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A critical analysis and evaluation of the mechanisms of leadership and control used within xxxxxxxx NHS Foundation Trust

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A critical analysis and evaluation of the mechanisms of leadership and control used within xxxxxxxx NHS Foundation Trust
A critical analysis and evaluation of the mechanisms of leadership and control used within xxxxxxxx NHS Foundation Trust.

Introduction and background

I have worked within the NHS for the whole of my working life and have worked for my current employer, (XXXXXXXX) for the past 12 years. During this time frame and long before, there has been a consistent message coming from the Government, the Department of Health and many parts of the British media; Leadership within the NHS needs to change in order for the service to continue. As long ago as the 1983, the Griffiths report (Griffiths 1983) questioned the consensus style of management structures which had underpinned the NHS for the previous decade (DHSS 1972); and many would argue still exists to a great degree today.

Research completed more than 20 years ago by Stewart and Ranson (1988) remains relevant, they highlighted the very specific challenges faced by managers and leaders within the NHS as:
Politicised and political. Strategic decisions are invariably made whilst balancing a number of difficult and unclear political situations and processes.
Shifting accountability. Leaders are accountable in different ways, at different times to a number of different people.
Needing to constantly reflect, respond and change. The mechanisms for feedback on the service being provided is not always clear within the public domain and as such skills need to be developed to create an environment which allows time to pause, reflect and learn from situation before possibly changing strategies.
Effective leadership within such a complex backdrop is both challenging and vital.

XXXXXXXX is an extremely large NHS institution compromising of 3 large hospitals and two community services. The trust employs 12500 staff, has 1100 beds, has 1.6 million patient contacts each year and has a turn over totalling £1.1 Billion. An organisation chart for XXXXXXXX can be



Bibliography: Alderfer, C (1972) Existence, and growth: Human needs in organizational settings. Baker GR (2011). The Roles of Leaders in High Performing Healthcare Systems [online] Alimo-Metcalfe, B., & Lawler, J. (2001). Leadership development in UK companies at the beginning of the twenty-first century: lessons for the NHS? Journal of Management in Medicine, 15(5), 387-404. Bass, BM and Stogdill RM (1990) Bass and Stogdill’s Handbook of Leadership: Theory, research and Managerial applications, New York:Free Press Burns, J Department of Health and Social Security (1972). Management Arrangements for the Re-organised Health Service: The Grey Book Fiedler, F. E., & Chemers, M. M. (1967). A theory of leadership effectiveness (Vol. 111). New York: McGraw-Hill. Goleman, D (1998) Working with Emotional Intelligence, London: Bloomsbury Griffiths R (Chair) (1983) at: www.sochealth.co.uk/history/griffiths.html (Accessed 17/11/2012) Ham C (2003) Ham C, Dickinson H (2008). Engaging Doctors in Leadership: What can we learn from international experience and research evidence? Coventry: NHS Institute for Handy, C. (1985) Understanding Organisations, 3rd edition, Harmondsworth:Penguin Hersey, P., & Blanchard, K Herzberg, F. M. (1959). B. & Snyderman, B.(1959). The Motivation to Work. 2, Kings Fund (2011) The future of leadership and management in the nhs: No more heroes Kings fund (2012) Leadership and engagement for improvement in the NHS: Together we can. London: The Kings Fund. Available at www.kingsfund.org.uk/publications (Accessed 10/11/2012) Maslow, A Monitor (2010), Service Line Management: An overview Monitor:London (Online) Available at www.monitor-nhsft.gov.uk (Accessed 21/11/2012) Pearce CL, Conger JA (2003) Roebuck C (2011). Developing Effective Leadership in the NHS. A short report for The King’s Fund [online] leadershipcommission (Accessed 12/11/2012) Santry C (2011) research says’. Health Service Journal, 6 July. Stewart J, Ranson S (1988) Management in the public domain Public Money and Management Tannenbaum, R., & Schmidt, W. H. (1958). How to choose a leadership pattern (pp. 3-12). Institute of industrial relations. Thomas, KW (1976) Conflict and Conflict Management. In M Dunette (ed.), Handbook of industrial and organisational Psychology, Chicago, Il:Rand McNally Turnbull James K (2011) kingsfund.org.uk/leadershipcommission (accessed 12/11/2012)

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