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The rapid technological developments particularly in the sectors of information technology and communication and the phenomenon of globalization create a new society more competitive and they impose continuous technological and qualitative upgrade of services that is offered in the consumers. This changes affect in the growth and in the metamorphosis of economy and society. Independent from their objective that is the maximization of profit most organisms either it is commercial enterprises or for not speculative organizations as universities and hospitals try for the best possible so that they acquire sufficient share of market. However, the most sensitive sector is the sector of health because it concerns with human lives. The context and challenges for health and healthcare across the Europe are changing rapidly and in many cases are converging.
In this paper ..will try to introduce and analyze the topic of leadership in NHS. Firstly, given the general definition of leadership, because leadership has a lot of different ways to be fixed.
Leaders today must be deeply knowledgeable about the past, widely informed about the present, and willing to substitute the common good for their own.(David Pierpont Gardner , On leadership)
Before we get started, let’s try to define leadership. The leadership is difficult to be fixed precisely. Have become a lot of efforts of determination leadership in organizations of Britain but there are many different opinions about it and its determination are problematic. There are many definitions as to what leadership is: it is something that is easily recognized, but not easily defined. So Hersey and Blanchard defined leadership as “the process of influencing the activities of an individual or a group in efforts toward goal achievement in a given situation,” (Transformational Leadership in Health Care by Joan Trofino). Also, leadership is “the relationship between the leader and the led that induces followers to act for certain goals that represent the wants and needs of both parties”. (Burns 1970’s). One thing is clear; leadership is a process where a leader influences the direction of a unit in achieving its objective in a given situation. The leadership from its nature includes the element of control and the force to influenced the behavior of persons, it can be formal or informal and be concerned a big or small team of persons respectively. In any group of children or adults, there are those who step forward to organize people and events to achieve a specific result.
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For the leaders of health care, leadership can be defined as a dynamic process of seeking a vision for change in which the leader is supported by two main groups: fans within its own organization, and influential agents external organizations that work to the outside of leader environment. However, a good approach of leadership can become if we return in the typology of Weber that determines three types of leaders: the reasonable – lawyer, the charismatic, and the traditional. Also, Robert Blake and Jane Mouton managerial grid. Other styles of leadership which indentified in the literature are the democratic, autocratic, bureaucratic, laissez faire, and employee controlled. Likert (1974). After research that became in enough organizations of Great Britain for the leadership existed a lot of and different opinions(Alimo Metalifare). The three types of leaders according to the typology of Weber present itself in most of organizations in Great Britain but are not attributed equally well in the organization of all, for this reason has begun to take shape a new model of leadership the transformational model.
The key word so that it copes a modern economic unit and concretely a modern organism of health is the leadership. “There are many elements to a campaign. Leadership is number one. Everything else is number two. “(Anthony T. Dadovano -Bernd Brecher.” Bernd Brecher on Leadership). The successes and the failures of each constituted social structure (associations, enterprises, states) are attributed at a very significant percentage in their leadership. This fact makes the leadership one of the most important parameters that determine the good operation and the development of each social organization small or big.
Successful organizations are those which have leaders smart, creative to think quickly, have training in administration, fluent in speaking, persuasive, knowledgeable about group task and have a vision to work and communicate effectively. Effective leadership is essential if a health services organization is to provide high-quality care and succeed financially. “Effective leadership is a key ingredient in modernizing today’s health services. Better leadership means better patient care and improved working practices for NHS staff.” (NHS Modernization Agency, 2004a). Leadership ensures that the organization works successfully and accomplishes the desired goals. The functionals in the sector of health seek from a side the benefit of medical care and from other side trying for restraint the cost.
In the NHS there is lack of leadership skills and developing methods but it has been recognized and their development is a high priority. Leaders are the key to the delivery of quality care in an organization.
Burns (1987) was the first who reported in two innovative type of leadership, which can be corresponded successfully in the requirements of NHS. This type of leadership is the Transactional Leadership and the Transformational Leadership. The Transactional Leadership is based on exchange theory that includes performance bonus and compensation with exchange the successful execution of the work which assigned to the group.” Here there is two standards of action: the contingent reward and the management by exception.”(Kurz 1998). According to Bass (1985) the four main characteristics of transactional leadership are: charisma, inspiration, spiritual momentum, individualized approach. This type of leadership tends to maintain the current operational status of the organization. The leader seeks to maintain the overall structure of the system through the control and partial upgrading of structures and processes. For example, in a university hospital whatever changes could be done in personnel and equipment, it would be remained university oriented in research and education.
The transformational leadership according to Burns (1978) happen when one or more people involved and cooperate with their manner in order to the leaders and colleagues to push each other to ever higher levels of motivation and incentive for greater efficiency. The main difference from the transactional leadership is that the leader here seeks to change the entire organizational culture and structures of organism. According to Bass (1984) the transformational leadership has three characteristics: The transformational leadership might be lead to most successful and sustainable solutions if it combined with the already existing process of transactional leadership. The Vision of transformational leader to have success in the future is to secure the consent of all the factors of organism, and makes the environment more receptive to the introduction of innovative methods and modes of action.
Leadership and management are two meanings obviously like, but not identical. Many people confuse management with leadership. Leadership is much more than management. It is more an art than an ability, which making others want something that you are convinced should be done. Leadership is closely tied with the terms of strength, power and influence. Leaders must have supporters to be successful. Leaders are they who go to the front, they brought profound changes and innovations, in addition to managers who are they try to improve the efficiency of operation in a fixed place with a controlled way. Although leadership and management are both important, Bennis and Nanus identified a profound difference between the two: “Managers are people who do things right and leaders are people who do the right things”.( Transformational Leadership in Health Care by Joan Trofino).
The environment of health care is so complex and powerful and contains a variety of disciplines to help them function properly. As long as more highly a leader want to reach an organization of health, so much more needs the leading faculty and influence. The influence that it can have the leadership is very important for the achievement of objectives. The leadership should prompt the persons to follow its even from curiosity. This effort was not small time duration, but long-lasting and laborious, otherwise would be failed. This proves that leadership developed day with the day and no in one day. The healthcare sector needs leaders who can communicate verbal with others, setting goals, have adaptability to changes, take risks. The leaders in the NHS must make the right choice of people who constitute their team, inspire and empower them to achieve their best.
The right leadership should be draw rightly the processes that are required to be followed as well as the time and the way of pursuing them, so that is achieved the objective. Its application in NHS it would be predetermines course of action, places the objectives, adapts the priorities, informs the basic collaborators, leaves time margin for the acceptance, impetuously advances in the action, waits for that it will have problems, re-examines daily the drawing. The leadership should see the future developing the experience of past and taking ideas from executives and from the remainder personnel, which is required for the achievement of objectives. If the leadership has powerful character, the persons entrust it and they entrust its faculty to unfold their dynamism. This not only gives in the personnel of health sector hope for the future but also promotes their faith in and in their organism.
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Each time in the NHS where the leadership is found front on a problem, the leaders should park it immediately and try to solve using the perspicacity. Of course, the perspicacity combine itself with good knowledge of object, and with who tactic to apply or who objective to place, so that it prompts the workers in the organism to function in the right direction of his achievement with enthusiasm and effectiveness. Furthermore, important role in the guidance of leadership for the realization of objectives play the faculty of choice of resources and their way of exploitation. The leadership should see each situation with criterion the available resources e.g. money, raw material, technology and, more important, the available human resources. Never it should not it forgets that the more precious resource they are the persons.
The effective leadership has always aimed at the successful outcome of any effort. Three ingredients are required to have the leadership to reach success in NHS: a) vision to inspire all employees, b) ability to develop various skills, such as executives who each have different talents and c) dedication to the success of this objective and pass it around the body. Which effort would do and what time will do is very important for a successful outcome. The choice of timing for taking the appropriate action is very important because the wrong action at wrong time is sure to lead to negative results, the right move at the wrong time will bring resistance to the wrong move at the right time is wrong and only right move at the right time leads to success. Effective leaders give positive reinforcement and they should be admit when they are wrong. It makes people feel comfortable asking them for help and advice.
The leadership eventually to be able to achieve its objectives, must maximize every resource available to the benefit of the organization. Especially, in the NHS should be combined in an optimal way all the available resources where there are, especially human resources (doctors, nurses, administrators, technicians). Because the sector of health is more complex and the NHS “aim is to promote the establishment of a comprehensive health services designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention diagnosis and treatment of illness” (The New Politics of the NHS, Rudolf Klein 2006), this will require leaders and managers to develop new skills and innovate practices. Leaders must have the right tools to make decisions and to provide the best solution for their organism.
Finally, leaders in the NHS have to be both accountable and transparent in their decision-making for sure, but they also need to be open to the other people’s point of view, to be visionary and capable of communicating that vision and motivating others to achieve their best for the benefit of patient care. Also require the ability to empower other healthcare personnel. The competence and creativity of managers and leaders at all levels in health care will be fundamental to the effective implementation of the health strategy. Being a healthcare leader today means being faced with daunting challenges, including complex organizational structures, unfamiliar operational and strategic issues, rapid change, and lack of time. Overcoming these obstacles requires new leadership competencies and a renewed attention to traditional competencies. These competencies are rooted in leadership values that give you focus in turbulent times, that help you deal with stress and that help you align others during organizational change.
Apart from the effective leadership that is the most important elements that are required in the NHS, it also required planning and organization. In order to exists effective leadership will be supposed exist right organization and planning, because the organization is the process that in each worker is given some concrete work and the planning fixes what should become for this. The combination of this three elements with a creative and charismatic leader can compose in the NHS the essential elements for its success. Demands for healthcare are unpredictable, especially in the 4 NHSs in the United Kingdom because they exist in different geographically – distant locations, with different culture and different needs of people.
This paper has explored the leadership in the healthcare field and has the aim of providing an easy way for effective leadership in it, and related research flowing from the key findings of the independent inquiry in Carmarthenshire, with the aim of providing a practical way forward for healthcare leaders pursuing system change. Strengthening organisational leadership and capacity for inter-organisational collaboration requires a combination of long-term investments in building relationships and trust, and in developing a culture in which senior leaders are role models of cooperation. Although it has not been possible to cover all issues in depth, hopefully the paper provides practical ideas for healthcare leaders in developing their leadership style, executive teams, interpersonal relationships, and inter-organisational relationships and collaboration. Thus, for example, some researchers have focused on studying who leaders are and on what leaders do, specifically, through the identification of those personal attributes which differentiate those individuals who are perceived as leaders, or who act in the role of leader. Conversely, others have focused more on what leaders do, and how they do it. Thus, more recent research has focused attention on the relationship between leaders and followers, which has come to be seen as the study of leadership behaviour, rather than just leader behaviour. In parallel, some writers have stressed the need to study followership, not only because all leaders are also followers, but also because modern notions of leadership place considerable emphasis on the power and importance of followers in ultimately enabling leadership to have greatest effect (e.g., Hollander, 1978; Lee, 1993).
- connectedness with stakeholders, internal and external to the organisation, the development of leadership in others by empowerment and encouraging the questioning of approaches to one’s job and the way in which service is delivered
- Medical practices and hospitals spend great sums of money building and renovating facilities and purchasing new equipment, but relatively little time or effort developing a better ubderstanding of the people who work in them.
- Healthcare leaders need to undersyand the nature of healthcare organizations and the work they do (to improve organizational performance we need to understand human performance
- People with a high level of need for achievement tend to prefer situations in which we can take personal responsibility for solving problems.
- we have little understanding of how and why some persons are more effective leaders than others.
The truth is that anyone can be an effective leader. They just need to find the right balance between social, moral and business aspects of leadership. An effective leader is generally someone that leads by example and other people just tend to follow because they believe what they do is the right thing. Think of anyone you have looked up to in the past, were they an honest individual that put others before themselves? That is a quality of effective leadership. Being honest gives a person credibility and result in other people trusting and believing in that person.
Effective leaders lead by example and merely invite others to come along with them. Keeping promises is another sign of effective leadership. They believe in others and never fail to reward or compliment someone when they see they are doing well.. Effective leaders admit when they are wrong and admit when they make mistakes. Everyone is human and makes a mistake at one time or another. It’s how a person handles a mistake that gives them a certain leadership quality
Good listening skills are a big part of effective leadership. A person who is willing to listen to problems or concerns an employee or a friend may have will give them more information. Therefore, the effective leader can make a well-informed and thought out decision. . Effective leadership is about asking or requesting a person to do something, not commanding them. Effect leaders make recommendations to follow. Effective leaders are willing to get their hands dirty. They realize that they are more than just a figure head or a boss.
Most of the quality workshops will focus on certain aspects of leadership training. Strong language skills and effective words to express effective leadership are inherent to the programs and they are great ways to deal with staff communication.
In conclusion leadership has a high correlation with all elements of the organizational learning system and it is a means to leverage knowledge through organizational learning.
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