Clinical Leadership And The United Kingdom National Health Service

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Clinical leadership is a concept growing in usage. Word frequency in the English lexicon shows the term increasing in the last two decades, despite its composite words remaining static over the same period (Graphs 1 and 2).

Graph 1: Word frequency in the British Lexicon of “leadership” and “clinical” (Google 2015)

Graph 2: Word frequency in the British Lexicon of “clinical leadership” (Google 2015)

Clinical leadership as a term grew out of opposition to New Public Management (Hood 1991) and the corporatisation of health services in the 1970s to 1990s. The recent focus on catastrophic medical errors in the United Kingdom National Health Service (NHS), in particular at the Mid Staffordshire trust, has resulted in
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Organisations are doing more to foster it, with some success, but barriers remain. Background
Leadership is often juxtaposed against management. In classical business teaching, Kotter (2001, reprint p4) defines the difference: ‘Management is about coping with complexity. Leadership (by contrast) is about coping with change.’ Leadership is more commonly distributed across all organisational levels, and leaders are seen as those who empower others to significantly improve organisation performance. Managers are those involved in performance monitoring, target setting, and most importantly with the operational oversight of employees. They organise resources and maintain stability. This is a large field, but for current purposes we accept that, though there is overlap, Kotter’s definition serves to highlight a valid distinction.

Leadership as a term has differing meanings through time. The influence of ‘Great Man’ theories stem form the socio-politico models prevalent in much of the first half of the twentieth century. However, personality traits map poorly to successful leaders, and this theory has waned. Post-war good leadership was thought to be based more around behaviours. It was out of this that models for behaviour arose, including Adair’s (1973) three circles model (task, team and individual). Truly good leadership will undoubtedly involve a mixture of nature (or traits) and nurture (behaviours). Current theory is
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