Leadership matters

We have recently been discussing with some of our colleagues in a number of teams the type of leadership we need in order to nurture an improvement culture in our organisation.

There’s plenty of evidence – both from academic research and anecdotally from within ASPH – that leadership is the most influential factor in shaping organisational culture. So if we are wanting to embed a culture which fosters quality improvement, clearly leadership matters.


Quality improvement (QI) approaches are used in many different industries and comparisons are often drawn with manufacturing and engineering (Toyota, Ford, etc).  But more recent intelligence points to fundamental differences between these sorts of industries and our own.  We need to take this into account when it comes to leadership.

In healthcare we are dealing not with products, but with people – this means dealing with complexity and uncertainty and volatility every day.  So having leaders who can understand, tap-into and contain all of these things is really important.

Healthcare also brings together a wide range of knowledge and experience from different professions – it is built on interdependencies.  Having leaders who can connect with people and can role-model and facilitate connecting with other people is really important too.

Also, psychological safety is an essential foundation of QI and this is particularly important in healthcare where the stakes are elevated.  So leaders who can create a climate of trust and security for their teams are critical.

The recent King’s Fund report focuses on the links between QI and leadership in the NHS and Prof. Don Berwick from the IHI describes it in the video below: (click here if the video doesn’t load)

Here Dympna Cunnane (for the Health Foundation) describes why leadership is so important in creating a culture of improvement and why leadership in healthcare requires different approaches to other industries: (click here if the video doesn’t load)

We think that leadership matters and we would be really interested to know what you think.

Let us know your thoughts in the comments section below.


Rebecca – @Rebecca3005


5 thoughts on “Leadership matters

  1. Very interesting article and I think the key point you raise is taroundrole modelling. To often I am seeing managers and other leaders in my Trust who say the right thing but don’t do it themselves. So yes….Leadership matters but only if the leader models it themselves. The challenge which I think people in leadership positions face is to stop thinking ‘I need to say the right thing’ and to start trusting their instinct more. It goes back to whether leadership can be taugbt or nutured….

  2. I strongly agree to this, I believe leaders should lead by examples, personally what my superior does motivate me, I get encouraged when my boss does what am normally suppose to do, it builds team work, respect and loyalty . It also encourages me to trust and give my tasks 100% because my boss came down to my level to help.. That I think is a selfless leader.
    Asph has the potential to stand out in the health industry, it’s the little changes to our culture that would give us an edge… We will not only be unique but sort after

  3. To lead is not only by example and knowing when to ‘muck in’ but to ensure the people/ team you are leading are clear in their roles and the part they play in the team. You cannot lead a team that is resentful of the leader therefore each individual needs to be given a clearly defined role and each treated as an individual with their positive points highlighted. Not everyone is good at everything BUT everyone is good at something, as a skilled leader this should be given some thought before defining individuals roles thus, in turn ending up with a team ‘onside’ and ready to go forward.

  4. To be a good leader you need to have respect. To have respect you need to earn it. Not only do you need to lead by example and have the “mucking in” ability but each member of your team needs to be recognised as an individual, and individuals need to have a good understanding and be given a clearly defined role that works for the individual and for the team. We are not all good at everything BUT we are all good at something and all have a good working role within a team that needs to be recognised thus giving the individual a sense of being valued and inevitably making the leadership role slightly easier to have a solid working team behind them. If you read Belbin’s philosophy (worth googling) there are places for all with recognised responsibilities within a team. Team asph is a good one but how fantastic can we be with all onboard feeling valued and knowledge of their role and which part they play.

  5. Thought-provoking comments here – thank you! You’ve given me some ideas for a follow up blog on leadership behaviours that I’m just about to write! There are a few points in particular that I think you collectively get across really well:

    1) That the best leaders consistently and discernibly demonstrate the same high standards that they ask of their teams
    2) That the best leaders take time to build mutual trust and respect with each individual member of their teams
    3) That the best leaders will help out with their team’s workload or “muck in” when it’s needed
    4) That the best leaders do all of this sincerely – because they feel intuitively that it’s the right thing to do.

    I think that last bit shows how complex the leadership challenge is. We need leaders who are instinctively in touch with what “the right thing” is at any point in time, and who are themselves enabled, and supported and nurtured to turn instinct into action.

    Please keep reading and commenting, and look out for the next blog!

    P.S. Heather, I think I feel a blog on effective teams coming on!

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