What is happening to leadership in health care?

Abstract

Purpose

The purpose of this paper is to re-examine the challenges facing leaders in health care, to explore the impact of these on the choices available to healthcare leaders, and to re-visit the nature of leadership in general. It identifies a distinction between care that is a set of auditable transactions and care that is also a covenant, and suggests that leadership too can be practised in these distinctively different ways. It draws on a three year learning set of senior practitioners in the NHS in England.

Design/methodology/approach

This paper draws on the authors own observations over 25 years of educating and developing clinical leaders, and also on the insights of a learning set of senior NHS practitioners over a three period.

Findings

The paper provides empirical insights about how both health care and leadership have changed over the last 30 years, and proposes that treating either of them as a set of auditable transactions in a market place results in dissatisfied leaders as well as practitioners, and that a covenant of both care and leadership needs to be understood and established.

Research limitations/implications

Observations have been limited to the NHS in the UK although there are indications that the issues are of wider applicability.

Practical implications

The paper includes implications for the behaviours of those leading health care organisations, those being led, and those influencing the context.

Originality/value

This paper challenges prevailing definitions of leadership and prevailing explanations for difficulties in health care organisations.

Citation

Iles, V. (2013), "What is happening to leadership in health care?", International Journal of Leadership in Public Services, Vol. 9 No. 3/4, pp. 82-89. https://doi.org/10.1108/IJLPS-10-2013-0024