Why choose to be a leader? - Healthcare

Improving care
Above all else, healthcare professionals should be focusing on the quality and safety of the treatment and care provided to their patients. Leaders can improve care well beyond their personal control but many do not choose to become leaders, they simply become leaders.
As a newly qualified healthcare professional you might see a better way for things to be organised in your workplace. Or you might want to introduce innovative practice to an established system – such as a service improvement idea, as discussed in the next chapter of this book. You will certainly be expected to work with others to deliver high quality, safe, professional care to patients. And you may see something about the way that the team works which could be improved.
The skills and behaviours needed to bring a team together and to change things are those which leaders use. In order to practice your professional skills to their fullest extent, you will need to develop your ability to lead. Good leaders are skilled in influencing thought, direction, policy and actions.

Influencing change
You may wish to share your research or clinical vision, or opinions and experience with others in order to promote your ideas more widely. Once again, the key leadership skills of building rapport, communicating a vision clearly and encouraging others are all essential to the spread of new ideas, techniques or behaviours. If you want to make a difference well beyond your own sphere of control you will need to influence others and shine a light for them to follow.

Reward and recognition
Reward and recognition in health care is usually related to your overall contribution to achieving the aims and objectives of your employer. This contribution can be affected by qualification, grade, level of specialism, level of professional responsibility, responsibility for resources and leadership. As you progress throughout your career you will often be given the opportunity to acquire additional responsibilities and be rewarded accordingly. The extent to which you exercise your leadership skills will, therefore, influence your career progression, earnings and recognition amongst your peers.

Because you have something to give
The modern healthcare sector is no longer a place where leadership is unquestionably hierarchical and inherent to a position. Leading today is personal, emotional, organic and fluid. It is not about power or status but about conviction, values and ethical behaviour. Today, a good medical/surgical team will no long unquestioningly follow the lead consultant; it will question, challenge, contribute to decisions, review progress and develop as a team of equals. Your role as a newly qualified healthcare professional will be to share what you know, to learn more and to be a full and active member of your team. And if the occasion arises when you are called upon to lead in the interests of patient care and safety, you should feel ready to do so.

Leadership and management
Most organisations need to establish a system of responsibility and accountability in order to be clear about the relationship between an individual or a team’s role and the aims of the organisation as a whole. They define who is responsible for what. So we talk about people being responsible for managing budgets, managing people, managing equipment and managing tasks, and so on. Managers may be responsible and accountable for their area of control but they are not necessarily and automatically leaders. Some of the key differences in leadership and management are expressed by Northouse (2012), implying that leadership produces change and movement whereas management produces order and consistency. There are a number of examples of behaviours that would be consistent with leadership, such as establishing direction, as compared to management behaviour, such a planning and budgeting. In real life there are few roles where people will not be called upon to exercise skills from both of these paradigms. Managers will have explicit leadership roles and good ones will display behaviours that empower and enthuse people. They will also have to account for expenditure, carry out performance appraisals and react quickly to situations as they arise. Whilst leadership commentators like to play up the differences in approach, the reality is not so clearly defined. Leaders are expected to manage well and managers to lead.
Critically, for the newly qualified healthcare professional, there is not really an ‘either/or’ option with regard to management and leadership. As you increase your professional skills, you will be expected to take on greater management responsibilities. And as your management role expands you will be seen as a leader by others. It is important, therefore, to accept the need to develop the skills and behaviours of leaders and managers as integral to your continuous professional development throughout your career.

Leadership and culture
Organisational culture has a significant impact upon the success of the enterprise in achieving its goals. In NHS healthcare settings there appears to be a correlation between the culture, as expressed by staff satisfaction, and mortality. The research carried out by Michael West (2014) has suggested that leadership is the most important influence on culture:
‘Every interaction by every leader in health care shapes the culture of their organisations. The best leaders promote partnership and participation and involvement as their core strategy; promote appropriate staff autonomy and accountability for improvement; ensure staff voices are encouraged encourage staff to be proactive and innovative…’
Good leaders West suggests ‘…avoid command and control except in crisis; take action to address system problems and unnecessary tasks that prevent staff from delivering high quality care’.
Above all, he continues, good leaders ‘model compassion in dealing with patients and staff’.
In summary, it is a key task of all leaders to ensure that the culture of the organisation is supportive of the aims of that organisation. If it is not, it is their responsibility to challenge it and change it.

What is your approach to leading?
The following are all examples of effective leadership:
Leading others to achieve goals.
Leading thinking by sharing ideas.
Sharing knowledge.
Leading by example to establish standards.
Commanding and controlling resource and task allocation.
Lighting the way for others.
Purposefully building collaborations, coalitions and networks to achieve an agreed, shared aim.
Behaving in a way which aligns your actions with the values you espouse.
All have an appropriate place in every healthcare setting, every time an interaction takes place. The job of the healthcare worker is to adjust their approach to the setting and the occasion. In an emergency, you may need to take command of the situation and direct others. As a professional you may be asked to provide authoritative advice that will guide others’ actions. As a mentor of others, you may be asked to guide self-reflection and self-development.Time for reflection
Think now about your experiences of leadership in others and yourself:
Who do you admire as a leader? Why?
Is anybody you know a natural leader?
What elements of what they do would you like to emulate?
What model of leadership do you feel most comfortable with?