Leadership in Health and Social Care: An Introduction for Emerging Leaders

by Louise Jones, Clare L. Bennett

Overview

From reviews:

"I found this book to be an excellent read... My favourite part is at the end of each chapter where the authors very kindly give a chapter summary. I would say this, with learning outcomes for each chapter, is the reader’s ‘pot of gold’ – and an excellent resource for students.
The social and political stance of this text is sensitively weaved throughout, encouraging the wider thought processes of the reader. Images and illustrations provide a welcome and useful change to the traditional academic text, and I would recommend the book as an important reference resource for those starting on their leadership journey, or for those wanting to update. A well-informed, easy read that I will be recommending to our students to support their studies."

The Biomedical Scientist, 2013: 70 (4)

"This is an excellent book for anyone who is starting to take an interest in Leadership within their health or social care role...  Overall, the book is clearly aimed at practitioners and should be a ‘must-read’ for those who wish to understand more about practical leadership and who aspire to more senior positions within their field of practice."

Lecturer, Staffordshire University Faculty of Health Sciences

Leadership in Health and Social Care is an accessible text for students and practitioners seeking to develop their leadership skills.

"I commend this book to you as a ‘way in’ to the leadership world for anyone working in health and social care. It treats you like an adult and expects you to take responsibility for your own leadership development.

We now know that good leadership has a direct relationship with good services and we can certainly no longer afford mediocrity. We need leaders to enable the disruptive innovation that will be required to improve the quality of care with less resource to do so."

From the Foreword by Karen Middleton, Chief Health Professions Officer for England.

Key features:

·         Introduces the concept of leadership and its importance in health and social care.

·         Discusses the skills and qualities that make for effective leadership.

·         Analyses the role of the leader as a catalyst for change.

·         Helps readers to explore their own perceptions of leadership through activities and scenarios.

Product Details

ISBN-13:	9781908625038
Publisher:	Lantern Publishing
Publication date:	09/01/2012
Sold by:	Barnes & Noble
Format:	eBook
Pages:	152
File size:	2 MB

Read an Excerpt

Leadership in Health and Social Care

An Introduction for Emerging Leaders

---

By Louise Jones, Clare L Bennett

Lantern Publishing Limited

Copyright © 2012 Louise Jones and Clare L. Bennett
All rights reserved.
ISBN: 978-1-908625-03-8

---

CHAPTER 1

What do we mean by leadership?

LEARNING OUTCOMES:

When you have completed this chapter you should be able to:

1.1 Describe what is meant by the term 'leadership'

1.2 Discuss the importance of leadership in the world of health and social care today

1.3 Recognise the different forms that leadership can take

1.4 Identify what makes a positive leadership experience.

WHAT DOES THE TERM 'LEADERSHIP' MEAN TO YOU?

The fact that you are reading this book suggests that you are interested in leadership and want to know more about being a leader. You may be a student who is about to qualify or be early in your career in health and social care but whatever the reason, this book will help you understand some of the key concepts and knowledge that will help you unleash your potential for leadership.

You may already be a leader, perhaps as captain of a sports team or youth club leader, or you may be a course representative at university or teach a class at your local sports centre. You may have taken on the role of organising a social event at work or leading a Continuing Professional Development (CPD) session as part of staff development. In any of these situations you will have enabled people to move forward together towards the same goal, not because you are forcing them to do so but because they want to. That is leadership.

Leadership skills are like any other skills; they need to be practised and refined in order to develop. Experience will shape not only the leadership skills themselves but the ways in which you use them. It will also allow you to recognise opportunities where you can take on a leadership role.

SO WHAT IS LEADERSHIP?

There are many different ways in which leadership can be, and has been, defined. What is widely recognised, however, in the simplest terms, is that in order to be a leader you have to have followers.

Rost and Barker (2000) provide us with a definition which includes influence, intention, responsibility and change, as well as the creation of a shared purpose: 'Leadership is an influence relationship among leaders and followers who intend real changes and outcomes that reflect their shared purpose'. This definition fits well with leadership in health and social care environments today.

It is a common misconception that leaders are primarily in the top layers of an organisation; leaders can exist at all levels within organisations and society. In addition, leadership is not confined just to people working in identified leadership positions. Anyone can take the lead at some point. Jones and Jenkins (2006) identify that leadership can relate to small actions that impact on just those closest to them or much larger actions that impact on a wide range of people across, or even beyond, an organisation.

You may well have been surprised by the number of opportunities you identified in Activity 1.3, particularly by including your personal life as well as your work life. It is important to remember that many leadership skills are transferable between these two contexts.

Every experience of leadership can be different because it depends on the context as well as the skills of the person in the leadership role. However, it is very valuable for you to reflect on what makes a positive or negative experience, as this can influence how you utilise and develop your own leadership skills to ensure you are effective as a leader.

From the number of texts and articles available it is evident that leadership continues to be a source of interest to many people and it is still evolving as a discipline.

WHY IS LEADERSHIP SO IMPORTANT IN HEALTH AND SOCIAL CARE TODAY?

Health and social care has always experienced change over the years; however, the pace of change and increasing complexity of the services being delivered mean that effective leadership is more important than ever. With globalisation, society has much more social, cultural and racial diversity today and there is an increasingly ageing population who require more intervention, because long-term conditions often have more complications (Freshwater et al., 2009).

Technology is becoming more advanced and affordable, and care is shifting away from institutional settings to care closer to home – for example the increasing use of telemedicine to avoid travelling to hospital. In addition, the size, shape and number of organisations involved in delivering care in the public, private and voluntary sectors has increased, such as the emergence of social enterprises and more condition-specific charities.

As a result of these changes, the approaches to care are evolving and an increasing number of different roles and functions have emerged in health and social care, such as assistant practitioner, family case worker or extended scope practitioner. This has also meant the approach to leadership has had to change, because there is a need for more leaders at all levels in order to ensure that patients and clients receive the best possible care. Instead of the strict hierarchy of previous decades, the current health and care services are less about the position or authority of an individual within an organisation and more about a leadership approach which enables effective change and enables staff to think and behave differently to bring about improvements for service users and carers. The current challenge within health and care services is to enable each individual member of staff to be actively engaged in recognising when and where they can make a leadership contribution (Jones & Jenkins, 2006).

Chapter 7 broadly considers the context in which you are, or will be, working; an understanding of which is important in order to lead effectively. It outlines the current macrostructure and functions of the National Health Service (NHS) and care services and explores how changes in government policies and the financial environment have led to new roles and ways of working within the NHS and local authorities. However, different systems and processes are in place in the four regions which make up the United Kingdom due to the devolution process, and a brief explanation of these is included. It is important to note, however, that the focus of control is moving away from the people who work in health and social care organisations to the service users who benefit from their services. For example, the Secretary of State for Health explicitly stated in 2011 that there would be 'no decision about me, without me' and this philosophy underpinned the government White Paper, Equity and Excellence: Liberating the NHS (Department of Health, 2010a), which proposed wide-ranging changes for both health and social care in England.

Another important factor to recognise when taking on the lead in health and social care is the increasing expectations that the public have of the health and care services. Access to the plethora of information available through the internet, including the NHS Choices website, means that people are now more informed than ever before. Service users and their carers also now expect to be treated as customers in the same way they would if they were buying a product or service in a shop or online.

The increasing awareness of the public in respect of health and social care issues suggests an increasing interest in their own health and wellbeing, which is really positive. However, it also creates additional challenges to those undertaking a leadership role as it changes the context in which you are working beyond the traditional boundaries of care.

INFORMAL AND FORMAL LEADERSHIP

Leadership can take many different forms, as will be discussed as you progress through this book. However, it is important to recognise that it can be both informal and formal, and that there are many different leadership styles. These will be explored in detail in Chapter 2.

Formal leadership usually occurs in relation to a job role or position within an organisation. It may be that you are a designated team leader or key worker. These people are leaders because they are in a leadership position rather than because they necessarily have excellent leadership skills. Informal leadership tends to happen on an ad hoc basis; it may be short term, limited to the duration of a project or a particular client's care, or longer term. An example of this would be where your work colleagues turn to you and place you in a leadership role in a particular context because of your personal skills and attributes relevant to that context.

In this scenario, June takes on a leadership role because of the situation but also because of her level of expertise in this particular context. She is approachable and enjoys her work, which is demonstrated in the way she interacts with her patients and colleagues, and they admire her for this. However, it is an informal role rather than a positional role which is accepted by ward staff, as she is well liked and respected by her line manager and senior staff within the multidisciplinary team who recognise her skills and expertise within this area of work.

Team leadership can be both formal and informal. In many circumstances the team leader is decided upon by a line manager; however, there is an increasing use of informal groups within the health and social care sector. In these situations, when you undertake a leadership role may be less clear. Sometimes there can be consensus within the group as to who should be the leader, occurring either with or without a nomination process, and on other occasions it can be left for a leader to emerge. This form of leadership is becoming more prevalent due to the increased emphasis upon teamwork in organisations and an increasingly educated population who have their own expectations and desire to influence outcomes. An additional factor is the complexity of society where the nature of the issues to be addressed often requires a range of problem-solving skills that are seldom found in a single person (Chambers et al., 2007).

Another, more informal form of leadership is becoming more apparent within health and social care. This is distributed leadership, which was originally developed within the education sector. It is seen as being the product of an interactive group or network of individuals rather than the act of a single person and it opens up the boundaries of leadership to those who would previously have been excluded from leadership activities. The underpinning principle for distributed leadership is the spreading of expertise across an organisation rather than it being concentrated on just a few people. This fits well with the concept of informal leadership mentioned above and with the comments made by Lord Darzi, about unlocking talent, in the final report of the NHS Next Stage Review, High Quality Care for All (Department of Health, 2008); '"unlocking talent" involves tapping into the leadership skills and potential of all frontline staff to deliver high quality, safe and effective care to patients and service users'. This fits well with the key idea that good leadership can and should exist at all levels within an organisation, and why your emergence as a leader is so valuable.

LEADERSHIP OR MANAGEMENT?

It is important to understand how leadership differs from management, since the two concepts are often confused and misunderstood (Martin et al., 2010). It should be noted, however, that leadership and management often coexist in a single person, although in different ratios; leaders often need managerial skills and managers may require leadership skills. Jones and Jenkins (2006) identify leadership in action as normally being non-routine, ranging from small actions which are only noticeable to those involved in them, to significant actions which affect a much larger number of people. The differences between leadership and management are more fully explored in Chapter 2, which will enable you to recognise when you or your colleagues are engaging in management or leadership activities and respond appropriately. However, Schoemaker and Russo (1993) propose the comparison shown in Table 1.1.

Schoemaker and Russo use decision-making to draw the comparison; however, their work can also be seen to directly relate to the different roles of leadership and management. You can see why, if both leadership and management roles coexist in the same individual, they may feel some internal conflict.

WHAT MAKES A GOOD LEADER?

Much work has been carried out in identifying what constitutes a 'good' leader. This is focused on in more detail in Chapter 3. However, a key characteristic that you are likely to have identified in Activity 1.7 is the behavior of the leader. This is expanded upon below.

The behaviour of a leader can have a significant impact on the way in which a team works. It can be reflected in how motivated they are, as well as in their attitudes and values. In any group, it is the leader who has the maximum potential to sway their colleagues' emotions (Goleman et al., 2009). However, it is the relationship between the leader and the team members which is the critical factor in achieving outcomes, so even when you are acting as a follower, rather than overtly taking the leadership role, you can have a positive influence on what happens. This reflects authentic leadership where the interpersonal processes between leaders and followers are pivotal. Eagly (2005) makes it clear that the relational nature of authentic leadership between leaders and followers does not rest on the efforts of the leader alone. It is a reciprocal process because leaders affect followers and vice versa.

Chambers et al. (2007) identify that a good leader is followed mainly because people trust and respect them. This trust and respect arise because of a number of qualities, amongst which are integrity, honesty, positivity, confidence and commitment. Good leaders develop a rapport with their team members by acting in four ways: they listen, they consult, they involve others and they explain why things need to be done as well as what needs to be done. Chambers et al. (2007) also argue that effective leaders are those who stick to the issues under discussion and try to minimise personal comments about individuals.

There are varying theories as to what characteristics, attributes or skills contribute to someone being considered a good leader. However, for many people the experience of being led is very personal. There are a few people whom the vast majority of observers would consider outstanding leaders, such as Martin Luther King, Jr. or Mother Teresa of Calcutta, but it is less easy within the NHS and social care in the UK to find leaders whom a whole organisation or region believes are excellent. This is because there are so many different facets to being a leader and many different perspectives from which leadership can be viewed. However, when you have reached the end of this book we hope that you will be able to identify clearly those things which contribute to successful and effective leadership and apply these to your own development.

QUESTIONS

Question 1.1

What do you understand so far by the term leadership? (Learning outcome 1.1)

Question 1.2

Why is leadership increasingly important in health and social care? (Learning outcome 1.2)

Question 1.3

What are the different forms that leadership can take? Illustrate your answer with examples from your own experience from, or outside of, work. (Learning outcome 1.3)

Question 1.4

What factors do you believe are important for good leadership? (Learning outcome 1.4)

CHAPTER 2

THEORIES OF LEADERSHIP

LEARNING OUTCOMES:

When you have completed this chapter you should be able to:

2.1 Outline the differences and commonalities between leadership and management

2.2 Give an overview of the history of leadership

2.3 Describe the most prominent theories of leadership

2.4 Compare the advantages and disadvantages of the different styles of leadership

2.5 Identify which leadership styles you need to develop in order to enhance your effectiveness as a leader.

INTRODUCTION

So far you have been thinking about what is meant by the term 'leadership' and the importance of leadership in health and social care today. You have also been considering the different forms leadership can take. You have related this to your own experiences of leadership and you have identified why some leadership encounters may be more positive than others. This chapter moves on to examine the key theories that underpin leadership today and will inform your analysis further. It starts by delineating leadership and management. It then goes on to consider the history of leadership and leadership theory. The various styles of leadership are then critically examined to help you to develop an awareness of the various leadership styles and how these can be applied to your daily work. The discussions and activities will help you to apply the theories to your personal and professional development as a leader.

ARE YOU A LEADER OR A MANAGER?

There is much confusion surrounding the distinction between leadership and management, with the two terms often being used interchangeably. In practice, many 'managers' will have leadership roles and many 'leaders' will have managerial responsibilities, which exacerbates the confusion. However, in order for practitioners to flourish in these respective roles, leadership and management need to be viewed as two distinct concepts (Stanley, 2006).

Your list of management activities will probably have been largely concerned with operational issues such as planning, resource management and problem solving, as these are roles that characterise managerial responsibilities. Managerial activities are essential to the smooth running of any organisation and the attainment of care standards and targets. They are not, therefore, secondary in importance to leadership roles, as is sometimes perceived (Iles, 2006).

(Continues...)

---

Excerpted from Leadership in Health and Social Care by Louise Jones, Clare L Bennett. Copyright © 2012 Louise Jones and Clare L. Bennett. Excerpted by permission of Lantern Publishing Limited.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

---

Table of Contents

1 What do we mean by leadership?
2 Theories of leadership
3 The skills and qualities of effective leaders
4 Leadership, values and culture
5 Leadership, power and influence
6 Leadership and change management
7 Leadership in health and social care
8 Leadership development – so where do you go from here?