Leadership and the new development landscape

Leadership development in the healthcare sector is changing. Christina Pond, executive director of core contracts and policy at Skills for Health, shares some NHS successes and explains best practice.

Over recent years, the issue of leadership and the pursuit of effective leadership development has become a major focus in healthcare. But when we talk about management and leadership development, it’s important not to just think about an individual as leader because leadership in the NHS, or indeed anywhere else, is a dynamic process.

It’s about a set of relationships that exist in a complex system, and it is important to focus on both the context in which that person is working, and the skills that they will need to draw on at different times and for different challenges.

Skills for Health offers management and leadership development courses that support managers to develop their workforce. Additionally, all of our core skills and knowledge frameworks specifically identify the knowledge and skill required for people leading the transformation of care.

The concept of the framework is that it can be used by the individual themselves to identify their learning needs, it can be used by an employer to identify what they need their workforce to be able to do, and it can be used by an education provider to develop a curriculum.

Success through training
We worked with the Salisbury NHS Foundation Trust, to devise a leadership programme for managers. The trust wanted to help its Grades 5 and 6 staff embrace the challenges of leadership and management, learning how to balance conflicting demands on time and find ways of improving services to the public.

The trust had already identified their development needs, and so Skills for Health worked with them to identify the required training, and a delivery model that utilised a mix of face-to-face sessions, e-learning and coaching. The aim of the eight-month programme was to help participants – including administrative and clerical staff and nurses – to identify the personal qualities of a good leader. Developing an understanding of effective team leadership, they learnt how services could be delivered more effectively by empowering team members, and studied a good leader’s use of emotional intelligence.

Skills for Health delivered a number of one-day workshops, including introduction to leadership, leadership styles and qualities, dealing with change and communication skills.

Demonstrating new skill
An overall programme evaluation received a very positive response, with delegates stating they had developed skills and knowledge around leadership and management, whilst participants evaluated their achievements using the NHS 360-degree feedback system. Thanks to the training, the trust’s patients have benefited as a result of the new ways of working which have since been implemented.

For example, a physiotherapist improved the way that elderly patients were taken through the hospital, while another clinician improved the running of a retinal screening clinic.

Participants reported feeling better equipped to carry out leadership duties, particularly with regard to managing teams, and they increased their understanding of different issues and working environments.

All the modules in the leadership development programme were matched to the Management and Leadership National Occupational Standards, thus ensuring transferable skills.

Janine Osmond, head of Learning and Development for Salisbury NHS Foundation Trust, said: “Our staff have had their eyes opened to management and leadership, and as a result, our patients have benefited through improvements to their services.”

One size doesn’t fit all
As the Salisbury Trust example shows, we work with leaders to help them support, develop and coach their own workforce. It’s not a one size fits all approach. Whittington Hospital NHS Trust also worked with Skills for Health to develop a competence‑based leadership programme. The trust pioneered the programme for front line managers. The intention was to provide a wider range of skills and strategies for new managers to draw upon when fulfilling their roles, reducing high levels of dependence on middle and senior managers.

Training and development to support first and second line managers identified a gap in skills around performance management, so the competence-based leadership programme ‘Coaching Skills for Managers’ was created to increase participants’ confidence, as well as their ability to deal effectively with challenging staff issues. Supported by Skills for Health the trust used the Management Standards Centre competences as a guide to ‘plug’ skills gaps. The resulting programme focused on specific management activities such as motivating and supporting staff, monitoring progress and quality of work, and conflict resolution.

A total of 17 people completed the programme and it has been judged especially successful for those new to management roles. Feedback from participating managers was positive, with many reporting increased confidence and greater ability to communicate and manage staff. Colleagues have also seen an improvement in appraisals, with more sensitive handling of work issues.

The programme has stimulated interest in coaching skills across the Trust and has resulted in a further programme, across two trusts, to roll out coaching skills in partnership with 60 managers and staff side representatives.

Carrie Graham, who worked on the Transformation Programme Team at Whittington Hospital, said: “Giving participants these practical skills equips them for the challenges of being in a management role. The skills and competences developed are practical, and act as a boost to individuals in their working lives.”

In practical terms, Skills for Health recommends ‘ten top tips’ for good practice in leadership, which emphasise the true purpose of leadership – namely to nurture ability and inspire people to achieve incredible things. The first touchstone for leaders to look at is finding supporters in order to build a receptive local culture and a critical mass for change. A successful leader should engage with colleagues and key stakeholders to build support and trust.

Best practice for making change
Those who are seeking change shouldn’t forget that it’s fine to ask the ‘killer’ question and challenge existing models. Just because something is done a certain way does not mean that it is being done in the best way. Enquiring minds must seek advice from those who have knowledge in areas where they are lacking and invite challenge.

Keeping the approach simple is key – an organisation needs a shared direction of travel that everyone understands, but those involved in delivering change must have ownership and feel involved in the creation of the vision for change. You should value people and show appreciation, as an organisation is only as good as its staff.

Think about creative ways of recognising the efforts of staff and celebrating achievement. Any good leader must also admit when they have made mistakes – and be honest with themselves and others when they are wrong, or simply don’t know. Personal integrity and openness are important characteristics of any leader.

Remember the benefit of a ‘team’ and do not try to go it alone. A good leader should have the confidence to draw upon all available resources, including the skills and abilities of others. After all, by delegating and sharing, you enable and develop their skills. Good communications can play an important role in building a sense of team within an organisation and can help encourage meaningful dialogue between different parts of an organisation.

And don’t forget that a dialogue is just that – meaning you must commit to really listening as well as broadcasting your ideas. Make no judgements, just understand the subtext of what people are saying, and pay as much attention to the non-verbal signals as to verbal presentation. As a leader, you lead by example, so be what you want others to be. You need to ensure that what you do and what you say reflect the values and behaviours you expect of others, so make sure you are setting the right example.

A key for any leadership success is to never stop learning. For a very few people leadership comes naturally, but for the vast majority leadership skills need to be developed. In today’s ever-changing workplace it is important to not only develop your leadership skills but to also work on the skills and knowledge vital to your profession.

Finally, make sure that you know yourself, as effective leadership begins with self‑knowledge. You need to understand your own emotional responses and be aware of the impact that people and situations have for you. The skills of self-awareness and self‑regulation, components of your emotional intelligence like other leadership skills, can be developed. They are absolutely vital to success when it comes to leadership development.

Further information
www.skillsforhealth.org.uk