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Leadership and leadership development in health care

The evidence base


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    Kirsten Armit

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    Dr Lola Loewenthal

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    Dr Regina Eckert

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    Thomas West

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    Allan Lee

A key challenge facing all NHS organisations is to nurture cultures that ensure the delivery of continuously improving high-quality, safe and compassionate health care. Leadership is the most influential factor in shaping organisational culture and ensuring the necessary leadership behaviours, strategies and qualities are developed is fundamental. But what do we really know about leadership in health care services?

The Faculty of Medical Leadership and Management, The King’s Fund and the Center for Creative Leadership share a commitment to evidence-based approaches to developing leadership and collectively initiated a review of the evidence by a team including clinicians, managers, psychologists, practitioners and project managers. This report summarises the evidence emerging from that review.

Key messages

  • Leadership in NHS organisations needs to ensure direction, alignment and commitment to the core task of developing cultures that deliver continually improving, high-quality and compassionate patient care.

  • Leadership needs to: develop inspiring visions that are put into practice at every level by leaders; identify clear, aligned objectives for all teams, departments and individual staff; provide supportive and enabling people management; develop high levels of staff engagement; support learning, innovation and quality improvement in the practice of all staff; and promote effective team-working.

  • Leaders need to work together, spanning boundaries within and between organisations, prioritising overall patient care rather than the success of individual components, and to build a co-operative, integrative leadership culture – in effect collective leadership.

  • Developing collective leadership for an organisation depends crucially on local contexts and is likely to be done best ‘in house’ with expert support, integrating both organisational development and leadership development.

  • Experience in leadership is the most valuable factor in enabling leaders to develop their skills, especially when they have appropriate guidance and support. Focusing on how to enhance leaders’ learning from experience should be a priority.

  • Evidence-based approaches to leadership development in health care are needed to ensure a return on the huge investments made.