Too often those already in post are the focus of leadership development, obscuring the needs of the next generation, says Elisabeth Fradd. Leave a comment on on this story to contribute to a national debate on the future of NHS leadership
We must urgently seek out potential leaders across all aspects of nursing, because the workforce is ageing and many nurses will retire in five to 10 years.
Nurses are expected to deliver high quality, compassionate care in increasingly complex clinical and social environments. They provide leadership every day in many ways and in many contexts. Yet, given how frequently the importance of effective leadership is cited in health reform, it is surprising the nursing profession has not collectively responded to this challenge. This may be because the NHS as a whole is only just beginning to grasp the vital role of leadership. NHS chief executive Sir David Nicholson recently said: “We have not systematically identified, nurtured and promoted talent and leadership.”
Nursing has a number of opportunities to put this right – not least in the report of the Prime Minister’s Commission on the Future of Nursing and Midwifery.
Former health minister Lord Darzi said: “Within the patient experience, nursing and nurse leadership roles are the most important enablers in really transforming what happens in a ward or the community.” It is, therefore, the duty of existing nurse leaders to foster talent by supporting and encouraging the next generation by every means possible. As well as the usual formal development programmes, this support could include mentoring by recently retired experienced senior nurses, secondment opportunities outside the NHS to see how things could be done differently or through the establishment of leadership development networks.
Escalating budget pressures mean it is even more important to identify and invest in those who are going to be able to lead and innovate with confidence. We need to spot leaders using criteria such as those set out in the Hay Group’s report Nurse Leadership: being nice is not enough.
The Hay Group identified the following factors that should be used to select staff for accelerated development programmes: an eagerness and willingness to learn something new; a breadth of perspective that enables the individual to take a wider view on issues; an understanding of others; and personal maturity, which includes the ability to take feedback and use difficulties as a chance to learn.
It must be accepted by those already in leadership positions that it is their responsibility to bring on the next generation of leaders. Different organisations and specialties need leaders with different skills and backgrounds. The approaches needed to spot, develop and support future leaders must be flexible enough to accommodate this. Boards must seek assurance that existing clinical leaders are being supported and potential leaders found, in order to drive change locally and across organisational boundaries.
If we are truly committed to the leaders of the future, healthcare organisations of all kinds, including schools of nursing and their leaders, have a responsibility to spot future leaders and ensure core competencies are built into development programmes – competencies like managing uncertainty, business skills, commissioning and political acumen. In this way, existing leaders can help those further down the organisational ladder understand the context in which they will have to operate – a vital prerequisite to successful leadership in complex environments.
Any significant change in healthcare on the scale intended requires bold leadership at all levels to sustain the necessary reforms. This is why nurse leaders must act now to find those capable of following them. It is also why nursing must grasp the opportunities to demonstrate the capability and capacity of nurses to lead.
Dame Elisabeth Fradd is an independent adviser on health services. She was previously assistant chief nurse at the Department of Health and director of nursing at the Commission for Health Improvement
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