International Practice Development Journal


Title of ArticleLeading the health service into the future: transforming the NHS through transforming ourselves
Type of ArticleOriginal Practice Development and Research
Author/sMansoor Akhtar, James Norbert Casha, Julia Ronder, Mohamed Sakel, Catherine Wight and Kim Manley
ReferenceVolume 6, Issue 2, Article 5
Date of PublicationNovember 2016
Keywordsclinical leadership, collective leadership, critical companionship, micro-systems, transformational leadership, workplace culture

Background: Leadership development impacts on quality of care and on workplace cultures for staff. Clinical leadership embracing transformational and other collective leadership approaches is a key enabler for developing effective workplace cultures at the micro-systems level. Following the development of a shared purpose and values framework, an internal interprofessional clinical leadership programme was set up to grow a critical community of transformational leaders across one NHS organisation in England. This programme had been unsuccessful in engaging medical doctors for more than two years.

Aims and objectives: This paper shares how a dedicated, practice development-based clinical leadership programme set out to support medical doctors across one organisation with their leadership journey, equipping them to become transformational and collective leaders, and facilitators with the skills to develop and sustain person-centred, safe and effective workplace cultures.

Methods: Practice development methodology, with its collaborative, inclusive and participative approach to developing person-centred cultures, combined with clinical leadership strategies, formed the basis of the programme. It emphasised the use of active and action learning, drawing on the workplace as the main resource for learning, development and improvement. Self-assessment and collective thinking about clinical leadership, together with collaborative analysis of evaluation data, led to the synthesis of insights through the use of reflection and action planning.

Findings: These are presented at two levels:

  • Five individual reflections by authors to illustrate their leadership journeys, which also demonstrate the use of a range of tools and their impact. Insights and learning include recognition of the benefits of peer support and networking, development of a disciplined approach to learning, and self-management
  • A collaborative reflection and critique that embraced a sense of team ethos and community cohesion, for the first time in a safe environment, as well as a sense of shared purpose and values.

Conclusions: The programme helped to identify the impact of leadership on workplace cultures and to begin to embed ways of working that are collaborative, inclusive, participative and celebratory. This unique approach by one organisation to leadership development has enabled medical clinical leaders to embark on a journey of self-transformation.

Implications for practice:

  • An internal model grows clinical leadership capacity across an organisation through peer support and networking, and collective leadership
  • Investing in a safe, confidential space for clinical leads and other staff groups is a potentially effective strategy for leadership development practice
  • There is need to develop more skilled critical companions to support leadership, improvement and development activities
  • Clinical leadership development, informed by practice development methodology, demonstrates the potential to enable transformative and collective leadership to promote person-centred cultures in the workplace

See also Novice to transformational leader – a personal critical reflection by Kenneth Adedeji Adetokunbo Adegoke (IPDJ Vol. 7. No. 1). This article is a personal reflection by one of the participants on the pragramme.

This article by Mansoor Akhtar, James Norbert Casha, Julia Ronder, Mohamed Sakel, Catherine Wight and Kim Manley is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.

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