'Shared leadership is based on the idea that teams work together more effectively if all team members assert their individual leadership qualities'

Plastic-wrapped Devon fudge appearing in the office kitchen is a sure sign that August has arrived. Bringing back treats from your summer travels can be a nice way to foster team spirit, but it's not necessarily the most effective.

The Health Foundation has been testing ways to build strong teams using the principle of shared leadership. Shared leadership is based on the idea that teams work together more effectively if all team members assert their individual leadership qualities. This doesn't mean no-one is in control, just that the team will continue to function effectively even if the leader is absent or leaves the organisation.

As part of this initiative, the Health Foundation gave awards to six diabetes teams 18 months ago. But we didn't just hand over a cheque. Instead, we gave them development opportunities in the form of a leadership development consultant. Each team received tailored leadership development to meet their specific needs, including goal-setting and developing strategies and activities to improve the delivery of diabetes care.

The teams agree that the programme helped them focus on the priorities for patients, find ways to achieve their goals and increase motivation. As one participant said: 'We could have done all of this without the award, but we wouldn't have done it.'

Coping with change

One reason we picked diabetes was because cross-organisational networks of clinicians were relatively well established. We hoped this would allow improvements in team-working to be easily replicated throughout the UK.

What we didn't predict at the time was the huge impact of reconfiguration on the selected teams - particularly those in England. One of the teams we selected had none of the original applicants in the core team by the end of the award period. This team has learned how to ensure that high-quality patient care doesn't depend on one passionate, charismatic leader but is instead a responsibility shared throughout the team.

We will have to wait for the formal evaluation due at the end of the year to see all the benefits of the programme, but from what we can tell so far these teams are highly confident. Whatever hurdles come their way - restructuring, funding pressures or team members leaving - their commitment to delivering the best care possible for people living with diabetes will not diminish. Their ambitions have grown and our relatively modest intervention has indicated that paying attention to team processes and individual development can pay significant dividends.

Stephen Thornton is chief executive of the Health Foundation.

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