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Leadership conversations: the impact on patient environments

Rachel Macdonald (Facilities Management Graduate Centre, Sheffield Hallam University, Sheffield, UK)
Ilfryn Price (Facilities Management Graduate Centre, Sheffield Hallam University, Sheffield, UK)
Phil Askham (Facilities Management Graduate Centre, Sheffield Hallam University, Sheffield, UK)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 1 May 2009




The aim of this study is to examine 15 NHS acute trusts in England that achieved high scores at all their hospitals in the first four national Patient Environment audits. No common external explanations were discernible. This paper seeks to examine whether the facilities managers responsible for the Patient Environment displayed a consistent leadership style.


Overall, six of the 15 trusts gave permission for the research to take place and a series of unstructured interviews and observations were arranged with 22 facilities managers in these trusts. Responses were transcribed and categorised through multiple iteration.


The research found common leadership and managerial behaviours, many of which could be identified from other literature. The research also identified managers deliberately devoting energy and time to creating networks of conversations. This creation of networks through managing conversation is behaviour less evident in mainstream leadership literature or in the current Department of Health and NHS leadership models.

Practical implications

The findings of this study offer managers (particularly those in FM and managers across NHS) a unique insight into the potential impact of leaders giving an opportunity to re‐model thinking on management and leadership and the related managerial development opportunities. It provides the leverage to move facilities management from the role of a commodity or support service, to a position as a true enabler of business.


Original research is presented in a previosuly under‐examined area. The paper illuminates how facilities management within trusts achieving high Patient Environment Action Team (PEAT) scores is led.



Macdonald, R., Price, I. and Askham, P. (2009), "Leadership conversations: the impact on patient environments", Leadership in Health Services, Vol. 22 No. 2, pp. 140-160.



Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited

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