Engaging with staff

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 3 October 2008




(2008), "Engaging with staff", Leadership in Health Services, Vol. 21 No. 4. https://doi.org/10.1108/lhs.2008.21121dab.003



Emerald Group Publishing Limited

Copyright © 2008, Emerald Group Publishing Limited

Engaging with staff

Article Type: News and views From: Leadership in Health Services, Volume 21, Issue 4

Keywords: Performance improvement, Effective leadership practice, Organisational culture

Engaging with staff is the surest way for leaders to raise productivity, says Beverly Alimo-Metcalfe, Professor of leadership at Bradford University. “Engaging leaders are accessible, approachable, personable. They take time to talk to people. They inspire others and infect them with their enthusiasm.”

When staff are already working under pressure, what can you do to encourage extra effort and commitment of the kind that will have a noticeable impact on the organisation’s productivity? With NHS spending increases over the next three years budgeted at much lower levels than the service has grown used to over the last five years, maximising productivity will be an increasingly important marker of success. New research, with implications for all kinds of organisations but carried out in the NHS itself, has unearthed compelling evidence about how leaders can enhance the performance of their staff.

It found that the aspect of leadership to have the most significant impact on staff was not the leader’s capabilities or their vision for the organisation but the extent to which they engaged with the people they led. “People at all levels get really excited about this model of leadership,” says Professor Alimo-Metcalfe, professor of leadership at Bradford University and chief executive of the consultancy Real World Group, which carried out the following research. “You can switch them on with this. They find it instantly appealing.”

The research was carried out over three years with 46 mental health crisis resolution teams and 763 of their team members. Data from them led the researchers to identify three aspects of leadership culture: leadership capabilities, visionary leadership and engaging with others.

Among the 14 leadership capabilities were using strategy to achieve objectives, ensuring clarity of roles and success criteria, commitment to high standards of service and quality outcomes, and having well-designed procedures and systems to use resources effectively.

Visionary leadership included having a clear idea of what the team was aiming for, being sensitive to stakeholders and inspiring them with the team’s passion and determination.

Engaging with others comprised items such as concern for the needs of staff, trusting them to make decisions, listening to others’ ideas and being willing to act on them, finding time to discuss problems whatever other pressures existed, supporting staff by coaching and mentoring, inspiring all staff to contribute fully to the team and actively promoting its achievements.

Researchers examined how these three aspects of leadership culture affected staff’s attitudes to work and their sense of wellbeing while there. “Attitudes” encompassed their levels of job satisfaction and motivation to achieve, as well as their sense of job commitment and their commitment to the organisation. Wellbeing at work included their sense of fulfilment, levels of self-esteem, self-confidence, job-related stress and job-related emotional exhaustion, as well as their sense of team spirit and the team’s effectiveness.

All three aspects of leadership culture significantly affected several elements of staff’s attitudes to work and their wellbeing. The extent to which team members saw their leadership as competent affected motivation, job satisfaction and a sense of the team’s effectiveness, although not other aspects of commitment and wellbeing. Visionary leadership had a positive effect on motivation and most aspects of wellbeing, including a sense of fulfilment. It also helped reduce stress and exhaustion.

But only leaders’ engagement with others had an impact on every element of motivation and wellbeing. What is more, when the researchers analysed the teams’ performance, leadership capabilities were shown not to have had a significant effect – but the teams with the highest productivity were shown beyond doubt to be those whose leaders engaged most with others. This remained the case even when local circumstances were taken into account.

Several characteristics distinguished leaders who had developed an engaging style. They formed strong relationships with stakeholders from the outset in order to shape the nature of their service and lay the foundations for the continuing co-operation necessary for its success. They enabled team members to play a part in deciding the vision of how the team should work and its operational policies: this gave them a sense of owning their work and of belonging to something they valued. Regular meetings and informal communication such as office banter sustained the vision.

Devolved leadership encouraged people to take the lead when appropriate, although every team had an appointed leader. Team members felt comfortable seeking advice and sharing work-related problems as they could draw on both informal support from colleagues and the team leader, as well as the formal support of regular individual and group supervision. This created a culture of joint problem-solving, which allowed team members to take the risks necessary to be innovative. Leaders consulted members on impending changes and took their responses into consideration. As a result, the team responded collectively to top-down change and formulated a joint action plan for tackling it.

“Most important is showing a genuine concern for others – their aspirations, how it feels being them in the organisation, coaching them, seeing their strengths, seeing the world through their eyes,” says Professor Alimo-Metcalfe. “Engaging leaders are accessible, approachable, personable. They take time to talk to people. They inspire others and infect them with their enthusiasm.

“They question traditional ways of doing the job and encourage people to be curious. They set firm boundaries, they are clear about targets and timeframes, but within them they give empowerment and involve staff as much as possible in implementing change. They are decisive and unafraid to take risks. They recognise that mistakes are inevitable if you are trying to be innovative and entrepreneurial. That destroys the culture of blame we have in the NHS.

“They accept that different team members, partners or stakeholders will have a different agenda or professional background or constituents, but encourage them to be open enough about their differences to build a shared vision. They make connections between different ideas and bring in best practice from outside.”

Professor Alimo-Metcalfe says the study is one of the first to provide evidence of a cause-and-effect relationship between leadership behaviour and organisational performance. The findings clearly have important implications for how the NHS selects and develops its leaders: it needs to foster a culture of engagement. “It’s not just about their qualifications, but how they relate to their team and their colleagues. The study also has implications for appraisal decisions.”

But for engagement to be sustained, Professor Alimo-Metcalf says, it has to be embedded in the organisation, starting with the chief executive and the top team but not resting merely with formal leaders. “But I don’t think it’s a big deal.” She cites the example of a local authority that her organisation worked with to help change its leadership culture. Within 18 months it had received a national award for services previously judged unsatisfactory, and it became the first public sector organisation to appear in the top 20 of the Sunday Times list of best companies to work for.

She does not believe that introducing a culture of engagement into the NHS would take “a lot of work”. It is, she says, “almost about giving people permission. There is an absolute need for targets, boundaries and clarity. And you can’t escape the reality of limited resources. But we have choices about how we achieve those targets. Engagement is about brainstorming within the team about how to do it.”

For more information: www.executive.modern.nhs.uk

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