Carry on caring

How leadership development boosts NHS performance

opular theory has it that leaders are born, not made. While few would doubt that there is some substance to that claim, logic tells us that the ready packaged leader is the exception rather than the rule. For the majority of us, therefore, it is the way we develop our leaders that can enable them to stand out from the crowd.

Many are waking up to the fact that leadership is inextricably linked with organizational effectiveness. Develop the right leaders and the dream of long-term sustainability becomes ever more attainable. The opposite is, of course, also true. Like most other things, leadership is subject to change. Trends come and go and todays leadership style can quickly become tomorrows relic. Only those models with one eye on the future are able to stand the test of time.

The changing face of leadership development

There is growing belief that transformational leadership is one such model. Instead of a total focus on specic organization objectives that is typical of transactional leadership, this open-ended style places more emphasis on innovation and vision. Recognizing and developing the ability to lead is at least as important as achieving any number of dened outcomes. The UKs National Health Service (NHS) is an organization that realizes the benet of encouraging a more exible and less prescribed mode of leadership. One consequence of this has seen the emergence of a leadership development program aimed at human resource (HR) professionals and other NHS leaders. In line with the shift in trend towards transformational leadership, the main aim of the program is the development of people and not the development of the HR itself. However, the NHS does believe that many elements of transactional leadership still have a part to play. Establishing the Leadership Center in 2001 is proof that the NHS takes leadership seriously. Indeed, the body readily admits to an eagerness to learn from other sectors in its quest to develop internationally recognized leaders. Perhaps it is not before time. After all, by its own admission the Center acknowledged that NHS leadership had typically been disjointed and somewhat slapdash in nature. It was scant consolation to discover that similar standards endured within parts of both the private and voluntary sector.

NHS leadership program

The Leadership Through Effective Human Resource Management (LTEHRM) program aimed to raise standards, with better patient care and improved working practices the ultimate goal. Working alongside various domestic and international partners, the NHS is able to deliver a learning program that contains teaching, residentials, and projects all backed by online support. A range of learning modes are deployed, enabling participants to

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VOL. 20 NO. 4 2006, pp. 28-30, Q Emerald Group Publishing Limited, ISSN 1477-7282

DOI 10.1108/14777280610676990

 For the majority of us, therefore, its the way we develop our leaders that can enable them to stand out from the crowd.

learn through mentors, role play, doing, and teamwork to name but a few options. The clear focus on action learning is highly important given that many observers believe the phenomenon is integral to leadership development. It has been a case of so far, so good for this program. From the several intakes to date, feedback has generally indicated that students remain positive about the effect of the program on both themselves and their organizations. And as many participants have valued the total experience of the program, the whole here is clearly greater than the sum of its parts. Integration between each program element and all partners involved is obviously crucial. The various outcomes of the program include:
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academic certication; development or improvement of transactional management skills and transformational leadership capabilities; gaining practical insights to later apply in the workplace; a greater appreciation of NHS needs; extensive personal development; and more self-awareness.

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That is pretty much in line with the objectives the NHS set out to achieve. But that is not all. Participants also commented on their increased capacity to inuence others, partly as a consequence of being more aware of their preferred leadership style. Others admitted to becoming proactive enough to utilize leadership and vision across the organization. In this context, however, the most signicant comments undoubtedly related to making patient care the main priority and initiating the kind of changes able to affect this area most.

Maintaining the standards

Getting participants more patient focused perhaps provides the clearest indication of the programs success. However, that does not mean the NHS is resting on its laurels. Far from it, in fact. The organization is big on assessment and various procedures are used to evaluate the program at different levels. Formative and summative assessment ensures that the program retains its future orientation and evolves to meet the needs of the NHS and the ongoing personal and professional development of participants. John F. Kennedy once said that leadership and learning were indispensable to each other and this seems to have been taken on board. Continuous improvement is clearly the name of the game because lessons learned are incorporated back into the program for future use. LTEHRM is the culmination of several initiatives designed to broaden the focus of leadership development with the aim to promote best practice and leadership diversity. The program has provided a platform for the NHS to develop its leadership further in relation to teams and partners, while also enabling leaders to acquire the exibility of style demanded by different contexts. Some analysts also believe that the link between leadership and patient care is open to further research. For any leadership development program to succeed, there are invariably barriers to overcome as many participants discovered here. The issues include:
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organizational culture built on command and control with leadership perceived as individualistic rather than as a shared responsibility;

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leadership programs lacking the scope to meet organizational needs; senior management support, crucial, yet demands of time means that such support cannot always be guaranteed; insufcient time away from the workplace; participants with other responsibilities being overburdened with work; a target driven culture meaning limited opportunity to put learning into practice; insufcient time for reection; and poor facilitation; a failure to ensure that project outcomes are acted on.

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Comment
The review is based on: Leadership development: does it make a difference? by Ruth Boaden (2006). The article discusses leadership development and the shift from transactional to transformational leadership models that has seen less focus on dened outcomes and more on developing leadership ability itself. The author analyzes a leadership program developed for the UKs National Health Service and concludes that the program has been so far successful in meeting the needs of both the individual participants and the organization. Many of the outcomes and benets are pointed out, as are potential barriers that can hinder the success of both this program and others. This article provides an interesting read and contains many useful strategic implications for the customer-focused practitioner.

Keywords: Leadership development, Leadership, Continuous improvement

Reference
Boaden, R.J. (2006), Leadership development: does it make a difference?, Leadership & Organization Development Journal, Vol. 27 No. 1, pp. 5-27, ISSN 0143-7739.

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