Conflicting demands have robbed top NHS jobs of their lustre. HSJ gathered experts to debate how the NHS can get the right leaders and enhance their capabilities. Alison Moore (HSJ) reports.
In the midst of the NHS’s everyday turmoil, it is easy to overlook questions about its future. Buf one of the most crucial is what sort of leaders are needed and how can they be identified, developed and given what they need to improve the entire system.
That was the theme of the first of two roundtables linked to the HSJ100 list of the most influential people in healthcare. It involved a number of those on the list, as well as outside experts and others working in the NHS.
“One of the challenges for leaders is that we operate in the context we are given and how is leadership is rewarded and, sometimes, penalised.”Independent consultant Mike Farrar (who chaired the event)
Sir Robert Naylor – Chief Executive of University College London Hospitals Foundation Trust and the chair of HSJ’s independent commission on leadership – said there were three characteristics of leaders: they needed intelligence, experience and – most importantly – emotional intelligence.
“These are the kind of skills that need to be developed to take on the much more collaborative integrated environment we will find ourselves within in the future,” he added.
Angela Hillery, chief executive of Northamptonshire Healthcare FT, highlighted resilience as a very important characteristic for leaders.
Amanda Doyle, co-chair of NHS Commissioners and chief clinical officer of Blackpool Clinical Commissioning Group, said it was pointless putting effort into recruiting people and then losing them. “We treat people appallingly once we have them,” she said. “We don’t develop them to have the emotional resilience.”
But the system often does not encourage clinical leaders to come through, said Jonathan Fielden, a medical director of University College London Hospitals FT. Leadership is often hard work and needs to be worthwhile, both in terms of recognition and financial reward.
“People will not take the knocks unless they are treated reasonably,” he added. But do leaders have to accept the hand they are dealt or should they do more to change it? Peter Lees, chief executive and medical director of the Faculty of Medical Leadership and Management, said leadership involved changing the context they were working in, but many round the table highlighted the restraints on their freedom of action.
Jeremy Taylor, chief executive of National Voices, added: “The job of leadership is to change the context, not to live with it. But there are aspects of the context which are outside the control of NHS leaders.
“If you look at where the responsibility in organisations to care about patients is, it is often nursing… Doctors get let off the hook. There’s something about leadership being a shared experience.”