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'Nurse leaders must be willing to devolve responsibility to others'

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A leadership culture of trust and empowerment will boost levels of care, argues Chief Executive of the Institute of Leadership & Management, Charles Elvin

Last week’s second annual NHS Leadership & Management Summit focused on leadership for engagement, looking at the necessity of leaders who are able to engage with and inspire the people they work alongside. In a vast, multi-faceted organisation such as the NHS, with its great network of employees and stakeholders, it is all the more vital that everyone within the organisation understands the goals they are working towards and, just as importantly, feel motivated to do so.

ILM is in agreement with the panel that met at the King’s Fund last Wednesday, in considering it the responsibility of leaders to ensure engagement across the organisation to deliver common goals. This cannot be done through a leadership model of ‘command and control’ – the NHS is too large, too complex and too fluid an organisation for this to be possible.

Moreover, it is clear that NHS leaders cannot, and should not be expected to control every corner of the organisation; they are reliant upon the people they lead, such as frontline nursing staff, to make important decisions and be responsible for delivering organisational goals and engaging stakeholders. With so many relationships to negotiate and maintain (patients, doctors, members of the public, boards and partner organisations), it is necessary that there are people at every level of the nursing profession, able to engage with and inspire the people they work alongside.

For this to work in practice, leaders must be willing to devolve responsibility to others and need to trust the people they lead. Leaders who trust their teams give those at other levels, who may have access to knowledge and insights that they do not, the freedom to use these insights to their full capacity – which also facilitates knowledge sharing within a team.

Trust also embeds a sense of individual accountability, leading to higher levels of commitment as individuals take ownership for their work. ILM’s research into workplace trust has demonstrated the link between trust and organisational efficiency. It showed that high trust environments produce more efficient and motivated organisations, reduce staff turnover, absenteeism and stress, and ultimately result in greater productivity, quality and achievement of goals.  

Creating a coaching culture can have a useful role to play in cultivating workplace trust. Coaching, which is a facilitative, two-way process, is an effective way of communicating organisational values. Internal coaching allows leaders to communicate their skills and empower their colleagues to establish their own solutions and approach, and in particular can be a tool for engagement between different levels of seniority. Therefore, coaching is well suited and beneficial to the nursing profession.

It is, however, important to be aware that coaching is a specialist management skill, involving training, experience and on-going development. Moreover, everyone can benefit significantly from coaching and it shouldn’t be regarded merely as a one-off event – it is about delivering a high-performance culture that will become embedded over time.

In a sphere of work where high levels of care are a priority, a trusting and participative leadership culture should also be the goal. Leadership and management development, such as coaching, can help to bring about this cultural shift and give nurses at all levels the skills and confidence to deliver excellent standards of care.

Charles Elvin is chief executive of the Institute of Leadership & Management.

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