Neil Goodwin on developing NHS leaders

The new leadership framework provides a coherent national approach to senior managerial development across the English NHS.

Sustainable leadership development has long been a challenge for the NHS. Various national leadership centres and initiatives have had mixed success. If there is one lesson from the past, it is that national approaches to implementing development of this kind do not work, no matter how much money is thrown at them.

However, the new national leadership framework is different. It acknowledges that implementation will only work locally, albeit within an agreed set of simple and easily understood national competencies. These are a distillation of the 15 competencies that make up the NHS Institute for Innovation and Improvement's leadership qualities framework, along with other relevant research on the leadership role of NHS chief executives.

"Developing a vision for local services is as motivationally important as developing a vision for the NHS as a whole"


The six national competencies are intended not only to simplify the approach to development but also to reflect more accurately the day-to-day work of leaders across the NHS.

From theory to practice

The national framework, created after a competitive procurement process, comprises seven consortia chosen from 24 bids. The bids were invited on the basis of delivering a curriculum built around the six core competencies. Crucially, the curriculum has to be delivered by academic centres, focusing on teaching academic leadership theory, and by personal development practitioners focusing on how to translate the theory into practice.

Two other features of the procurement are also important. First, bids had to show how leadership skills could be built over time. Leadership cannot be taught in a day, weekend, week or month. Developing more positive and influential personal behaviour requires personal effort over many months.

Second, performance management had to be an essential underlying principle of the programmes. After all, virtually everything else in the NHS is performance managed, so why not the delivery of personal development by universities and other organisations?

The seven consortia that comprise the framework are now available for drawing down by strategic health authorities for developing senior managerial leadership programmes in their own regions. This framework is only the beginning and will need to be complemented by middle management and board development, as well as the more systematic engagement of doctors and other clinical staff in management and leadership.

Finally, the national framework provides NHS chief executive David Nicholson with the opportunity to align himself with the leaders of successful organisations in other sectors by focusing on the one variable that differentiates them from the rest, namely taking a strong personal role in the development of senior managerial talent.

The six national leadership competencies

1.     The basics: vision, delivery, control and decision-making

Failing public and private organisations often lack vision and control. Developing a vision for local services is as motivationally important as developing a vision for the NHS as a whole.

2.     Understandingand managing context

Context provides vital motivation and relevance. In the NHS it is both local and national. Managers must be able to interpret national context for local meaning.

3.     Emotional intelligence

Emotional intelligence (EQ) involves using thinking about emotions to guide behaviour. The cornerstone of EQ is self-awareness, namely the ability to see and understand ourselves as others see us. This is important because our emotions are powerful drivers of leadership style and the impact it has on other people. Self-awareness, along with career experience, is the key to the development of personal wisdom and maturity as well as coping with, and learning from, failure.

4.     Relationship building

In addition to creating an exciting and passionate vision for change, leadership necessitates creating implementation networks across and beyond organisations.  

5.     Team and people development

The days of the single leader are over and today's NHS leader is only as good as their team and wider leadership network. Good leaders should appoint people with experience and personal skills that complement their own.

6.     Tackling difficult issues

Tackling difficult issues, particularly those involving implementing change and managing adverse performance, can be very stressful.


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Reader Response

2/2 The whole thing works together to develop a persons’ moral capacity (the goal) as they move from pure motivation at the beginning to a sophisticated mix with experience at the end. It’s a lifetime not a couple of months.

I work with lots of “doers” who know this and I watch them every day, helping the “thinkers” replace proselytised techniques with complimentary people. By the way, moral capacity is merely the ability to make judgements, based on principles and guided by conscience. For it to work, people also need a bit of physical, mental, emotional and social capacity. Oh Dam! Have I just said there are five capacities, in a sort of “six competencies” kind of way?

1/2 "Schadenfreude", did he mean epicaricacy or just the pleasure of dwelling on evil thoughts? As usual leadership is being pursued as a goal rather than a product of doing things properly.

Competency is just not good enough, being in reality only a tiny step away from incompetency. I like the idea of also helping to put the six bits into practice, but it tastes like another set of refurbished deckchairs, or as a wise man once put it ... "second-hand eloquence". Excellent irony!

There are only two components of competency: knowledge and skill. To move away from mere competency requires 'application' (the bit I liked) and that also has components: talent and values.

In addition to the leadership traits mentioned, I would like to add being creative and able to take calculated risks as important in this fast changing world. The health sector needs to be constantly innovating to meets the needs of a chnaging society. I find that the current culture in general is too focus on risks management and targets and hence restrict the ability of leaders to be bold and try new things!

Mary Shek

I would appreciate more schemes to develop staff from the bottom ranks into Senior Management. We need more secondments since it can be difficult for certain capable people to break the ranks due to lack of development opportunities and the job selection process.