Vision-impaired leaders s 'hold back'NHS

A lack of vision and application from senior management is impeding leadership development programmes and the future performance of the NHS, new research commissioned by the NHS Leadership Centre has warned.

The research, presented at the inaugural HSJ Forum last week and carried out by Cranfield University, reveals that many managers focus on broad organisational goals rather than individual performance, prioritise short-term development activities, and rely too heavily on inhouse programmes.

The speakers, Cranfield University's Martin Clarke and Neil Offley, programme director of the Leadership Centre, recommended that trusts develop more tailored leadership programmes rather than relying on generic ones, whether organisationally or individually focused.

The research is based on detailed questionnaires and workshops with managers on leadership development programmes.

Two-thirds of respondents said they believed there was a direct link between investment in senior leader development and the performance of the NHS, while the same proportion thought that other activities were being given priority (double that found in a similar Cranfield University study of private sector managers).

Mr Clarke, director of Cranfield University's general management development programmes, said: 'Respondents believed that leadership development was not seen as key to organisational improvement. The organisation was thought by senior managers to be too big or too small or going through too much change.A lot of this was down to organisation politics. There was not always enough emphasis on the development of individuals, but rather a tendency for organisations to use a one-size-fits-all approach.'

Similarly, 86 per cent thought the NHS has an ineffective or completely absent approach to developing 'future thinking' among its managers.

Although over 80 per cent of those surveyed thought executive coaching and mentoring would have been an effective approach for developing senior leaders, only 28 per cent said it was used frequently in their organisation.

Only 42 per cent thought inhouse development programmes were highly valuable.

Time was thought the most likely reason for leader development programmes not being pursued, although a fifth of respondents blamed lack of money.

The research also reveals that the views of human resources and general managers on leadership programmes were sometimes at odds, with the former emphasising wider organisational goals and the latter focusing on personal development.

Comparison with the private study suggests that HR professionals who are themselves part of leadership development programmes were most closely allied with general management colleagues.

Mr Clarke also criticised a reluctance by managers to look outside the NHS for ideas on leadership: 'Too often, 'outside thinking' is taken to mean 'outside my trust''.

The Leadership Centre is planning further work with Cranfield, due to be published in spring.

Also speaking at the forum, Greater Manchester strategic health authority chief executive Neil Goodwin said his own research into the success criteria for good leaders in the NHS emphasised political skills, delivery of results, an ability to balance national and local objectives, communication and the willingness to make hard decisions. He said: 'Those chief executives that my research found to not be good leaders were not hard enough and were not hard enough on delivery.

A good leader will recognise that the weakest link in a team can affect the whole team.'

In a separate presentation, Professor Beverly Alimo-Metcalfe of Leeds University warned managers against misuse of the 360degree appraisal process. She said the greater use of such appraisals in the public sector could actually make morale worse if findings are not acted upon.

'Where there is no follow-up, you simply create more cynicism and it reduces self-esteem.'

The findings of the research will be covered in detail in an HSJ supplement, sponsored by the NHS Leadership Centre, published next week

Foundations 'will make politicians of many leaders'

Foundation status will make huge and so far under-recognised demands on senior managers' political skills, according to Mike Pollard, chief executive of first-wave applicant Essex Rivers Healthcare trust.

Mr Pollard said 'managing the electorate' of members and governors under the new system 'will make politicians of many leaders'.Combined with the introduction of financial flows, he said this would mean 'a new mindset where the cultures of business and healthcare converged'.

He said technical and strategic skills would become only the entry requirement to leadership and that emotional intelligence would grow in importance.'You will be dealing with disparate stakeholders, with power, and we need to create languages to deal with that. It will not be enough just to speak on behalf of the secretary of state.'

No room for silos in clinical leadership

The development of better clinical leadership means working to erode traditional 'silos of medical teams', according to Royal College of Physicians president Professor Carol Black.

She said that work to comply with the new rules on doctors'hours under the working-time directive was acting as a catalyst for clinicians to consider the wider needs of the hospital as well as their own area.

Her own hospital, the Royal Free Hampstead in London, began work in spring to comply with directive rules a year ahead of next August's deadline.'There were teething problems...but the key was to push forward and show that it could work without affecting care' She said the Royal Colleges were working together on how different specialists could work together to provide cover.