Whither the elephant?: the continuing development of clinical leadership in the UK National Health Services

Abstract

The paper revisits the theme of clinical leadership in UK countries, following an earlier (2009) review. It examines the competency-based approach; considers the emerging voices of clinical leaders; explores the results of evaluation research studies; identifies learning from intra-UK and international comparisons and considers the issue of leader development versus leadership development. It concludes that there is little conceptual clarity; that there continues to be a major disconnect between clinicians and managers; that different approaches to developing clinical leaders are emerging in different parts of the UK and that the major challenge remains to develop leadership, rather than leaders.

Clinical leadership development in postgraduate medical education and training: policy, strategy and delivery in the UK National Health Service

“…The model of the leader who will be the "superhero" is not fit for purpose in the current health care environment (p 18). 36 By choosing to develop "leaders" as opposed to relationships between individuals, Edmonstone 106 contends that leadership can become divorced from the context in which it occurs and fails to harness the importance of teams and networks, making leadership a "multi-professional and multi-agency concern" (p 290). He is critical that most leadership activities in the NHS have been based upon developing individual leaders rather than that of "health care leadership", which is much more challenging and complex.…”

Developing healthcare leaders and managers: course-based or practice-based?

“…[16] Such an approach is helpful in enabling agreement on core leadership and management desiderata and providing a common language about which to speak of leadership and management activity, [17] but the approach also:…”

Service quality and maturity of health care organizations through the lens of Complexity Leadership Theory

“…The above‐mentioned changes in policies also required new approaches to leadership. Many authors have offered relevant and recent research on new leadership frameworks in health care organizations . Therefore, we can conclude that leadership is a crucial element of the organization's success, and its role is recognized as an important factor for achieving better performance .…”

“…Recently, there has been a transition from traditional models of leadership to approaches that reflect its complex nature . Edmonstone presented leadership in health care organizations as an “ emerging phenomenon .” Considering these complex features of leadership, our goal was to explore whether the Complexity Leadership Theory (CLT) generated actions from leaders that enabled higher levels of organizational performance. Within CLT, Uhl‐Bien et al identify 3 broad types of leadership: (1) leadership grounded in traditional, bureaucratic notions of hierarchy, alignment, and control (administrative leadership); (2) leadership that structures and enables conditions in which CAS can optimally address creative problem solving, adaptability, and learning (enabling leadership); and (3) leadership as a generative dynamic that underlies emergent change activities (adaptive leadership).…”

“…Many authors have offered relevant and recent research on new leadership frameworks in health care organizations. [22][23][24][25][26][27] Therefore, we can conclude that leadership is a crucial element of the organization's success, 25 and its role is recognized as an important factor for achieving better performance. 28 In this study, we explore leadership grounded in complexity theory, 29 having identified health care organizations as CAS.…”