Letters

Your recent feature on leadership in the NHS ('Some things wicked', page 28, 19 April) does the subject less than justice.

It focuses almost exclusively on the King's Fund programme which it describes as a 'national nursing-leadership programme'.

This is true only to the extent that it recruits participants nationally across all countries in the UK. It is in fact a selffunding programme run as a commercial venture.

Within the NHS in England there are a number of truly 'national' nursing-leadership programmes which are organised on an all-England basis and funded likewise. These include the 'leading an empowered organisation' (LEO) programme run by Leeds University and the Royal College of Nursing's clinical leadership programme. There are also national nursing programmes for cancer nurses and for mental health nurses.

As the joint author of a number of evaluation studies conducted on regionally organised leadershipdevelopment programmes between 1997-2000, I feel strongly that rather than providing free publicity for a single commercially run programme you might more usefully have pointed out the major challenges in the leadership field:

The importance of developing a common, shared vision of leadership across the service which addresses such questions as the distinction between leadership and management, the differences between clinical and managerial leadership, and the appropriate requirements for transactional and transformational leaders.

The need to 'dovetail' national, regional and local (workforce development confederations) activity in this field, not least in terms of funding regimes to ensure that the NHS gets value for money.

The worrying 'fashion swings' which the NHS engages in between leadership programmes for individuals and more workbased approaches linked to the modernisation agenda, which produces an either/or thinking when clearly both are needed.

John Edmonstone Programme associate Centre for the development of nursing policy and practice Leeds University