Never mind the legislation, it's the quality of leadership that will transform the health and care system
21 April 2021
There is a lot of attention focused on the health and care white paper and its proposed legislation to transform the system. The legislation may be helpful, but ultimately its impact will have more to do with the quality of leadership to interpret it and deliver its benefits as the skillfulness of the drafting of the Bill.
So what nature of leadership will be required to ensure that the new approach to system working develops and triumphs in the years ahead? We believe that leaders of today and tomorrow will need the ability to:
1) operate without formal hierarchical authority but by finding common purpose with others
2) listen and understand the position, hopes and fears of partners
3) operate inclusively so as to engage partners, staff and citizens and to set out a clear and compelling shared narrative that can motivate - even when organisational or cultural barriers are present
4) speak honestly and constructively in leadership groups and boards, including being able to challenge others without accusation
5) ask questions (rather than make statements) to ensure a proper understanding of the views of partners
6) accept that on occasions you may not win the argument, but recognise that continuing on the journey is what matters
7) reflect on why you hold the position you do and whether, through walking in others shoes, you can see a different and better perspective
8) believe that the future can be different to the past and this isn’t just going round the loop again
9) create shared and trusted whole-system-single-versions of the truth, using data and evidence rather than anecdote and bias
10) act with kindness and humility as a matter of personal leadership style and to maintain this even when under pressure.
These may seem trite and statements of the obvious. But they have not always been in abundance in the NHS’s recent past. Nor indeed have these styles been rewarded by the powers that be - whether inspectors or the performance management regime. They are, however, traits and styles that can be coached and, in particular, are subject to shared learning and organisational development programmes.
Without this clear focus on leadership, we could end up unable to properly deliver and cement the changes set out in the forthcoming legislation, leaving instead the need for further change later. If that were to happen we would regret not investing enough in getting the nature of our leadership approach right this time. There is everything to play for in our determination to deliver transformation across the healthcare system and leaders are key.