Many in HSJ’s top 50 chief executives list were operating in the most complex of environments and achieving remarkable results, writes Dr Alex Till
Over recent months I’ve had the pleasure of interviewing some of the NHS’s top chief executives.
The interviews were part of the research for an executive MBA I am undertaking at Warwick Business School. My dissertation was entitled: “The journey of an NHS chief executive – routes to the top” and included an analysis of the HSJ’s Top 50 chief executive rankings.
As a result of this work, I was invited to join the 2019 judging panel.
Achieving a place in the HSJ’s top 50 is certainly no mean feat. In the five years from its inception in 2014 until 2018, there have been only 117 different chief executives named; 10 medics, 28 clinicians and 79 non-clinicians.
Sense of social responsibility
While there is much debate as to whether medics, clinicians or non-clinicians make “better” chief executives, let me assure you, the overwhelming finding of my cross-sectional analysis of the three cohorts is that, irrespective of their background, the underpinning element common to all chief executives, was an uncompromising set of values and a personal sense of social responsibility that intrinsically drove their success.
Getting a place in the HSJ Top 50 required individual chief executives to have taken on difficult leadership roles, led through complexity and for their impact and the individual difference that they were making to have been felt at all levels, for the patients, the staff, the organisation and the system
They found it a privilege to lead an organisation that provided something incredibly valuable for their local population. They all aimed to foster a culture which supported, valued and protected those for whom they had the responsibility to lead and care for.
Acting as their “true north”, these values not only guided their individual behaviour, but the performance of their organisation and their contribution to the wider system.
It is clear, that whether they realised it or not, HSJ’s esteemed judging panel were selecting some of the most values-based leaders in the NHS, many of whom were operating in the most complex of environments and achieving remarkable results.
Of course, performance mattered, but to “make it” into the list required much more than simply sitting comfortably (if such a thing exists!) in a well performing trust or being rated “outstanding” by the Care Quality Commission.
Getting a place in the HSJ Top 50 required individual chief executives to have taken on difficult leadership roles, led through complexity and for their impact and the individual difference that they were making to have been felt at all levels, for the patients, the staff, the organisation and the system.
The study I led assessed the different journeys that chief executives take on their “route to the top”. It showed that very few chief executives proactively sought leadership roles.
The majority described multiple “crucibles” whereby their leadership, and understanding of themselves as a leader, emerged through either informal mentoring, values-based challenges or through opportunistic leadership experiences which they seized because they could and because they wanted to make a difference.
This reveals a hidden component of leadership development, where through the “power of neoteny” one’s values retain the energy, curiosity, and confidence necessary to overcome the overwhelming adversity that one must face in order to develop into and excel as a top NHS chief executive. It also confirms that both formal and, crucially, informal leadership development must be provided from the earliest stages in a professional’s career.
It has been argued that a values-based leadership culture is “noticeably absent” in the NHS, but that is not the case here. To be named as one of HSJ’s Top Chief Executives is an incredible honour and we must all learn from their example, and their developmental journeys, to nurture the next generation.