Effective leadership programmes work to a model of organisational change; Charles Marshall explains how to make this a reality.

Research surrounding the nature of leadership is exhaustive. Our understanding of the component parts of leadership has increased dramatically over recent years and a far more complex picture has emerged moving us away from the “Great Man” concept of the last century to a much more comprehensive understanding.

Disappointingly, however, even modern theory has remained one dimensional in its approach; focussing primarily on the role of the individual and the characteristics those individuals need to display in order to perform as an effective leader. Interestingly, concepts such as situational and transformational leadership carry strong references to a wider set of influences on leadership, yet still focus on individual characteristics, traits and behaviours.

Providers of leadership development with a wide range of leaders, primarily in healthcare have for many years focussed on individual development, the hope being that these individuals are then able to return to their place of work and instigate, support and encourage positive change within that work environment.

While partially successful, this approach has never really achieved the kind of significant and transformational organisational change that was initially envisaged. In house programmes incorporating work based projects have gone a long way towards this but very few have led to significant, lasting change in the way in which healthcare is provided.

As one of those providers of leadership development, our understanding has recently begun to shift from an approach to leadership which focuses on the individual to one which embraces a much wider, multi-dimensional framework.

Interestingly and central to this, lies a model of organisational development rather than one of leadership. In A causal model of organisational performance and change Burke and Litwin’s approach to organisational development places leadership at the heart of a process which creates linkages between a complex set of external and internal causal factors necessary to create transformational organisational change.

The idea is taken a stage further by Karan Janman suggesting that that leadership cannot effectively exist without “context”, as it is the context within which the individual operates that tends to dictate the opportunity for them to lead.

Our objective therefore has been two-fold:

1.     To develop a new understanding of leadership development based on a multidimensional approach

2.     To move away from a theoretical understanding to a practical application. This could then be reflected through a forward looking leadership development programme.

At the heart of this new approach lies a framework which effectively mixes aspects of the more conventional approach to leadership with less conventional thinking and the wider components of effective organisational development. The driving force being the critical link between the need for organisational change and the leadership which is required to make it happen (see diagram 1).

The practical outcome being a programme designed around these key principles which delivers sustainable, measurable change, in harmony with the organisations strategic goals and objectives whilst at the same time developing a strong cohort of individual leaders who are likely to be critical to future changes going forward.

Effective Change

Any leadership programme must have a purpose, a clearly described outcome and must be built around a large enough cohort from within the organisation to grow into a guiding coalition which can then go forward to instigate change within the system. Taking people out of their work environment and “teaching” them leadership will not have a significant effect upon the organisation. The Warwick model for whole system leadership supports this.

 Traditional approachWhole system approach
Unit of analysisThe IndividualThe workgroup / team
Starting pointTheoryPractice / problem
LocationThe retreatThe front line


The size and nature of the cohort is also important. In order to achieve critical mass the leadership cohort needs to be a significant number ideally between 50 and 100 and drawn from the entire breadth of the organisation , this adds depth to the quality of the group and ensures that a wide range of perspectives are taken into account during group sessions within the programme.

Linking to context

The fact that it is no longer acceptable in todays healthcare system, to adopt a myopic view of service or system redesign appears to be widely understod but seldom practiced. It is a basic requirement for anyone leading change in this sector to have a full understanding of the context in which they operate and to start with an organisational or inter organisational network as the unit of analysis rather than the individual themselves.

One of the key elements of this whole approach is to emphasise the importance of context as a focus for leadership. Only by doing this will individuals develop a more strategic outlook which will be essential to the organisations success in the future.

Programmes therefore must provide a “golden thread” which links up to date policy and legislation with the practical aspects reflected in the programme workstreams built around key strategic objectives developed by the board.


The application of ready made solutions to recurrent problems is primarily the domain of the manager. Facing wicked problems which are hugely “complex” and have no clear solution is the domain of the leader. Todays leaders in health operate in an environment of high ambiguity, programmes need to reflect this and provide opportunities to test out practical solutions to real problems, not theoretical brain teasers.

So called adaptive leaders need to be encouraged to make connections across systems where the solutions may lay in the hands of the stakeholders. Leadership may often be in helping stakeholders to realise they are part of the problem and therefore part of the solution rather than being expected to provide magical solutions to complex problems.

Key elements of any programme must be to incorporate a direct approach to these problems within the work streams and not shy away from issues which are either too complex or too large scale to provide an immediate solution within the bounds of the programme itself. These may go on to form long term projects which the organisation can inherit and build upon.


Taking the concept of the adaptive leader a stage further builds upon the basic qualities of emotional intelligence and requires individuals to react appropriately within their changing environment.

This demands resilience, capability, credibility and a broad knowledge base outside their particular field of specialty. It forms the bridge between the more organisational based elements of the framework and the personal qualities of the individual leader.

To address this within the programme requires an approach which can make this critical link such as action learning or individual one to one coaching conducted by a skilled facilitator or qualified coach.


Represented within the previous aspects of the framework is a strong case for the understanding and development of solid professional and social networks. The value of networks is now well established, but is often an area of anxiety for aspirant leaders. Programmes need to take a multi disciplinary approach, particularly regarding the involvement of clinicians and encourage the development of inter organisational networks via the learning sets or task based works groups. This forms an excellent base from which to develop wider, system based networks.

Organisational raids can develop strong links to alternative sectors and provide a good basis for networks as well as insights into best practice.


It is only now; having addressed the previous five elements of this framework that we finally arrive at the point of focus which has been the traditional approach to leadership development, the individual and their ability to lead.

Underpinning the need to accommodate the wide range of change and leadership components is the need to develop a well equipped tool box of leadership behaviours, based on an equally well equipped set of beliefs and values. This development at the individual level is critical to the success of any programme and support via one to one coaching or action learning is essential.

The choice of tools however, is critical and requires much more than a set of competencies. There have been all too many examples of toxic leadership which have been ostensibly “competent” but underpinned by perverse and destructive values.

An evidence based approach with a reliably valid 360 degree assessment such as the LPI has been found to be widely acceptable and highly effective, backed up by a set of principles and behaviours which can be successfully integrated into the programme content.

The overall premise proposed is that leadership development is not actually about leadership but about successful organisational change. Leadership may form part of that successful implementation, but otherwise struggle to survive in isolation.

If organisations are to invest in this kind of development they require to see a return on their investment and rightly so. In order to deliver this, any programme must begin with the end in mind and that end must be defined by the organisation. This in itself may often require some focussed attention.

Individuals will develop as leaders within that context and be able to reference that development against tangible goals as opposed to a more esoteric plan proposed by traditional leadership development programmes.