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First published 2005 by Blackwell Publishing Ltd

Library of Congress Cataloging-in-Publication Data

Jasper, Melanie.

Effective healthcare leadership /Melanie Jasper and Mansour Jumaa.

p. ; cm.

Includes bibliographical references and index.

ISBN-13: 978-14051-2182-8 (pbk. : alk. paper)

ISBN-10: 1-4051-2182-3 (pbk. : alk. paper)

1. Health services administration–Great Britain. 2. Leadership–Great Britain.

[DNLM: 1. Health Services Administration–Great Britain. 2. Leadership–Great Britain. 3. Evidence-Based Medicine–organization & administration–Great Britain. 4. Models, Organizational–Great Britain. 5. Organizational Case Studies–Great Britain. W 84 FA1 J39e 2005] I. Jumaa, Mansour. II. Title.

RA971.J37 2005

362.1’068–dc22

2005005882

ISBN 10: 1-4051-2182-3

ISBN 13: 978-14051-2182-8

A catalogue record for this title is available from the British Library

The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry policy, and which has been manufactured from pulp processed using acid-free and elementary chlorine-free practices. Furthermore, the publisher ensures that the text paper and cover board used have met acceptable environmental accreditation standards.

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Donald H McGannon wrote that leadership is an action not a position. I agree with this statement wholeheartedly. The National Health Service (NHS) is changing rapidly, it is now as concerned with health promotion and well-being as it is with sickness and curing. It is becoming truly patient led and everything we do as professionals is increasingly being measured by the impact it has on patients.

Today’s NHS needs good leaders to ensure that services are delivered to a consistently high standard and are developed to meet the needs of individuals whilst not losing sight of the needs of the wider population. These leaders must be able to captivate, motivate and inspire their colleagues in order to respond effectively to the ever changing demands of healthcare.

This book explores the content and processes of leadership within today’s NHS. Rather than being another textbook about the theory of leadership, it looks in depth at existing practice in clinical settings across the health service and identifies the key ingredients for and features of successful leadership.

I was particularly interested in the chapter identifying service challenges and how management and leadership techniques are used to solve them. By focusing on how the nursing profession has developed leadership strategies to deliver on the government’s modernisation agenda, it is clear that nurses have been at the forefront of delivering many health reforms and policies.

Leadership is the art or process of influencing people so they willingly and enthusiastically move towards the achievement of a goal. The book rightly, in my view, concludes that strategic leaders are not superhuman with a clearer picture of the world than anyone else. Rather, they successfully create the right environments and understand their people to achieve successful out-comes.

Good leaders are aware of their strengths and weaknesses as well as those of others; they take responsibility for their actions and those of their teams; are able to set a clear direction of travel; use sound evidence to support decisions; keep their knowledge base current; and, through deploying all of these things, achieve and maintain the respect of colleagues across and beyond the organisation. Through the work they do on a daily basis and from the leadership they have shown in delivering on healthcare reforms, it is clear that many nurses already have a substantial range of these skills. For those looking to further develop their management skills and expertise, this book will be a valuable and inspirational resource be they nurses or other healthcare professionals.

Professor Chris Beasley CBE

Chief Nursing Officer

Department of Health

Dr Jo Alleyne, Principal Lecturer in Nursing and Healthcare Management, School of Health and Social Sciences, Middlesex University, London

Jo is the current Chartered Management Institute’s Programme Director for the Institute’s Approved Centre at Middlesex University. She devised and successfully applied a model of Group Clinical Supervision as part of her doctoral studies, through a co-operative inquiry approach, which used focused management and leadership interventions. She is an RCN and National Association for Teachers in Further and Higher Education (NATFHE) activist, a member of the RCN Education Forum and the negotiating secretary for the Middlesex University NATFHE branch. She is Chair of the Health Educators Forum. Jo combines her management and leadership knowledge and skills to support her teaching and research and to contribute towards effective negotiations in her trade union activities.

Dr Nadia Chambers, Consultant Nurse for Older People, Southampton University Hospitals NHS Trust

Nadia qualified in 1982 and gained extensive experience in medicine and care of older people. She has led both practice and service developments for older people, including influencing the development of a staff support system for victims of violence experienced at work, developing quality standards for care of the older person, developing the care of the older person in an acute medical assessment unit and developing a rapid access Transient Ischaemic Attack Service. In addition to this, her experience as a teacher in higher education has included innovative curriculum developments such as post-graduate studies in clinical governance and clinical leadership.

Christopher M.A.D. Gbolo, Charge Nurse, Mental Health, Barnet, Enfield and Haringey Health Care NHS Trust, London

Christopher is a charge nurse/team leader in the psychiatric intensive care unit in Barnet, Enfield and Haringey Health Care NHS Trust in north London. He trained as a psychiatric and general nurse in Ghana and migrated to the UK in 1999. He progressed in his nursing career and became a charge nurse by 2003. He studied at Middlesex University and obtained an advanced diploma in healthcare, ethics and law and an advanced diploma in health and social care management. He is currently studying to obtain a BSc Honours degree in nursing studies and a professional diploma at Middlesex University and Chartered Management Institute respectively.

Lindsey Hayes, Senior Fellow, Leadership for Primary Care, Royal College of Nursing Institute, London

Lindsey brings many years of knowledge, skills and experience as a community nurse, teacher and trainer to the world of leadership in primary care. Her passion for primary and public health developed when she was working as a health visitor in an inner city multicultural and ethnically diverse area. Then she chose to work with disadvantaged community groups, specialising in the homeless, a fairly unique health visiting role. Her interest in individual and group behaviours led her to undertake a period of ante-natal teaching and then go on to further education, where she managed and taught a large child care course in one of the most deprived inner London boroughs. Her passion for health and understanding of behaviour was further enhanced through counselling and more recently completing an MSc in health psychology. She is now Senior Fellow, Leadership for Primary Care at the Royal College of Nursing Institute in London.

Mark Hodder, Head of Organisational Development, Mid and West Wales (NHS Secondment from Centre for Health Leadership, Wales)

Mark is a training and development professional working to improve organisational and individual performance in NHS Wales through the implementation of the balanced scorecard approach to performance management. Mark gained his leadership experience as a Royal Air Force Officer developing and delivering officer training both in the UK and overseas. He is also a qualified performance coach, master practitioner of neuro-linguistic programming and hypnotherapist, skills that he uses to develop excellence in others.

Professor Melanie Jasper, Professor and Head of Health and Social Welfare Studies, Canterbury Christ Church University College

Having practised in the community as a midwife and health visitor for a number of years post-qualification, Melanie moved to the University of Portsmouth as a senior lecturer in 1990. She led the Masters curriculum and the Professional Doctorate in Nursing, as well as developing her academic field in critical reflection, reflective practice and reflective writing, until her appointment at Canterbury. She was appointed Editor of the Journal of Nursing Management in 2002, and holds an honorary appointment with Thames Valley University as Visiting Professor in the Adult Nursing subject group.

Helen Julu, Senior Practitioner, Health Visiting, London Borough of Enfield

Helen trained as a nurse in Uganda and migrated to Great Britain in 1983, elevating her nursing career to the level of a Ward Sister by 1998. Her ambition carried her further and she obtained an Honours degree at the University of South Bank in Specialist Community Nursing Public Health/Health Visiting in 2000 and an advanced diploma in Management in 2003 with the Chartered Institute of Management and Middlesex University, London.

Dr Mansour Jumaa, Chartered Manager and Executive Coach, Chief Emeka Anyaoku R&D Centre for Work Based Learnig and Leading. Anyaoku Centre, West Sussex

A Florence Nightingale Foundation Scholar in Evidence-Based Practice in Healthcare and Nursing Management, Academic Group Chair (Healthcare Management), and former Chartered Management Institute Programme Director at Middlesex University, London. Mansour is now a Chartered Manager and Executive Coach at the Anyaoku Centre, West Sussex. He is the first nurse, the first West African, the first Nigerian and the first black person of African origin resident in the UK to be awarded Chartered Manager status, the hallmark of the professional manager. His award was based on his ability to use knowledge management processes for performance improvement within organisations. Mansour has over 30 years of experience within the NHS and the higher education sector in the UK. Since 1987 he has taught, facilitated and supervised management and leadership courses from doctorate and masters levels to single study days at many universities in the UK – the Middlesex, the London School of Economics, and the Universities of Sussex, Surrey, and Wales in Swansea. He is committed to widening management and leadership access to first- and middle-line managers, particularly managers from black and minority ethnic communities. It is for this reason that he has established L4T – Leadership For Today (www.leadershipfortoday.com).

Dr Ilkka Kunnamo, Editor-in-Chief, EBM Guidelines, Finland

Ilkka, a specialist in general medicine, wrote his doctoral thesis in the field of paediatrics. Since 1986 he has worked as a general practitioner at Karstula in central Finland. He developed the idea of Evidence-Based Medicine Guide-lines (www.ebm-guidelines.com) and has served as its Editor-in-Chief since 1988. He is the author of about 30 research papers. He has been involved in several projects in primary care computing and medical informatics. He is a member of the Editorial Board of Clinical Evidence (BMJ Publishing Group, London) and the core reviewer group of BioMed Central.

Stuart Marples, Former Chief Executive, Institute of Healthcare Management, London

Although Stuart has now moved on in his career, at the time of writing he was Chief Executive of the Institute of Healthcare Management. The Institute is the professional body for managers working in healthcare. He is also a Fellow and Companion of the Institute. His 38-year career has been mainly in the NHS, including a long period as Chief Executive Officer of a large NHS Trust. He is a Business Studies Honours graduate and NVQ assessor and verifier. His personal interest is in management.

Dr Janet McCray, Principal Lecturer, Portsmouth Institute of Medicine, Health and Social Care, University of Portsmouth

Throughout her career, Janet has always maintained a connection with learning disability services. This has been broad, ranging from leading one of the first community care projects in North West England in the 1980s to taking forward the validation of the first joint prequalifying programme in nursing and social work in the learning disability field in the 1990s. Recently she has explored further practice roles in the field, gaining her PhD in 2002, and from this developing a conceptual framework for practice. At present she is beginning further testing of the framework and exploring its potential as a leadership tool.

Robert McSherry, Principal Lecturer, Practice Development, School of Health and Social Care, University of Teesside, Middlesbrough

Rob’s current post is Principal Lecturer in Practice Development at the School of Health and Social Care, University of Teesside, Middlesbrough. His long-term aim is to develop and strengthen practice development within the School of Health and Social Care, local community and NHS Trusts locally, regionally and nationally. Rob has facilitated and supported the advancement and evaluation of many innovative practice developments by focusing on the promotion of multiprofessional collaboration and teamworking in delivering evidence-based practice. Rob’s main concern is seeing research being utilised at a clinical level, whereby nurses, midwives, nurse specialists and other allied health professionals are equipped with the essential skills and knowledge to aid this process. Rob has shared and disseminated his work on practice development in three key areas – practice development, healthcare governance and evidence-informed practice – nationally and inter-nationally through publications, conferences, consultancy and workshops.

Paddy Pearce, Head of Healthcare Governance, Hambleton and Richmondshire Primary Care Trust

Paddy is the Head of Healthcare Governance for Hambleton and Richmondshire Primary Care Trust and is responsible for the integration of clinical and corporate governance. He trained as an RGN, practised in orthopaedics and has established clinical audit, clinical effectiveness and clinical governance in secondary and primary care trusts. Paddy holds a BSc (Honours) in Professional Studies in Healthcare and an MSc in Social Research Methods. He is a Health Care Commission Clinical Governance Reviewer and Cochrane Reviewer.

Janice Phillips, Service Manager for Learning Disability Services, Glen Care Organisation, Epsom, Surrey

Janice was a ward manager with the North London Forensic Service when she wrote her chapter. She has a specialist interest in risk assessment and risk management, and also self-harm and suicide. This has led to a number of clinical practice publications, where she has sought to challenge and test current clinical thinking, based on her own interpretation and application of research findings within the clinical environment. Much of her development in the clinical arena has been driven by clinical-based problem resolution, which has identified the need for a systematic strategy to improve the management of staff, resources and information systems.

Gülnur Salih, Patient Advocate and Language Interpreter, Camden PCT Advocacy and Interpreting Services, St Pancras Hospital, London

As a Health Advocate, Gülnur has worked for the NHS for 13 years, under-taking a range of duties providing help, advice and support for patients from the Turkish communities. She has established and run health education groups for Turkish communities and also devised and delivered training on Turkish culture to clinical and non-clinical staff. Achieving management and leadership qualifications has given Gülnur a new perspective on healthcare provision, which has allowed her to extend her effectiveness and interactions with patients and other health and social care staff. She has recently been seconded to work on a project involving healthcare provision to children and will be undertaking work to do with public consultation of the recommendations.

Theresa Shaw, Chief Executive, Foundation of Nursing Studies, London

Theresa Shaw is the Chief Executive Officer of the Foundation of Nursing Studies (FoNS), a small charity committed to supporting nurses to lead and develop innovative ways of working that improve patient care. Theresa successfully combines her role of charity manager with that of practice development facilitator, a role she believes is key to enabling development and research in practice. Prior to joining FoNS 6 years ago, she had been working in the NHS for 17 years. Her experience spanned clinical nursing, education and practice development, and whilst her clinical expertise lies in cardiothoracic nursing, she has worked with a variety of nurse-led teams. Theresa is currently undertaking the Doctor of Nursing Programme at Nottingham University, with specific focus on the impact of practice development.

Alyson Wadding, Senior Lecturer for Leadership Development, School of Health and Social Care, University of Teesside, Middlesbrough

Alyson is a Senior Lecturer for Leadership Development, responsible for leading the development and delivery of multiprofessional leadership programmes for all health and social care staff. She is a registered practitioner in the use of the Myers Briggs Type Indicator and is experienced in using this tool for individual and team leadership development. She is a registered feedback facilitator and trainer for the NHS Leadership Qualities Framework 360-degree diagnostic tool for leadership development and has integrated this framework into the design of leadership programmes. She is a licensed facilitator of the Leading an Empowered Organisation Programme, with a wide range of experience of delivering this programme to various groups. Alyson is also experienced in providing mentorship to clinical leaders in practice.