The Leadership Myths

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The Leadership Myths

• Its rare
• Its found at the top
• Its about being super-human

1 2 3
With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
2
Sparkling leadership

• As you look back what sparkling moments stand out
  for you as experiences of being really well lead
  or managed? What did you learn about worked well?
  
• As you look back what sparkling moments stand out
  for you as examples of where you were really
  effective as a leader or someone making a
  positive contribution to change? What did you
  notice worked well for you at that time?

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What is leadership?

• Some view leadership as a set of traits or
  competencies possessed by certain individuals
• others view leadership as an emergent social
  phenomena, a social process shaped by
  relationship within groups.
• Bolden, 2004

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Law of the Situation

• Leadership is transient and contextual
• Where knowledge and experience are needed the
  person who can is the right person to do it.
• Not all leadership should be determined by
  position power yet people with authority should
  be prepared to exercise it.

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The essence of leadership and management

• is the creation of environments in which people
  can be creative.. Where they can exercise power.
• leadership can only be judged by results
• valued outcomes for users and their supports,
  and other key stakeholders

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Three Domains for Improvement

• Leadership The art of getting things done by
  enabling others to achieve more than they could
  or would do otherwise.
• Improvement Science The study and practice of
  enhancing the performance of processes and
  systems of work.
• Care Delivery Systems The practical realities
  and future possibilities of how care is
  experienced by professionals, users and the
  public.

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The power lies in the overlap
Leadership in Health Social care
Improvement of health social care
Leadership for theImprovement of Health Social
Care
Leadership for ImprovementImprovement of
Leadership
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The Successful Leader

• Communicates clear vision,direction, and roles.
• Strategically influences and engages others.
• Builds relationships (with individuals, within
  teams, and across boundaries).
• Challenges thinking and encourages flexibility
  innovation.
• Develops, enables, and encourages others.
• Drives for results and improvement.
• Practices political astuteness.
• Displays self-awareness.
• Commits with passion to values and mission.
• Demonstrates management skill.

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The Successful Practitioner of Improvement Science

• Sees whole systems and understands how they work.
• Centres improvement on the experiences and voice
  of users/clients, carers, and staff.
• Seeks to translate evidence into practice.
• Exposes processes to mapping, analysis and
  redesign.
• Applies engineering concepts of flow, capacity,
  demand, and waste-reduction.
• Encourages flexible, innovative rethinking of
  processes and systems.

More
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The Successful Practitioner of Improvement Science

• Facilitates active local improvement, innovation,
  and reflective practice.
• Sets up measurement to demonstrate impact.
• Works constructively with the human dimension
  (psychology) of change.
• Sustains past improvement and drives for
  continuous improvement.
• Spreads improvement ideas and knowledge widely
  and urgently.

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Successful Care Delivery Systems

• Deliver evidence-based care in a timely,
  effective and caring manner.
• Earn and retain the confidence of users, their
  supporters, and the politicians.
• Operationalise a strategic vision of the future
  (encompassing trends in society, technology,
  funding, and the workforce).
• Link systems-design to a values-driven
  understanding of the experiences of service
  users.
• Create seamless-working across all types of
  boundaries for the benefit of service users and
  staff.

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Successful Care Delivery Systems

• Prioritise and focus limited development
  resources on the key issues and leverage points
  in the system.
• Continuously increase capacity to serve by
  improving effectiveness and efficiency.
• Engage practitioners and other operational staff
  in active improvement of the systems of care.
• Develop organisational cultures that are
  receptive and positive environments for change.
• Ensure that all central support functions service
  the requirements of care delivery.

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Leadership Qualities Framework
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Common Communication Development Decision-making I
ntegrity Role model Negotiation Knowledge Professi
onal competence Setting standards Flexibility
focus
Leadership Inspiration Transformation Direction Tr
ust Empowerment Creativity Innovation Motivation
Management Delegation Performance Planning Account
ability Finance Teamwork team
building Monitoring evaluating Formal
supervision Control
Leadership and Management (the TOPPS version)
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Success factors for leadership

• having a vision for their organisation which
  transcends short-term issues and targets
• having the skills to communicate their vision to
  others
• building trust among different stakeholders
• being passionate about high performance and high
  quality in their organisations
• being authentic believing in what they do and
  transmitting this to their staff and those around
  them

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
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Success factors for leadership

• being visible to their workforce and to
  stakeholders walking the shop-floor and knowing
  many of their frontline staff by name
• being their own person being strong enough to
  do it your way

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
18
Success factors for leadership

• being prepared to shape their own destiny rather
  than simply feeling deluged by external pressures
  and initiatives
• building good teams around them which
  undoubtedly helps to avoid getting ground down by
  the day-to-day demands of the job
• being able to read the strategic direction of the
  service over a longer time framework and
  translate this into what it means for their
  organisation and then communicating this
  locally.

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
19
The time challenge

• the best leaders are those that deal with the
  top-down pressure and create space in which they
  can develop and pursue strategy. However, this is
  difficult and has to be achieved in spite of the
  system.
• Finding of Goodwin, N. date Leadership and the
  UK health service. Health Policy, 51(1)14960
• Need to defend time for ad hoc contact- being
  visible around the organisation.
• Emails, meetings and other demands compete!

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
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Transformational leaders are

• Charismatic Providing role models, aligning
  others around a vision.
• Inspirational Providing meaning and optimism
  about the vision and its attainability
• Intellectually stimulating Encourages
  questioning of basic assumptions, and to consider
  problems from new and unique perspectives.
• Individually considerate Developing the
  potential of others.

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Transformational leadership- roots

• James MacGregor Burns transformation as that
  which turns followers into leaders and leaders
  into moral agents.
• Transformational leadership occurs when people
  elevate each other into a higher level of
  motivation and morality.
• Thus inextricably linked with the social meaning
  that people attach to their work.

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A competency based approach is not enough.

Degree to which engaging or transformational
Need is to enact competencies in a
transformational way

Degree of competence
With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
23
Golemans (1995) five independent but mutually
reinforcing components of effective leadership

• moral purpose
• understanding the change process
• relationship building
• knowledge creation and sharing and
• coherence making.

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New paradigm approach

• Less concerned with Great man models of
  leadership
• More concerned with change/improvement
• Transformational- visionary leadership
• More soft stuff emphasis on working through
  others

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
25
New paradigm approach

• Leaders with more faith in other people than they
  have in themselves (and they have a lot of faith
  in themselves!)
• Leader as servant and partner
• Ambition, optimism, openness and personal
  humility
• Importance of connectedness and inclusiveness

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
26
Reflections of Sir Gerry Robinson

• Recognise ability
• Management is not an exercise in bludgeoning
  people. It is about getting people on side, about
  making them feel important. The secret is to make
  them feel special, part of an organisation that
  works, where they play their part.
• Chimes with Alimo-Metcalfe research on leadership

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
27
Reflections of Sir Gerry Robinson

• Achieve role clarity.
• Give CEOs more control of their organisations.
• There is too much interference from the centre
  and managers are not left to get on with the job.
  Clinicians dont feel management is there to lead
  or to set the rules.. I felt that managers do
  not believe they have the right to manage.

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
28
Reflections of Sir Gerry Robinson

• Felt that managers should be given clear
  objectives and a budget and allowed to get on
  with it.
• A good approach to working with complexity-
  specify ends not means.
• Sir Gerry is solution focused! It is about
  making the right things happen and stopping the
  wrong things happening.

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
29
New paradigm approach

• Leadership is a contact sport not a virtual
  reality

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
30
Conclusions from TLQ research

• A transformational or engaging leader may be
  defined as someone who encourages and enables the
  development of an organisation that is
  characterised by a culture based on integrity,
  openness and transparency, and genuine valuing of
  others.

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
31
Conclusions from TLQ research

• This shows itself in concern for the development
  and well-being of others, in the ability to unite
  different groups of stakeholders in articulating
  a joint vision, and in delegation of a kind that
  empowers and develops potential, coupled with the
  encouragement of questioning and of thinking
  which is critical as well as strategic.

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
32
Conclusions from TLQ research

• Transformational leadership is essentially
  open-ended in nature, enabling organisations not
  only to cope with change, but also to be
  proactive in shaping their future. At all times
  transformational behaviour is guided by ethical
  principles.

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
33
Research using the Team Leadership Questionnaire

• Showing genuine concern has the biggest impact
  on motivation.
• Being interested in your needs and aspirations
  and how thing feel for you.

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
34
Gowdy and Rapps observations

• managers constantly modeled good practice
• focused less on traditional features of
  management such as attending meetings, preparing
  reports and proposals
• spent most of their time helping either users or
  staff to achieve their goals

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As they say..

• My favourite thing to say is, You help people
  figure out what it is they want you figure out
  how to help them get it then you figure out how
  to get them to keep it. Mixed in with all that
  practical stuff is some kind of friendship, being
  a vehicle for them to broaden their support
  network... I think thats critical (Gowdy and
  Rapp, 1989, p.49).

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Study of Crisis Resolution Teams highlights

• IMPACT OF
• High concern with and engagement of staff
• Encouraging a shared vision
• Team leadership capabilities

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
37
Study of Crisis Resolution Teams highlights

• CRTs with higher admission rates had less
  positive culture-particularly leadership quality
  at team level re engagement of staff
• Individual productivity of staff also associated
  with this factor
• vision and team leadership significantly
  associated with attitudes to work and well-being
  at work but not on performance

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
38
The gender issue

• Women more transformational than men on all
  leadership scales, and significantly more
  transformational on most of the scales,
  irrespective of whether the person rating them
  was male or female
• Alimo-Metcalfe, B. Alban-Metcalfe, J. (2003).
  'Gender Leadership A Masculine Past, but a
  Feminine Future?'. Proceedings of the BPS Annual
  Occupational Psychology Conference, Brighton,
  January 8-10th, pp 67-70.

With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
39
Lessons learned from Australia-, Managing Change
in Long Term Conditions Liz Watson, 2006.
Broader lessons included

• Respect individual responses to change- cf-
  motivational interviewing.
• Compromise.. But not too much
• Manage yourself and your emotions

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• Think about the leaders youve been inspired
  with over the course of your working life. Almost
  without exception they will be people with high
  self-esteem, whose actions are congruent with
  their espoused views, who understand their own
  beliefs and values and who have a sense of their
  own direction.

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• ..To be truly effective as a leader youve got
  to be comfortable with who you are and what you
  are about. Essentially concentrating on leading
  yourself is a powerful way to grow your ability
  to lead others.
• Chris Lake. Programme Director. Developing
  Leadership Potential, Roffey Park Management
  Institute. Cited by Peter Gilbert

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Kouzes and Posner describe five fundamental
actions which people said build the credibility
of those they wanted to lead them.

• Know your constituents.
• Stand up for your beliefs.
• Speak with passion.
• Lead by example.
• Conquer yourself.

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Courageous leadership and the challenging of
basic assumptions

• e.g. Delegation of nursing management to local
  authority social services is therefore a definite
  route to partnership for Long Term Conditions
  s31 health act flexibilities allow ,
• but will anyone dare take it? .
• Lorimer, R. (2006) p47

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Four principles of effective team leadership

• Clients are people
• Learning for a Living
• Making something from nothing
• Focus on client outcomes

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The challenges

• financial pressures and targets encourage
  short-term thinking
• ..and research suggests reduced efficiency of the
  wider system
• managers are forced to focus upwards (e.g. to DH)
  and not across their trusts towards the interests
  of patients and staff

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
46
The challenges

• some policies, in particular payment by results,
  encourage trust boards to think about the
  survival of their own organisation rather than
  the wider health community
• the role of the chief executive, and how success
  should be measured, is not always clear

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
47
The challenges

• training can be inadequate, or non-existent, at
  all levels of management
• there is often a lack of evidence about what
  works if evidence were available, it could be
  used to inform decision-making
• decisions take a long time to implement because
  of reliance on consensus

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
48
The challenges

• Engaging practitioners is key to success and
  often falls short at every level
• there is a culture within the NHS which
  encourages bullying, and this stifles leadership
  potential
• the size of the workload and unrelenting pressure
  can stop managers from carrying out the work they
  should be doing
• many managers stay in post for only two or three
  years, while practitioners tend to remain at the
  same trust for many years
• while there are good even exemplary leaders
  in the NHS, there are not enough of them

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
49
The challenges

• middle managers, sandwiched between clinicians
  and senior managers, are often disempowered and
  need more support
• stability and more autonomy would encourage the
  development of new leaders
• every leader needs to prioritise supporting
  leaders in the level below.

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
50
The filling in the sandwich

• Middle management the critical layer between
  corporate management and practitioners.
• The most stressed group in the NHS workforce.
• Often feel disempowered- so like practitioners
  exercise what power they have by saying no or
  taking flight from authority.
• Thus need to link their development strongly with
  neighbouring layers in hosting organisations

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
51
Can leadership be learned?

• YES, BUT.
• Leadership is a set of skills but it is dispersed
  and dependent upon the context and the job
  needing to be done.
• How you do it is as important as what you do!- be
  transactional in a transformational-engaging way
• There are significant emotional components
• Reflective practice and learning is needed
  rather than books or story-telling alone
• Context, methods, and participants must be
  carefully matched for success

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Processes of development

• ..leadership practice takes shape in the
  interactions between people and their situations,
  rather than from the actions of an individual
  leader (Spillane, 2004)

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Processes of development

• ..if we consider leadership as a collective
  process rather than an individual property then
  we need to challenge the traditional approach of
  sending only senior management on leadership
  development programmes, and encouraging others in
  the organisation to follow the leader.
• Bolden, 2005, p.7

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What are the major blocks to the success of
leadership development initiatives?
1 2 3

• Senior managers- excluding themselves
• Senior managers- discrepant views with
  subordinates regarding what leadership is
• Senior managers- simply blocking development

From Alimo-Metcalfe, B. et al (2000). British
Companies at the beginning of the 21st Century.
Factors that impede leadership development
initiatives. London Carers Research Forum.
With acknowledgement to Bev Alban-Metcalfe of
www.realworld-group.com
55
Development to make a difference

• Take a longer term view which encompasses the
  wider system.
• Create more time for really important issues-
  such as improving delivery and staff
  understanding of the wider strategy.
• Focus on practitioners, middle managers and the
  next generation of CEOs.
• Aim for more stability
• Ensure that espoused values are expressed in
  behaviour (e.g. by tackling bullying).

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
56
Development to make a difference

• Context requires a a much wider and more subtle
  range of influencing and persuasion skills than
  would be required in some other settings.
• Pay attention to the skills required for a much
  more complex world in which thinking, listening
  and influencing will become much more important
  (12).
• Develop sophisticated skills to deal with the
  emotional side of organisational life that are
  probably even more important than the need to
  improve technical skills
• NHS North West chief executive Mike Farrar

From NHS Confederation Report- The challenges of
leadership in the NHS. 2007
57
Some distant reflections from the turn of the
century!

• Goodwin (2000) advocated a move away from a focus
  on individual skill development towards a local
  leadership mindset.
• Leadership development as mandatory, locally
  focussed, based around action-learning
  principles, and concentrated on
  inter-organisational and shared leadership
  between organisations rather than leader-follower
  relationships within organisations.
• Goodwin, N. (2000). The national leadership
  centre and the national plan. British Journal of
  Health Care Management. 6(9), 399-401.