We have witnessed the impact of organisational culture on quality of care, safety, and organisational effectiveness in the NHS. Prominent failures such as Mid Staffordshire highlighted that a good organisational culture is a necessary condition for organisational strategy to succeed, and leadership is the preeminent influence factor for organisational culture.
Leadership culture must be understood as the product of collective actions of formal and informal leaders acting together for organisational success. It is not simply the number or quality of individual leaders that determine organisational performance, but the ability of formal and informal leaders to pull together in support of the organisation’s goals.
We believe that collective leadership in health care is necessary for overcoming challenges that the NHS now faces. Collective leadership means the distribution and allocation of leadership power to wherever capability, expertise and motivation sit. The responsibility of leadership is shared by each and every member of the organisation.
A collective leadership culture requires new mindsets, not just new skills. These take time to develop. Many health care organisations have focused their development efforts only on individual leader competencies. For sustainable change, they need to advance both individual and collective leadership mind-sets. Making the shift to collective leadership in an organisation requires strategic implementation.
Developing and implementing an effective collective leadership strategy comes in three phases:
Discovery, Design, and Delivery.
- The Discovery phase involves collecting data and intelligence about the strategy, vision, mission, future challenges, political context and opportunities for the organisation. This process enables organisations to identify the leadership capabilities required to face the future and the gap between current and required future capabilities.
- The Design phase involves identifying required leadership capabilities for individual and collective leadership and the means to acquire, develop and sustain those capabilities.
- The Delivery phase involves elements from organisational and individual leadership development alike, targeting culture, systems and processes, as well as leadership development in synchrony.
While the process of developing collective leadership starts at board level, all staff across the organisation will need to be involved in this endeavour with their respective expertise, contributing to the collective leadership process.
Collective leadership offers huge opportunities for creating cultures of continually improving, high quality, and compassionate care. But it requires courage, persistence and professionalism from all leaders (informal and informal) to fully realise its potential. The complete dedication of the board and leadership team to empower all staff as leaders, and trust in the process of collaboration in the organisation as the foundation for its leadership culture are keys to success.
We believe that the challenges that face health care organisations are too great and too many for leadership to be left to chance or to piecemeal approaches. Through working together with health and social care organisations and in consultation with patients, we can develop leadership strategies that will ensure the NHS confidently faces the future and delivers the high quality, compassionate care that is its mission.