The style of leadership required to carry out such tasks is frequently debated and lamented, but it would be critical to state at this point, that in my opinion what is deemed as “good leadership skills” are often arable and are required to be fluid enough to meet the changing demands of health and social care (Sheering, 2012). To be aware of the influences and inhibitors of leaders will allow development of appropriate skills to facilitate the leadership qualities required in health and social care, and overcome the barriers of resistance.
It is clear that the influences affecting leadership are plentiful and complex (Mimic and Phillips, 2009), none more so than the numerous white papers and service reforms of recent times (Department of Health 2000, 2003, 2008, 2012). Political reforms have outlined the future plans for health and social care, yet at the same time demand multifaceted actions from those delivering the service. As these mandates transfer down the hierarchy, the drivers for change become more plentiful and intertwined.
Budgetary allocations and financial status impact directly on staffing levels and work load, service delivery is performed with fewer providers and expected higher quality (The Kings Fund, 2012). Resulting in changing job roles and service providence expanded often beyond expectations, budget cutbacks and limitations enforce new and unrecognized clinical roles. This can be a difficult and a challenging aspect of leader’s role, with shifting basis of a team bringing about changing dynamics and cultural shifts (Simmons 2011).
Service users will also bring demands of their own and expectations of a succinct delivery of care, and while service users voice is a useful tool for measurement of effectiveness (Simmons 2011 these changes can have direct impact on how leaders shape the service and teams (Attire et al. 2011, Simmons, 2011). Further influences on leadership can include quality markers (NASH Leadership Academy, 2012, National Health Service (NASH) Institute for Innovation and Improvement, 2012, and The Kings Fund, 2012) and standards review (Department of Health, 2003), as well as independent review commissions (Francis 2013), complaints and litigation.
Professional regulatory bodies (Royal College of Nursing, 2013), Government advisory board, Healthcare and care standards commissions will all impact the effectiveness and direction of leadership within a health and social care environment. Personally I feel one of the most influential aspects affecting leadership is leader development. Although often seen as an appointed leader, many health and social service leaders are not formally developed into the role (NASH Leadership Academy, 2012).
Over recent years several organizations have attempted to design leadership development programmer to promote development and ensure quality improvement (Edmondson 201 1), but recently this responsibility has been handed to the NASH Leadership Academy (2012). The previous plethora of initiatives and organizations involved may have given rise to confusion and a less than coherent system of development (Edmondson, 2011). The aim of the development programmer are to enhance and cultivate the competencies quire to be an effective leader.
It can be argued that leadership is a complex issue (Mimic and Phillips, 2010) and not one style or competency works with every individual or indeed organization. Currently NASH and social care leadership programmer tend to be built upon a competency framework style of development which can reduce leadership traits to individual components, indicating a return to trait-based theories of leadership (Edmondson, 2011). In doing so, education and development looks only at each component in isolation and out of context with the situation it would be used in.
Good leadership s a holistic approach and development of such will lead to an improved and developed flexible skills required to lead (Fealty et al, 2011). Such competency based learning models can be disruptive to the natural flow of leadership development (Edmondson, 2011), with the focus of training being on the individual as a leader, rather than the context and situation in which leadership is needed. Seen as a one size fits all style of development, professional and personal differences can be over looked, and training is most effective when it can be incorporated into the real work of the leader (Wells and Hagen 2009).
The NASH and social care have many differing and varied roles and leaders, that it would be impractical to tailor a training programmer to each (NASH Leadership Academy), but what a generalist training programmer aims to do is give the basic fundamental theory and practicalities to enable leaders to create the right environment to allow good patient care to flourish (NASH Leadership Academy 2012). Whether leadership can be taught (Adair 2003, Grin 2010, Stanley 2005) is a long running argument but, in my opinion, the real education is how to apply the knowledge to practice.
That is where the use of a coach or mentor is most advantageous (Buddha and Spurge’s 2012). Coaching is seen as a recognized method of leadership development (Buddha and Spurge’s 2012), but not one readily used in health and social care. The reasons for this may be plentiful such as time and limits on resources to free the manpower to facilitate such development, but it can and has been an effective tool when used with nurse training for example (Peskiness, 2009).
Its aim is to tap into potential leadership traits and nurture the leader to develop within them (Sherman and Freak 2004) and it is often those congruent leaders that are seen as role models that will be he catalyst for coaching (Stanley 2005). The focus relies heavily on the personal need for development and the willingness to learn (Buddha and Spurge’s 2012), although the danger herein lies with the coach who has charismatic traits and agenda that is not all together in the views of the organization. This can cause conflict and ultimately a leader who has been developed without the organizations ethos at heart (Lee et al, 2010).
In my opinion, with the advent of white papers such as The NASH plan (DO 2000), Adair Report (Adair 2003) and The Health and Social Care Act (DO 201 2), the emphasis is now on a sleek, determined system (DO 2012) with fundamentally the patient focused at the centre of care. Both patients and careers have much louder voices now, in shaping the reforms underway, therefore those leaders with darkly charismatic traits will be exposed in the transformation and improvements that are currently coursing through health and social care.
It is clear that leadership development has a significant part to play within the new reforms (NASH Leadership Academy 2012), and those organizations that refuse to allow development of both appointed and natural leaders, are at risk of high profile examination and review Francis 2013). The way in which development is facilitated is, in my opinion, as individual as what makes a good leader. Personal traits, job descriptions, team dynamics, amongst other influences all impact on the development needs of an individual.
The importance is the recognized need for development as a tool in a leader’s armory, to enable them to combat the effects of high paced leadership demands in a healthcare setting (Lee et al 2010). At a higher level in the organization, Lucas (2012) demonstrates that a “proactive support of the employee leads to proactive strategy to enable organizational growth. ” Therefore he benefits to both the employee and employer are significant.
The belief is, that to develop and leading workforce and empower those that lead within the organization will allow for driving forward improvements and benefits in the quality of patient care in both heath and social sectors (Propose 2009) Effective leadership is a critical measure of high performance for health and social care (Well and Hagen 2009), and therefore it is in an organizations best interests to commit to the development and support of all their leaders, either appointed or natural, in order to provide the high standards of care and performance now expected in today health and social care environment (Francis 2013).
