line services is clearly far from the truth. As Oliver Warren, Clinical Director of Prepare to Lead, NHS London, put it, 'clinicians don't have a professional monopoly on caring about patients.'

What leaders need to do now is to focus on leadership practices in their organisations rather than on individual competences and behavioural style (although clearly these are still important), creating the kinds of organisations where leadership is present everywhere, not just at the top, and reaches across professional and organisational boundaries to address the complex problems the health system will need to solve in the coming years.

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N Mylvahan

Consultant Physician for the elderly,
Comment date
25 May 2011
Well said. i think the time has come for people to work across boundaries which means we need different type of leadership. This means who can work across boundaries and listening to differen people in different organisations and collectively deciding what are the best courses of action for the benefit of groups of patients. Its about time we stop teh way the NHS works in bits and pieces and start working in collective fashion. As a person interested in managing the frail eldelry age group this form of working in an integrated work is vital otherwise we will never solve the frail older person's problem in a piecemeal fashion.

Red Dolphin

Comment date
26 May 2011
This is along the right lines as it begins to address the entirely artificial division between primary and secondary care - and thinking along those lines will eventually lead to a rethink on the failed experiment that is the internal market in healthcare.
GPs 'buying' services from secondary care all funded from the same budget is a business nonsense and responsible for much unnecessary bureaucracy and delay.

Rekha Elaswarapu

Honorary Senior Visiting Fellow,
City University, London
Comment date
26 May 2011
Well said. Agree with the thinking that teams need to be developed as opposed to the individuals. This will help address the long standing problem of quality of care being highly dependent on an individual and when that individual leaves things deterioration drastically. We also need more multidisciplinary working and cross-boundaries working more so for older people as they need care for a complex multiple conditions from a variety of sources in a joined up way.

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