Does leadership matter for healthcare service quality? Evidence from NHS England

Abstract

In this paper we provide first-hand evidence that leadership quality matters for the quality of healthcare provision, based on NHS England hospital trust data between 2010 and 2014. This is the first paper to study this relationship using individual leadership styles, namely, task-, relations-, change-and integrity-oriented, and for different metrics of quality of healthcare provision, including staff and patient satisfaction survey measures and clinical performance indicators. We find that task-oriented leadership has the strongest relationship with staff-rated hospital quality while change-oriented leadership relates most to patient satisfaction and the clinical measure. We also find some evidence that organizational autonomy and competition across hospitals moderates the effect of leadership quality on healthcare quality. Overall, our results indicate that ideal healthcare leaders should behave as integrated leaders and that leadership matters at all levels of organizational hierarchy. This has important policy implications for continued support for the development and funding of integrated leadership programs in healthcare.

Mediating effect of organisational innovation in the prediction of change-oriented leadership on organisational performance

“…Precisely, our study extends the established view of change-oriented leadership’s effect on organisational performance, indicating that change-oriented leadership does not only affect organisational performance but also organisational innovation. Furthermore, this work adds empirical evidence to the extant association between on change-oriented leadership and organisational performance (Andersen, 2010; Bergsten et al , 2021; Elkomy et al , 2020; Fan et al , 2020; Ghasemy et al , 2020; Katz et al , 2009; Maechel et al , 2020; Maladzhi, 2015; Øygarden et al , 2020) by proposing and confirming the mediation role of organisational innovation on the relationship between change-oriented leadership and organisational performance. Although prior studies have examined the mediating role of organisational innovation on the effect of various leadership styles on organisational performance (Ebrahimi et al , 2016; Sethibe and Steyn, 2015; Zehir et al , 2012), such studies did examine the mediating effect of organisational innovation along with the path from change-oriented leadership to organisational performance.…”

Leadership in the public sector: A meta‐analysis of styles, outcomes, contexts, and methods

“…Although leader‐member exchange refers to the relationship between leaders and followers rather than to the characteristics and behaviors of leaders, it was included in the coding list, as there is growing interest in relational approaches to leadership in the public sector (Ospina, 2017). Some studies measure leadership with broad instruments covering multiple dimensions of leadership behaviors (e.g., Elkomy et al, 2020). These studies were considered in the meta‐analysis of main effects but excluded from the moderation analysis because the applied measurements and corresponding conceptualizations do not conform to the definition of leadership styles (i.e., specific patterns of leadership characteristics and behaviors).…”

Effects of Inclusive Leadership on Quality of Care: The Mediating Role of Psychological Safety Climate and Perceived Workgroup Inclusion

“…Leadership can have a tremendous impact in healthcare settings. For example, it affects group practices [ 11 , 24 , 29 , 30 ] and contributes to safe and quality patient care [ 31 ]. In particular, inclusive leadership deviates from the traditional approach and focuses on relational, communicative, and participative work environments [ 32 ] through “exhibiting words and deeds that invite and appreciate others’ contributions” [ 19 ].…”