'Foundation trusts will need to lead the way in learning to establish effective working relationships with their investors, namely primary care trusts and practice-based commissioners, and being proactive in discussing future strategy.'

Historically the NHS has been fond of talking about the alleged differences between the role of its senior managers and those in other sectors. The discussion tends to focus on the contextual differences and it is argued that there is nothing or little comparable in the private sector to compare with the political aspects of the NHS management role. It is an argument I have used myself on many occasions but over the years I have come to realise that it has been overplayed.

I came across a snippet of research recently that added to my conviction that the NHS needs to review its approach to developing the role of senior managers. The research said that chief executives and finance directors of public companies spent up to 30 per cent of their time on external networking. Principally the networking is with investors who have a significant stake in the future of the business and the discussion frequently focuses on future strategy.

This private sector experience has implications for NHS senior management practice as the NHS market develops. The market structure of the private sector offers little leeway for its organisational leaders in having to sustain their relationships with key external stakeholders. But historically in the NHS, the development and sustaining of key external relationships has been optional.

Getting equipped

Foundation trusts will need to lead the way in learning to establish effective working relationships with their investors, namely primary care trusts and practice-based commissioners, and being proactive in discussing future strategy. However, for many providers this will be counter-intuitive given that the historical inter-organisational power relationship has been in their favour.

So how are NHS senior managers to develop the necessary skills, maturity and wisdom for the new market-based world of the future? This month sees the start of a new approach to leadership development being piloted in the West Midlands. The programme has been constructed around themes that include vision, managing context and delivery; emotional intelligence; relationship building; team and people development; and tackling difficult or wicked issues.

The overriding aim of the programme is to achieve a greater balance between academic learning and the development of practical personal skills to put the learning into practice. Also, the programme is spread over one year to underscore the fact that personal leadership development requires consistent effort over time and cannot be learned by participation in a one-off programme.

By the end of 2007, most executive directors from the West Midlands' 44 NHS organisations will have entered the programme with the expectation that this will enhance senior managerial capacity and capability. Subsequent evaluation should demonstrate that this investment will translate into sustainable bottom-line performance. And perhaps more importantly, investment in programmes like that in the West Midlands should help managers anticipate and plan for NHS reform instead of spending time running faster merely to catch up.