From super-hero to super-connector, changing the ­leadership culture in the NHS

Abstract

The NHS Long Term Plan recently published recognises the critical role of leadership to the delivery of high-quality, sustainable healthcare and sets out an ambition for compassionate and inclusive leadership behaviours. There is good evidence that the biggest influence on organisational culture is the quality of leadership, affecting patient outcomes and staff experience. However, the current NHS staff survey paints a sobering picture of the current experience of the 1.2 million staff who work in the NHS in England. Changing culture requires leadership effort and behavioural change at every level of the system, from the clinical microsystem to the national arms-length bodies. Leaders can take positive action by regularly seeking feedback, paying attention to the leadership behaviours within their team and finding ways to ensure the team can reflect and improve their team working. This opinion article offers an introduction to compassionate and inclusive leadership in healthcare. Our intention is to provide the reader with a sense of agency to act and improve local culture for the benefits of patients and staff.

First, Be a Good Citizen: Organizational Citizenship Behaviors, Well-Being at Work and the Moderating Role of Leadership Styles

“…Essentially, leadership styles amplify the effect of OCBs on well-being at work, giving leadership a better-framed role. The leader does not have superpowers and is not responsible for all the good and bad that happens in organizations [187,188], rather the leader is one more important element in the complex network of relationships that are structured at work and who can contribute to more efficiency and well-being at work [189]. In fact, as our results indicate, more important than having good leaders is having good citizens.…”

Compassionate Leadership – mitfühlende Führung

“…Studien haben jedoch gezeigt, dass aktuelle Führungsmethoden im Gesundheitsbereich fundamentale strukturelle Probleme aufweisen, mit andauerndem Fokus auf Top-down-(d. h. hierarisch von oben nach unten) Überprüfung und -Kontrolle durch ein ziel-und leistungsorientiertes Management [2][3][4]. Fehler, Versagen in der Vergangenheit und negative Auswirkungen von klassischen Führungsstilen auf Mitarbeiter*innen haben dazu geführt, dass der Bedarf an einem mitfühlenden und mitarbeiterorientierten Führungsstil gewachsen ist [5][6][7][8].…”

“…Diese haben den gemeinsamen Grundgedanken, dass das Führungsverhalten die Kultur innerhalb der Organisation maßgeblich beeinflusst und mitgestaltet [9]. Studien zeigten zudem, dass ein Zusammenhang zwischen Führungsstil und Verbesserung der Versorgungsqualität besteht -wiederum ein Hinweis darauf, dass mitfühlende Mitarbeiterführung eine signifikante Rolle bei der Umsetzung von Veränderungen spielt [5,4,8]. In der Praxis bedeutet dies, dass mitfühlende Führungskräfte als Vorbild fungieren und positive Werte und Normen durch ihr eigenes Verhalten vorleben.…”

Staring into the crystal ball

“…Bailey and Burhouse describe the leadership that will be required to develop the necessary culture with compassion. 3 Finally, Nick Bosanquet provides a personal view reflecting on many decades of changing healthcare policy and NHS structure. 4 He describes missed opportunities that we must learn from if we are to optimise the future of our beloved NHS.…”