64175 Leadership Framework:Layout 1 - NHS North West

National Team pleased with

‘encouraging’ response to

Leadership Development Framework

The National Team state that they havehad ‘an exceptionally high qualityresponse’ to the Framework fromproviders in the field of leadership,organisatonal development and NHScommissioning. As you will know, theFramework was launched in July toprovide ‘a single overarching frameworkfor the leadership development of allstaff in health and care, irrespective ofdiscipline, role or function.’

Included in this PDF

Introducing the NHS Leadership Framework Page 2

Supporting Tools Page 2

NHS Leadership Framework - Full Document Pages 3 - 84

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360° Feedback

Introducing the

NHS Leadership Framework The NHS Leadership Framework provides a consistent approach to leadership development for staff in health and care irrespective of discipline, role or function, and represents the foundation of leadership behaviour throughout the NHS. It sets out a single model of leadership for all NHS staff should aspire.

It will be imperative that frontline clinicians and the wider workforce have the leadership knowledge, skills and behaviours to drive radical service redesign and improvement. This will involve working in collaboration across health systems, in developing new models of care, and further developing the skills of the entire workforce. The ability to influence and manage change at the frontline will be central to delivering this.

To enable this change to take place successfully and to support staff in this very important role we will need to further develop the leadership capability within the system.

The NHS Leadership Framework is based on the concept that leadership is not restricted to people who hold designated

leadership roles and where there is a shared responsibility for the success of the organisation, services or care being delivered. Acts of leadership can come from anyone in the organisation and as a model it emphasises the responsibility of all staff in demonstrating appropriate behaviours, in seeking to contribute to the leadership process and to develop and empower the leadership capacity of colleagues.

The NHS Leadership Framework integrates the Medical Leadership Competency Framework (MLCF) and Clinical Leadership Competency Framework (CLCF) and supercedes the Leadership Qualities Framework (LQF). Please visit www.nhsleadership.org.uk/framework.asp to learn more about the framework and how it can be used and applied. Supporting tools

There are a number of supporting tools already available, with more on the way in the coming months.

LeAD is a free and engaging e-learning resource to help clinicians develop their understanding of how their role contributes to managing and leading health services. The sessions are grouped into modules for ease of reference, however they are designed to stand alone providing an open learning pathway to meet individual development needs and interests. LeAD is appropriate for all clinical staff regardless of profession, specialty, or stage of training and offers one

component of an overall leadership training and development programme. There is also an Additional Educational Material area which holds videos, articles and other resources to further augment learning. To register for LeAD, please visit http://www.e-lfh.org.uk/projects/lead/register.html 360° feedback is a powerful tool to help individuals identify where their leadership strengths and development needs lie. The process includes getting confidential feedback from line managers, peers and direct reports. As a result, it gives an individual an insight into other people’s perceptions of their leadership abilities and behaviour. The new Leadership Framework online 360° feedback tool is in the process of being road tested and will be available to colleagues in the service from October 2011 onwards. If you would like to register your interest in the tool, please contact [email protected].

A free self assessment tool helps individuals identify where their leadership strengths and development needs lie, to assist with personal development. For further information and access to the self assessment tool, please visit the Supporting Tools section of the NHS Leadership Framework website.

Colleagues working in the higher education institutions or in workplace training facilities may find the Guidance for Integrating the Clinical Leadership Competency Framework into Education and Training very useful. This document describes the knowledge, skills, attitudes and behaviours required for each domain and provides suggestions for appropriate learning and development activities to be delivered throughout education and training, as well as possible methods of assessment. Please visit the Supporting Tools section of the NHS Leadership Framework website to download.

http://www.nhsleadership.org.uk/framework.asp

http://www.e-lfh.org.uk/projects/lead/register.html

mailto:[email protected]

http://www.nhsleadership.org.uk/framework-theframework-supportingtools.asp

http://www.nhsleadership.org.uk/framework-theframework-supportingtools.asp

NHS Leadership Framework

© 2011 Department of Health. All rights reserved.

The NHS Leadership Framework is published on behalf of the Department of Health by NHS Institute forInnovation and Improvement, Coventry House, University of Warwick Campus, Coventry, CV4 7AL.

Publisher: NHS Institute for Innovation and Improvement, Coventry House, University of Warwick Campus,Coventry, CV4 7AL.

This publication may be reproduced and circulated free of charge for non-commercial purposes only by andbetween NHS-funded organisations in England, Scotland, Wales and Northern Ireland staff, and their relatednetworks and officially contracted third parties. This includes the right to reproduce, distribute and transmit thispublication in any form and by any means, including e-mail, photocopying, microfilming, and recording. Noother use may be made of this publication or any part of it except with the prior written permission andapplication for which should be in writing and addressed to the Director of Leadership (and marked ‘re.permissions’). Written permission must always be obtained before any part of this publication is stored in aretrieval system of any nature, or electronically. Reproduction and transmission of this publication must beaccurate, must not be used in any misleading context and must always be accompanied by this Copyright Notice.

Warning: Unauthorised copying, storage, reproduction, adaptation or other use of this publication or any part ofit is strictly prohibited. Doing an unauthorised act in relation to a copyright work may give rise to civil liabilitiesand criminal prosecution.

The Clinical Leadership Competency Framework was created with the agreement of the NHS Institute forInnovation and Improvement and the Academy of Medical Royal Colleges from the Medical LeadershipCompetency Framework which was created, developed and is owned jointly by the NHS Institute for Innovationand Improvement and the Academy of Medical Royal Colleges.

NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2010) MedicalLeadership Competency Framework, 3rd edition, Coventry: NHS Institute for Innovation and Improvement.

© NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges 2010

Page

Foreword 5

The NHS Leadership Framework 6

Application of the NHS Leadership Framework 11

1. Demonstrating Personal Qualities 131.1 Developing Self Awareness 141.2 Managing Yourself 151.3 Continuing Personal Development 161.4 Acting with Integrity 17

2. Working with Others 192.1 Developing Networks 202.2 Building & Maintaining Relationships 212.3 Encouraging Contribution 222.4 Working within Teams 23

3. Managing Services 253.1 Planning 263.2 Managing Resources 273.3 Managing People 283.4 Managing Performance 29

4. Improving Services 314.1 Ensuring Patient Safety 324.2 Critically Evaluating 334.3 Encouraging Improvement and Innovation 34 4.4 Facilitating Transformation 35

5. Setting Direction 375.1 Identifying the Contexts for Change 38 5.2 Applying Knowledge and Evidence 395.3 Making Decisions 405.4 Evaluating Impact 41

6. Creating the Vision 436.1 Developing the Vision for the Organisation 446.2 Influencing the Vision of the Wider Healthcare System 456.3 Communicating the Vision 466.4 Embodying the Vision 47

7. Delivering the Strategy 497.1 Framing the Strategy 507.2 Developing the Strategy 517.3 Implementing the Strategy 527.4 Embedding the Strategy 53

Acknowledgements 55

Relevant reading 57

Appendix I: The Knowledge and Skills Framework (KSF) 60

Appendix II: Tables combining the indication of behaviours at different 61leadership stages from each domain

Table of Contents

3NHS Leadership Framework

NHS Leadership Framework 5

ForewordI am delighted to introduce the NHS Leadership Framework; it provides a single overarching framework forthe leadership development of all staff in health and care, irrespective of discipline, role or function.

It is underpinned by a consistent set of guiding principles, contained in the NHS Constitution, which reflectthe values of health and care staff. It therefore represents the foundation of leadership behaviour for staffthroughout the NHS, to support all staff to improve quality for our patients.

This is a unique period in the NHS and a time of significant change for health and care services in England,with an unprecedented level of responsibility being devolved to frontline staff. Building on our successes aswe design the future requires bold and thoughtful leadership, rethinking how we work, challenging currentpractice and thinking outside of our own organisational and professional interests.

It will be imperative that frontline clinicians and the wider workforce have the leadership knowledge, skillsand behaviours to drive radical service redesign and improvement. This will involve working in collaborationacross health systems, in developing new models of care, and further developing the skills of the entireworkforce. The ability to influence and manage change at the frontline will be central to delivering this. Thereis no doubt that we must continue to develop the leadership capability within the system. It is on this basisthat the NHS Leadership Framework has been designed.

Based on research and created through extensive consultation, the NHS Leadership Framework has beentailored to the specific needs and environment of the NHS, and is applicable to all staff at any stage of theircareer. It sets out the expectations of leaders at every level of our system and provides guidance to those whocommission leadership development.

The National Leadership Council (NLC) has led this work and I would like to thank everyone who hascontributed to the development of the NHS Leadership Framework.

Sir David NicholsonNHS Chief Executive

The NHS Leadership Framework

IntroductionThe NHS Leadership Framework provides a consistent approach to leadership development for staff in health andcare and represents the foundation of leadership behaviour throughout the NHS. It sets out a single model ofleadership for all NHS staff working in both clinical and non-clinical roles to which all NHS staff should aspire. It isintended as a developmental framework and there are a number of ways the NHS Leadership Framework can beapplied to develop leadership skills and behaviours across the service and to foster a shared understanding ofwhat leadership means in the NHS. The NHS Leadership Framework integrates the Medical LeadershipCompetency Framework (MLCF) and Clinical Leadership Competency Framework (CLCF) and supercedes theLeadership Qualities Framework (LQF).

The NHS Leadership Framework is made up of seven domains which describe leadership knowledge, skills andbehaviour. Staff will exhibit a range of leadership behaviours across these seven domains dependent on thecontext in which they operate, described in four stages. These are defined by their sphere of influence, extent ofresponsibility and accountability, and their impact on services.

Development of the NHS Leadership FrameworkThe National Leadership Council (NLC) commissioned the NHS Leadership Framework in 2010. Fundamental to itsdevelopment was a desire to create a single overarching leadership framework for all staff groups to enable themto understand their progression as a leader and to support the NHS to foster and develop talent.

In developing the NHS Leadership Framework detailed research and consultation with a wide cross section of staffand stakeholders has been undertaken including those with a patient perspective, and those involved inhealthcare outside of the NHS. These include professional bodies, academics, regulators and policy makers – a fulllist is available on page 56.

Those consulted embraced the concept of the NHS Leadership Framework because it affords a common andconsistent approach to professional and leadership development, based on shared values and beliefs which areconsistent with the principles and values of the NHS Constitution1.

1 Department of Health (2010) The NHS Constitution: the NHS belongs to us all. The NHS Constitution can be accessed viahttp://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx

NHS Leadership Framework6


Underpinning leadership principles of the NHS Leadership FrameworkPeople understand the term ‘leadership’ in many different ways. Perhaps the most common stereotypic ideais of the individual, powerful, charismatic leader with followers clearly in subordinate roles. Such situations doexist but are quite limited, rather outdated and by the very rarity of charismatic qualities make it a poor modelfor leadership development. This way of thinking tends to focus on the individual as a leader rather than theprocesses of leadership.

A more modern conceptualisation sees leadership as something to be used by all but at different levels. This model of leadership is often described as shared, or distributed, leadership and is especially appropriatewhere tasks are more complex and highly interdependent – as in healthcare. It is a universal model such thatall staff can contribute to the leadership task where and when their expertise and qualities are relevant andappropriate to the context in which they work. Not everyone is necessarily a leader but everyone cancontribute to the leadership process by using the behaviours described in the five core domains of the NHSLeadership Framework: demonstrating personal qualities, working with others, managing services, improvingservices and setting direction.

The National Health Service (NHS) principles and valuesThe NHS Constitution establishes the principles and values of the NHS in England. The Constitution setsout rights to which patients, public and staff are entitled, and pledges which the NHS is committed toachieve, together with responsibilities which the public, patients and staff owe to one another to ensurethat the NHS operates fairly and effectively.

1.The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age,sexual orientation, religion or belief.

2. Access to NHS services is based on clinical need, not an individual’s ability to pay.

3. The NHS aspires to the highest standards of excellence and professionalism – in the provision of high-quality care that is safe, effective and focused on patient experience.

4. NHS services must reflect the needs and preferences of patients, their families and their carers.

5. The NHS works across organisational boundaries and in partnership with other organisations in theinterest of patients, local communities and the wider population.

6. The NHS is committed to providing best value for taxpayers’ money and the most effective, fair andsustainable use of finite resources.

7. The NHS is accountable to the public, communities and patients that it serves.

These seven key principles guide the NHS in all it does and they are underpinned by the following corevalues. Patients, public and staff have helped develop this expression of values that inspire passion in theNHS and should guide it in the 21st century.

The NHS values provide common ground for co-operation to achieve shared aspirations:

Respect and dignity Commitment to quality of care Compassion Improving lives Working together for patientsEveryone counts.

As a model it emphasises the responsibility of all staff, in demonstrating appropriate behaviours, to seek tocontribute to the leadership process and to develop and empower the leadership capacity of colleagues.

The final two domains of the NHS Leadership Framework, creating the vision and delivering the strategy,recognise that a relatively small group of people do hold designated senior positional roles, and are requiredto act as leaders in formal hierarchical positions. These two domains therefore focus more on the contributionof individual leaders rather than the general leadership process.

Evolution of the NHS Leadership FrameworkThe NHS Leadership Framework has been designed to build on learning of the following internationally recognisedbest practice standards for leadership development. It was also informed by analysis of existing NHS leadershipdata and a review of contemporary leadership literature.

• The Leadership Qualities Framework (LQF)2. The LQF 360° tool has been used extensively by staff in roles aboveand beyond the executive population that the original LQF research was based upon. The NHS LeadershipFramework addresses this by describing leadership behaviours for all staff depending on their role and thecontext in which they work.

• The Medical Leadership Competency Framework (MLCF)3. Jointly developed by The Academy of Medical RoyalColleges and the NHS Institute for Innovation and Improvement, the MLCF describes the leadershipcompetencies doctors need to become more actively involved in the planning, delivery and transformation ofservices for patients. It applies to all medical students and doctors throughout their careers.

• The Clinical Leadership Competency Framework (CLCF)4. The NLC commissioned the NHS Institute to test theleadership competencies in the MLCF to see whether they could be applied to all healthcare professionals.These have been endorsed by the clinical professions and will be progressively embedded within professionalregulation and into education and training.


2 NHS Institute for Innovation and Improvement (2005) NHS Leadership Qualities Framework http://www.nhsleadershipqualities.nhs.uk

3 NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2010) Medical Leadership CompetencyFramework. 3rd ed. NHS Institute for Innovation and Improvement: Coventry.

4 Department of Health (2011). Clinical Leadership Competency Framework. NHS Institute for Innovation and Improvement: Coventry.

SettingDirection

PersonalQualities

Delivering theService

Broadscanning

Seizingthe future

Intellectualflexibility

Politicalastuteness

Drive forresults

Collaborativeworking

Effectiveand strategicinfluencing

Leading changethrough people

Self beliefSelf awareness

Self managementDrive for improvement

Personal integrity

Holding toaccount

Empoweringothers

LQF CLCF and MLCF NHS Leadership Framework

The five domains of the CLCF and the MLCF were informed by the LQF, and are shared with the core five domainsof the NHS Leadership Framework to create a single overarching leadership framework.


Design and structure of the NHS Leadership FrameworkThe NHS Leadership Framework provides a standardised and consistent approach to leadership development forNHS staff and represents the foundation of leadership behaviour throughout the NHS. The needs of the peoplewho use services have always been central to healthcare. However, if we are going to transform services, acting onwhat really matters to patients and the public is essential and involves the active participation of patients, carers,community representatives, community groups and the public in how services are planned, delivered andevaluated5.

Delivering services to patients, service users, carers and the public is therefore at the heart of the NHS LeadershipFramework. All staff work hard to improve services for people.

The NHS Leadership Framework is comprised of seven domains. Within each domain there are four categoriescalled elements and each of these elements is further divided into four descriptors. These statements describethe leadership behaviours which are underpinned by the relevant knowledge, skills and attributes all staff shouldbe able to demonstrate radiating out from those of the individual to those within the wider system.

We use the word ‘patient’ throughout the NHS Leadership Framework to generically cover patients, serviceusers, and all those who receive healthcare. Similarly, the word ‘other’ is used to describe all colleagues fromany discipline and organisation, as well as patients, service users, carers and the public.

The five core domains are:-

1. Demonstrating personal qualities - effective leadership requires individuals to draw upon theirvalues, strengths and abilities to deliver high standards of service. This requires them todemonstrate effectiveness in developing self awareness, managing themselves, continuingpersonal development and acting with integrity.

2. Working with others – effective leadership requires individuals to work with others in teams andnetworks to deliver and improve services. This requires them to demonstrate effectiveness indeveloping networks, building and maintaining relationships, encouraging contribution, andworking within teams.

3. Managing services - effective leadership requires individuals to focus on the success of theorganisation(s) in which they work. This requires them to be effective in planning, managingresources, managing people and managing performance.

4. Improving services - effective leadership requires individuals to make a real difference to people’shealth by delivering high quality services and by developing improvements to services. This requires them to demonstrate effectiveness in ensuring patient safety, critically evaluating,encouraging improvement and innovation and facilitating transformation.

5. Setting direction - effective leadership requires individuals to contribute to the strategy andaspirations of the organisation and act in a manner consistent with its values. This requires themto demonstrate effectiveness in identifying the contexts for change, applying knowledge andevidence, making decisions, and evaluating impact.

5 Patient and Public Engagement, Department of Health (2009) Putting Patients at the Heart of Care: The Vision for Patient and PublicEngagement in Health and Social Care. www.dh.gov.uk/ppe


There are two additional domains which apply particularly but not exclusively to individuals in seniorpositional leadership roles.

6. Creating the vision - those in senior positional leadership roles create a compelling vision for thefuture, and communicate this within and across organisations. This requires them to demonstrateeffectiveness in developing the vision for the organisation, influencing the vision of the widerhealthcare system, communicating the vision and embodying the vision.

7. Delivering the strategy – those in senior positional leadership roles deliver the strategic vision bydeveloping and agreeing strategic plans and ensuring that these are translated into achievableoperational plans. This requires them to demonstrate effectiveness in framing the strategy,developing the strategy, implementing the strategy and embedding the strategy.

The leadership contextThe application and opportunity to demonstrate leadership will differ and the context in which competencecan be achieved will become more complex and demanding with career progression. We have therefore usedfour stages to describe this and to help staff understand their progression and development as a leader. They are:

Stage 1 Own practice/immediate team - is about building personal relationships with patients andcolleagues, often working as part of a multi-disciplinary team. Staff need to recognise problems and workwith others to solve them. The impact of the decisions staff take at this level will be limited in terms of risk.

Stage 2 Whole service/across teams - is about building relationships within and across teams, recognisingproblems and solving them. At this level, staff will need to be more conscious of the risks that their decisionsmay pose for self and others for a successful outcome.

Stage 3 Across services/wider organisation - is about working across teams and departments within thewider organisation. Staff will challenge the appropriateness of solutions to complex problems. The potentialrisk associated with their decisions will have a wider impact on the service.

Stage 4 Whole organisation/healthcare system - is about building broader partnerships across and outsidetraditional organisational boundaries that are sustainable and replicable. At this level leaders will be dealingwith multi-faceted problems and coming up with innovative solutions to those problems. They may lead at anational/international level and would be required to participate in whole systems thinking, finding new waysof working and leading transformational change. Their decisions may have significant impact on thereputation of the NHS and outcomes and would be critical to the future of the NHS.


Application of the NHS LeadershipFramework and supporting toolsThe NHS Leadership Framework sets out the standard for leadership to which all staff in health and careshould aspire. It is intended for use as a developmental framework and there are many ways it can beapplied, for example:

• To raise awareness that effective leadership is needed across the whole organisation

• To underpin a talent management strategy

• As part of an existing leadership development programme

• To inform the design and commissioning of training and development programmes

• To develop individual leadership skills

• As part of team development

• To enhance existing appraisal systems

• To inform an organisation’s recruitment and retention processes.

The NHS Leadership Framework is structured to assist the user to understand how they relate to each of theseven domains. Staff will exhibit a range of leadership behaviours across these seven domains dependent onthe context in which they operate. To improve the quality and safety of health and care services, it is essentialthat staff are competent in each of the five core leadership domains: demonstrating personal qualities,working with others, managing services, improving services and setting direction. The two other domains ofthe NHS Leadership Framework, creating the vision and delivering the strategy, focus more on the role andcontribution of individual leaders.

To help users understand and apply the NHS Leadership Framework each domain is divided into fourelements and each of these elements is further divided into four descriptive statements which describe thebehaviours all staff should be able to demonstrate.

To assist users there are a number of indicators across a variety of work place situations which illustrate the typeof activity staff could be demonstrating relevant to each element and stage as well as examples of behaviours ifthey are not. These indicators are intended to be examples and only apply to part of each element.

The CLCF and MLCF are also available to specifically provide staff with clinically based examples and learningand development scenarios across the five core domains shared with the NHS Leadership Framework.

Supporting toolsA self assessment and 360° feedback tool support the NHS Leadership Framework; in addition an onlinedevelopment guide signposts development opportunities for each of the seven domains. The 360° is apowerful tool to help individuals identify where their leadership strengths and development needs lie. The process includes getting confidential feedback from line managers, peers and direct reports. As a result, itgives an individual an insight into other people’s perceptions of their leadership abilities and behaviour.

To assist with integrating the competencies into postgraduate curriculaand learning experiences, there is the LeAD e-learning resource. LeAD isa range of more than 50 short e-learning sessions that support theknowledge base of the MLCF and the CLCF. Examples and contexts

range across various different fields and specialties, all aimed at improving patient care and services. LeAD addresses how clinicians can develop their leadership contribution in clinical settings. Originally it was

produced to support medical trainees, however new sessions are being added to broaden out the learning toall clinical professions. In addition the resources section of each session includes examples of the MLCF andCLCF in practice and ideas for further development, useful to both the individual learner and also to trainersor supervisors.

LeAD is available on the National Learning Management System and through e-Learning for Healthcare(www.e-lfh.org.uk/LeAD).

How the NHS Leadership Framework fits with other career and skills based frameworks The NHS Leadership Framework is designed to be used in conjunction with career or skills based frameworkslike the Nursing Careers Framework and the NHS Knowledge and Skills Framework (KSF).

For example, a line manager may use the KSF to support an appraisal and development review whereas staffmay use the NHS Leadership Framework to understand where their leadership strengths and developmentneeds lie - for further information on the KSF see Appendix I on page 60.

The full NHS Leadership Framework follows, complete with examples in practice and work-placeindicators to demonstrate the practical application of the framework. Please note the indicators areexamples only and intended as a guide across part of the relevant element.


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DemonstratingPersonal Qualities


1. Demonstrating Personal Qualities

Effective leadership requires individuals to draw upon their values, strengths and abilities to deliver highstandards of service. To do so, they must demonstrate effectiveness in:

• Developing Self Awareness

• Managing Yourself

• Continuing Personal Development

• Acting with Integrity.


1. Demonstrating Personal Qualities1.1 Developing Self Awareness

Leaders develop self awareness: being aware of theirown values, principles and assumptions and by beingable to learn from experiences.

Competent leaders:

• Recognise and articulate their own values andprinciples, understanding how these may differ fromthose of other individuals and groups

• Identify their own strengths and limitations, theimpact of their behaviour on others, and the effect ofstress on their own behaviour

• Identify their own emotions and prejudices andunderstand how these can affect their judgment andbehaviour

• Obtain, analyse and act on feedback from a variety ofsources.

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Reflects on how factors such as own values, prejudices and emotions influence theirjudgement, behaviour and self belief. Uses feedback from appraisals and other sources toconsider personal impact and change behaviour. Understands personal sources of stress.

Appreciates the impact they have on others and the impact others have on them.Routinely seeks feedback and adapts their behaviour appropriately.

Reflects on their interactions with a wide and diverse range of individuals and groups fromwithin and beyond their immediate service/organisation. Challenges and refreshes ownvalues, beliefs, leadership styles and approaches. Overtly role models the giving andreceiving of feedback.

Uses sophisticated tools and sources to continuously learn about their leadership impact inthe wider health and care community and improve their effectiveness as a senior leader.Understands how pressures associated with carrying out a high profile role impact on themand their performance.

Contextual Indicators


1. Demonstrating Personal Qualities1.2 Managing Yourself

Leaders manage themselves: organising andmanaging themselves while taking account of theneeds and priorities of others.

Competent leaders:

• Manage the impact of their emotions on theirbehaviour with consideration of the impact onothers

• Are reliable in meeting their responsibilities andcommitments to consistently high standards

• Ensure that their plans and actions are flexible, andtake account of the needs and work patterns ofothers

• Plan their workload and activities to fulfil workrequirements and commitments, withoutcompromising their own health.

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Plans and manages own time effectively and fulfils work requirements and commitmentsto a high standard, without compromising own health and wellbeing. Remains calm andfocused under pressure.

Ensures that own work plans and priorities fit with the needs of others involved indelivering services. Demonstrates flexibility and sensitivity to service requirements andremains assertive in pursuing service goals.

Successfully manages a range of personal and organisational demands and pressures.Demonstrates tenacity and resilience. Overcomes setbacks where goals cannot be achievedand quickly refocuses. Is visible and accessible to others.

Remains focused on strategic goals when faced with competing and, at times, conflictingdemands arising from differing priorities. Identifies where they need to personally getinvolved to achieve the most benefit for the organisation and wider healthcare system.



1. Demonstrating Personal Qualities1.3 Continuing Personal Development

Leaders actively engage in continuing personaldevelopment: learning through participating incontinuing professional development and fromexperience and feedback.

Competent leaders:

• Actively seek opportunities and challenges forpersonal learning and development

• Acknowledge mistakes and treat them as learningopportunities

• Participate in continuing professional developmentactivities

• Change their behaviour in the light of feedback andreflection.

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Takes responsibilities for own personal development and seeks opportunities for learning.Strives to put learning into practice.

Puts self forward for challenging assignments and projects which will develop strengthsand address development areas.

Acts as an exemplar for others in managing their continuous personal development.Facilitates the development of a learning culture.

Develops through systematically scanning the external environment and exploring leadingedge thinking and best practice. Applies learning to build and refresh the service. Treats challenge as a positive force for improvement.



1. Demonstrating Personal Qualities1.4 Acting with Integrity

Leaders act with integrity: behaving in an open,honest and ethical manner.

Competent leaders:

• Uphold personal and professional ethics and values,taking into account the values of the organisationand respecting the culture, beliefs and abilities ofindividuals

• Communicate effectively with individuals,appreciating their social, cultural, religious andethnic backgrounds and their age, gender andabilities

• Value, respect and promote equality and diversity

• Take appropriate action if ethics and values arecompromised.

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Behaves in an open, honest and inclusive manner, upholding personal and organisationalethics and values. Shows respect for the needs of others and promotes equality and diversity.

Acts as a role model for others in demonstrating integrity and inclusiveness in all aspects oftheir work. Challenges where organisational values are compromised.

Creates an open, honest and inclusive culture in accordance with clear principles andvalues. Ensures equity of access to services and creates an environment where people fromall backgrounds can excel.

Assures standards of integrity are maintained across the service and communicates theimportance of always adopting an ethical and inclusive approach.



1. Demonstrating Personal QualitiesGeneric behaviours observed if individual is not yet demonstrating this domain:• Does not understand own emotions or recognise the impact of own behaviour on others• Approaches tasks in a disorganised way and plans are not realistic• Unable to discuss own strengths and development needs and spends little time on development• Demonstrates behaviours that are counter to core values of openness, inclusiveness, honesty and equality• Lacks confidence in own abilities to deliver results.

Examples in Practice for Demonstrating Personal Qualities:

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Radiotherapy Physicist X needed to focus her attention on her own professional development in order to meetthe state registration criteria with the Health Professionals Council. Accreditation required her to create aportfolio of evidence for various aspects of her work that demonstrated how she has developed the necessaryskills and experience to meet the standards set for registration. Radiotherapy Physicist X recognised the need tomanage her own workload with her educational and Continual Professional Development (CPD) requirementsto ensure that her professional goals were met without impacting on her day-to-day responsibilities.

Surgical Ward Sister C noted that her junior team was in awe of her and not always comfortable questioningwhat she said. She asked the team to challenge her more if they disagreed with her and admitted that she didhave a strong personality which might be seen as intimidating at times. In subsequent meetings sheencouraged openness by not reacting as defensively when nurses began to question what she said. She praised them when their ideas would benefit patients and thanked them when their comments wouldenable her to make improvements to her own performance. Surgical Ward Sister C set up a 360-degreefeedback process for the team designed to encourage the sharing of perspectives so that team members couldgain insight from some personal feedback on their performance. Despite her heavy workload she made thetime to sit with them and discuss their feedback one-to-one.

Associate Directorate Manager E recognised that he needed to spend time increasing his knowledge and self-awareness in order to make himself a more rounded leader at this level. Before moving into the AssociateDirector role, he undertook a number of secondments in different areas of the organisation to strengthen hisknowledge outside of his own functional specialism. He regularly requested feedback on his own leadershipstyle in order to gain insight into what he could do better. Feedback was that others were not always clearabout his expectations. To counter his natural tendency to leave the details to others, Associate DirectorateManager E spent time discussing his expectations with others. This not only helped build strong trustingrelationships, but enabled Associate Directorate Manager E to understand his team’s working methods andalign his approach with their preferences.

Chief Executive Officer Y knows how important it is to operate with a high level of emotional intelligence, selfconfidence and integrity at a senior level, particularly when balancing national and regional considerations,weighing up the competing needs of organisations, and considering the views of Members of Parliament. Thisis especially relevant when interacting with the Secretary of State, Members of Parliament, Counsellors andsenior officials within the Department of Health. Chief Executive Officer Y used his skills when two Trusts putforward a business case for a new specialist unit to be located on their patch when rationalisation meant thatfunding would only be available for one unit. He was required to adopt an objective perspective and includeother factors in the final decision that linked to how the decision would be aligned with national priorities at astrategic level including QIPP and diversity considerations. This then needed to be communicated sensitively toall parties involved. He took the time to speak to politicians and affected groups in person pointing out howthe decision taken would benefit all members of the community. He spent many hours negotiating counteroffers and compromises between senior executives when each of the parties raised equally valid points whichmade achieving a win-win outcome particularly challenging.

Working with Others

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2. Working with Others

Effective leadership requires individuals to work with others in teams and networks to deliver and improveservices. To do so, they must demonstrate effectiveness in:

• Developing Networks

• Building and Maintaining Relationships

• Encouraging Contribution

• Working within Teams.


2. Working with Others2.1 Developing Networks

Leaders develop networks: working in partnershipwith patients, carers, service users and theirrepresentatives, and colleagues within and acrosssystems to deliver and improve services.

Competent leaders:

• Identify opportunities where working incollaboration with others within and acrossnetworks can bring added benefits

• Create opportunities to bring individuals and groupstogether to achieve goals

• Promote the sharing of information and resources

• Actively seek the views of others.

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Identifies where working and cooperating with others can result in better services.Endeavours to work collaboratively.

Uses networks to bring individuals and groups together to share information and resourcesand to achieve goals.

Identifies and builds effective networks with a range of influential stakeholders internaland external to the organisation.

Works across boundaries creating networks which facilitate high levels of collaborationwithin and across organisations and sectors.



2. Working with Others2.2 Building and Maintaining Relationships

Leaders build and maintain relationships: listening,supporting others, gaining trust and showingunderstanding.

Competent leaders:

• Listen to others and recognise different perspectives

• Empathise and take into account the needs andfeelings of others

• Communicate effectively with individuals andgroups, and act as a positive role model

• Gain and maintain the trust and support ofcolleagues.

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Communicates with and listens to others, recognising different perspectives. Empathises andtakes into account the needs and feelings of others. Gains and maintains trust and support.

Builds and maintains relationships with a range of individuals involved in delivering theservice. Manages sensitivities between individuals and groups.

Builds and nurtures trusting relationships at all levels within and across services andorganisational boundaries.

Builds and maintains sustainable strategic alliances across the system and other sectors.Has high impact when interacting with others at all levels.



2. Working with Others2.3 Encouraging Contribution

Leaders encourage contribution: creating anenvironment where others have the opportunity tocontribute.

Competent leaders:

• Provide encouragement, and the opportunity forpeople to engage in decision-making and tochallenge constructively

• Respect, value and acknowledge the roles,contributions and expertise of others

• Employ strategies to manage conflict of interest anddifferences of opinion

• Keep the focus of contribution on delivering andimproving services to patients.

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Seeks and acknowledges the views and input of others. Shows respect for thecontributions and challenges of others.

Creates a supportive environment which encourages others to express diverse opinions andengage in decision- making. Constructively challenges suggestions and reconcilesconflicting views.

Integrates the contributions of a diverse range of stakeholders, being open and honestabout the extent to which contributions can be acted upon.

Creates systems which encourage contribution throughout the organisation. Invites contribution from different sectors to bring about improvements.



2. Working with Others2.4 Working within Teams

Leaders work within teams: to deliver and improveservices.

Competent leaders:

• Have a clear sense of their role, responsibilities andpurpose within the team

• Adopt a team approach, acknowledging andappreciating efforts, contributions and compromises

• Recognise the common purpose of the team andrespect team decisions

• Are willing to lead a team, involving the right peopleat the right time.

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Understands roles, responsibilities and purpose within the team. Adopts a collaborativeapproach and respects team decisions.

Helps lead others towards common goals, providing clear objectives and offeringappropriate support. Shows awareness of team dynamics and acts to promote effectiveteam working. Appreciates the efforts of others.

Takes on recognised positional leadership roles within the organisation. Builds high performinginclusive teams that contribute to productive and efficient health and care services. Promotesautonomy and empowerment and maintains a sense of optimism and confidence.

Contributes to and leads senior teams. Enables others to take on leadershipresponsibilities, building high level leadership capability and capacity from a diverse rangeof backgrounds.



2. Working with OthersGeneric behaviours observed if individual is not yet demonstrating this domain:• Fails to network with others and/or allows relationships to deteriorate• Fails to win the support and respect of others• Does not encourage others to contribute ideas• Does not adopt a collaborative approach.

Examples in Practice for Working with Others:

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Student social worker B is on a practice placement with a qualified social worker in a large inner city GPpractice. Whilst working with an elderly Asian man who has been newly diagnosed with diabetes she becomesconscious of the culture and familial factors affecting the man’s treatment and maintenance. Her supervisorsuggests that she explores what other support might be available to him. B approaches Diabetes UK, the localCVS and seeks advice from a contact at the Gurdwara. She is able to put her client in touch with a self-helpgroup for people with diabetes and a worker at the local Indian community centre. Together they start aweekly luncheon group for Asian elders which provides help and support on a number of health issues. Thisgreatly improves the patient’s response to his illness and helps maintain good diabetes care.

Chief Speech and Language Therapist G spent time maintaining good working relationships with her team oftherapists by providing support and guidance. One of the ways she did this was organising monthly meetingsto share information and discuss issues. At one such meeting she encouraged a team member to share someservice descriptions which he had written up. She suggested these were used as a blueprint for writing up thistype of information in the future. Speech and Language Therapist G also identified an opportunity for amember of her team to work with her on a new assignment involving video fluoroscopy. It was an area thatthe team member had previously expressed an interest in and provided the individual with the opportunity totake a leading role on the assignment.

Associate Medical Director M supported Lead Clinicians, PCT Medical Directors, Medical Advisors andDirectorate Managers both within and outside the Trust in setting up an Acute Stroke Unit. Associate MedicalDirector M was involved in leading and chairing meetings to develop the business plan for the initiative. Heworked closely with colleagues over whom he had limited authority and was required to use his influencingskills to persuade people as to the benefits of the proposal. By communicating the Trust’s vision, explaininghow individuals and teams could contribute to the strategy, clarifying roles and drawing on his expertise, hewas able to help them understand how the new stroke unit would enable them to achieve their owndepartmental goals. When a difference of opinion arose as to how the Acute Stroke Unit should be co-ordinated, Associate Medical Director M set up a meeting to allow all stakeholders to discuss their perspectivesand debate alternative strategies rationally. He facilitated the discussion and mediated between conflictingopinions in such a way that a successful outcome was ultimately achieved.

Chief Allied Health Professions Officer Z’s role requires her to focus on external issues, collaborate withGovernment Ministers and translate policy into practical strategies for the delivery of allied health professionalservices across the Service. She engenders trust and support from others who may not report into her directlyby drawing on her personal credibility and superior influencing skills. She met with the allied healthprofessional leads within each of the regional strategic health authorities on a six weekly basis to share insightsand discuss issues around government policy. Working in partnership with these leads, Chief Allied HealthProfessions Officer Z guided them though the process of creating a narrative outlining how a governmentwhite paper was likely to impact on allied health professionals and the services they offered. She influencedthe leads by outlining the benefits arising from the white paper for patients and staff and the long-termconsequences of remaining with the status quo. She also talked through the drivers that were making changeinevitable. Chief Allied Health Professions Officer Z encouraged all allied health professional leads to worktogether and link up with general practitioner consortia to proactively demonstrate the value they could offerto patients.

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3. Managing Services

Effective leadership requires individuals to focus on the success of the organisation(s) in which they work.

To do so, they must be effective in:

• Planning

• Managing Resources

• Managing People

• Managing Performance.


3. Managing Services3.1 Planning

Leaders engage in planning: actively contributing toplans to achieve service goals.

Competent leaders:

• Support plans for services that are part of thestrategy for the wider healthcare system

• Gather feedback from patients, service users andcolleagues to help develop plans

• Contribute their expertise to planning processes

• Appraise options in terms of benefits and risks.

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Contributes ideas to service plans, incorporating feedback from others - including a diverserange of patients, service users and colleagues.

Works collaboratively to develop business cases and service plans that supportorganisational objectives, appraising them in terms of benefits and risks.

Leads service design and planning processes. Communicates and keeps others informed ofstrategic and operational plans, progress and outcomes.

Anticipates the impact of health trends and develops strategic plans that will have asignificant impact on the organisation and wider healthcare system. Ensures strategicobjectives are translated into operational plans.



3. Managing Services3.2 Managing Resources

Leaders manage resources: knowing what resourcesare available and using their influence to ensure thatresources are used efficiently and safely, and reflect thediversity of needs.

Competent leaders:

• Accurately identify the appropriate type and level ofresources required to deliver safe and effectiveservices

• Ensure services are delivered within allocatedresources

• Minimise waste

• Take action when resources are not being usedefficiently and effectively.

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Understands what resources are available and organises the appropriate type and level ofresources required to deliver safe and efficient services.

Identifies resource requirements associated with delivering services. Manages resources andtakes action to ensure their effective and efficient use.

Forecasts resource requirements associated with delivering complex services efficiently andeffectively. Manages resources taking into account the impact of national and local policiesand constraints.

Strategically manages resources across the organisation and wider healthcare system.



3. Managing Services3.3 Managing People

Leaders manage people: providing direction,reviewing performance, motivating others, andpromoting equality and diversity.

Competent leaders:

• Provide guidance and direction for others using theskills of team members effectively

• Review the performance of the team members toensure that planned service outcomes are met

• Support team members to develop their roles andresponsibilities

• Support others to provide good patient care andbetter services.

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Supports others in delivering high quality services and excellence in health and care.

Provides others with clear purpose and direction. Helps others in developing their roles andresponsibilities.

Motivates and coaches individuals and teams to strengthen their performance and assistthem with developing their own capabilities and skills. Aligns individual developmentneeds with service goals.

Inspires and supports leaders to mobilise diverse teams that are committed to and alignedwith organisational values and goals. Engages with and influences senior leaders and keystakeholders to deliver joined up services.



3. Managing Services3.4 Managing Performance

Leaders manage performance: holding themselvesand others accountable for service outcomes.

Competent leaders:

• Analyse information from a range of sources aboutperformance

• Take action to improve performance

• Take responsibility for tackling difficult issues

• Build learning from experience into future plans.

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Uses information and data about performance to identify improvements which willstrengthen services.

Works with others to set and monitor performance standards, addressing areas whereperformance objectives are not achieved.

Establishes rigorous performance measures. Holds self, individuals and teams to accountfor achieving performance standards. Challenges when service expectations are not beingmet and takes corrective action.

Promotes an inclusive culture that enables people to perform their best, ensuring thatappropriate performance management systems are in place and that performance data issystematically evaluated and fed into future plans.



3. Managing ServicesGeneric behaviours observed if individual is not yet demonstrating this domain:• Disorganised or unstructured approach to planning• Wastes resources or fails to monitor them effectively• Does not effectively manage and develop people• Fails to identify and address performance issues.

Examples in Practice for Managing Services:

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Biomedical Scientist Z was asked to get involved in trialling a new Clostridium difficile kit that would result inthe strengthening of service outcomes for patients. She conducted a risk assessment on the kit and analysedthe strengths and weaknesses of the product. This included assessing factors such as the speed and accuracyof diagnosis provided by the kit thereby helping to ensure that a cost effective, high quality product waspurchased. Biomedical Scientist Z used feedback from colleagues when considering how to test the efficiencyof the equipment. She compared the performance of the new kit with performance data from old kits andconducted a literature review on alternative options available to ensure she was up to date with the latestdevelopments in the field. Following the trial, the new kit was put into operation and the speed and accuracywith which patients were diagnosed improved significantly.

Deputy Physiotherapist Manager E undertook a service review of the Medical Assessment unit. By looking atdata on the types and numbers of patients seen and the staff cover required, she took the decision to split theunit into two sections. She met with the Medical Directorate team to ensure this met with their requirements.She created a business case for recruiting an additional team leader. Deputy Physiotherapist Manager E thensupported a member of her staff who volunteered to take on the role of team leader in the interim. She provided advice and encouragement to the individual who appeared to lack sufficient confidence dealingwith the complexities of the situation. When a misunderstanding occurred between two members of the team,Deputy Physiotherapist Manager E worked with the interim team manager to manage the situation before itescalated and impacted on service delivery.

After taking up his post, Head of Operations P found a disparate group of directorates each operatingindependently in ‘silos’ and not managing services in a joined up manner. Head of Operations P introducedweekly Business Operational and Performance (BOPS) meetings where he spent time listening to the views ofthe team and demonstrated that each had a valuable perspective which could benefit others in terms ofconsidering efficiencies. He noted that silo behaviour existed largely because the culture previously washierarchical and revolved around the professional status of each area. Head of Operations P developed a‘decision tree’ tool to assist team members with challenging their own thinking and helped them realise that asa group they were able to achieve more than they could on their own. As the team began to trust him andunderstood what he was trying to achieve he began to challenge them more as part of their ongoingdevelopment. Together the team began to jointly prioritise actions and looked at opportunities for sharingresources to help one another deliver a better quality service to patients.

Chief Nursing Officer P is involved in an initiative to increase the number of health professionals. This was inresponse to changing government policy brought about by an ageing UK population creating more demandfor services. She worked with colleagues to gather information from a range of parties including politicians,special advisors, trade union representatives and health visitors, to further understand governmentrequirements and establish future resourcing strategies. Her first priority was to formulate a governance modelto clearly communicate the purpose of the initiative. Chief Nursing Officer P then looked at developing asuccession planning strategy designed to co-ordinate future resourcing requirements with regional needs. This included debating and refining future strategic imperatives, establishing performance expectations andreviewing resources across regions.

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4. Improving Services

Effective leadership requires individuals to make a real difference to people’s health by delivering high qualityservices and by developing improvements to services. To do so, they much demonstrate effectiveness in:

• Ensuring Patient Safety

• Critically Evaluating

• Encouraging Improvement and Innovation

• Facilitating Transformation.


4. Improving Services4.1 Ensuring Patient Safety

Leaders ensure patient safety: assessing andmanaging the risk to patients associated with servicedevelopments, balancing economic considerationswith the need for patient safety.

Competent leaders:

• Identify and quantify the risk to patients usinginformation from a range of sources

• Use evidence, both positive and negative, to identifyoptions

• Use systematic ways of assessing and minimising risk

• Monitor the effects and outcomes of change.

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Puts the safety of patients and service users at the heart of their thinking in delivering andimproving services. Takes action to report or rectify shortfalls in patient safety.

Reviews practice to improve standards of patient safety and minimise risk. Monitors theimpact of service change on patient safety.

Develops and maintains audit and risk management systems which will drive serviceimprovement and patient safety.

Creates a culture that prioritises the health, safety and security of patients and serviceusers. Delivers assurance that patient safety underpins policies, processes and systems.



4. Improving Services4.2 Critically Evaluating

Leaders critically evaluate: being able to thinkanalytically, conceptually and to identify where servicescan be improved, working individually or as part of ateam.

Competent leaders:

• Obtain and act on patient, carer and service userfeedback and experiences

• Assess and analyse processes using up-to-dateimprovement methodologies

• Identify healthcare improvements and createsolutions through collaborative working

• Appraise options, and plan and take action toimplement and evaluate improvements.

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Uses feedback from patients, carers and service users to contribute to healthcareimprovements.

Engages with others to critically evaluate services and create ideas for improvements.

Synthesises complex information to identify potential improvements to services. Identifiespotential barriers to service improvement.

Benchmarks the wider organisation against examples of best practice in healthcare andother sectors. Evaluates options for improving services in line with future advances.



4. Improving Services4.3 Encouraging Improvement and Innovation

Leaders encourage improvement and innovation:creating a climate of continuous service improvement.

Competent leaders:

• Question the status quo

• Act as a positive role model for innovation

• Encourage dialogue and debate with a wide rangeof people

• Develop creative solutions to transform services andcare.

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Questions established practices which do not add value. Puts forward creative suggestionsto improve the quality of service provided.

Acts as a positive role model for innovation. Encourages dialogue and debate in thedevelopment of new ideas with a wide range of people.

Challenges colleagues’ thinking to find better and more effective ways of delivering servicesand quality. Accesses creativity and innovation from relevant individuals and groups.

Drives a culture of innovation and improvement. Integrates radical and innovative approachesinto strategic plans to make the NHS a leader in the provision of healthcare services.



4. Improving Services4.4 Facilitating Transformation

Leaders facilitate transformation: activelycontributing to change processes that lead to improvinghealthcare.

Competent leaders:

• Model the change expected

• Articulate the need for change and its impact onpeople and services

• Promote changes leading to systems redesign

• Motivate and focus a group to accomplish change.

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Articulates the need for changes to processes and systems, acknowledging the impact onpeople and services.

Focuses self and others on achieving changes to systems and processes which will lead toimproved services.

Energises others to drive change that will improve health and care services. Activelymanages the change process, drawing on models of effective change management.Recognises and addresses the impact of change on people and services.

Inspires others to take bold action and make important advances in how services aredelivered. Removes organisational obstacles to change and creates new structures andprocesses to facilitate transformation.



4. Improving ServicesGeneric behaviours observed if individual is not yet demonstrating this domain:• Overlooks the need to put patients at the forefront of their thinking• Does not question/evaluate current processes and practices• Maintains the status quo and sticks with traditional outdated ways of doing things• Fails to implement change or implements change for change’s sake.

Examples in Practice for Improving Services:

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Physician B has been undertaking a major piece of audit work on the management of thromboprophylaxis.Physician B worked with a local Thrombosis Committee to collect and critically evaluate data relating to care ofpatients with thrombosis and compared the results with a set of defined standards. Physician B presented the resultsto the Thrombosis Committee who had responsibility for implementing policies on the management ofthromboprophylaxis. He recommended changes suggesting that a number of adjustments be made to currentworking practices including creating risk assessment sheets for patients and modifying blood charts, to ensurepatient safety and improve patient outcomes.

Specialist Orthoptist F took responsibility for implementing a new eye screening programme aimed at providing highquality eye tests for school children with learning disabilities. He wrote a proposal on the advantages of providingclinics in schools and worked closely with school governors and head teachers to educate them of the benefits.Despite facing initial challenges, the eye screening programme was implemented. Specialist Orthoptist F evaluatedthe programme some months later, by conducting an audit. He asked parents to comment on the new set up andreceived very positive feedback. Children were seen more quickly and were less stressed due to being treated in achild friendly environment. Parents also commented on how much easier it was to attend appointments now thatthey were scheduled on school premises.

Directorate Senior Business Manager T used his experience outside of the NHS to bring a fresh perspective todealing with service delivery improvements. He encouraged clinical staff to develop a mindset that viewed patientsin a broader sense as ‘customers’ rather than as just NHS patients. Directorate Senior Business Manager Tchallenged staff by asking them if a customer in another industry would be satisfied with waiting for a product forthirty weeks. After discussions with the team he identified that there were poor data systems in place. To achieve a‘quick win’ he asked his team to implement a cost effective tracking system that documented the patient’s journeyand helped identify where there were potential bottlenecks with processing patients through the system. Thetracking system was well received by staff and patients who saw tangible benefits in terms of time and moneysavings as well as increased patient satisfaction. Other areas within the NHS have subsequently asked about howthey might make use of this cost effective, easy to design tracking system.

Associate Medical Director S led a national initiative to transform emergency care through the delivery of ambulatoryemergency care to eliminate the need for overnight stay for certain conditions. The impact and benefits of thewidespread adoption of this would be comparable to the adoption of day-case surgery which has transformedinpatient elective surgical services. Dr S observed the delivery of ambulatory emergency care in a range of hospitalsover a two year period and identified 49 clinical scenarios where early senior assessment by a competent clinicaldecision-maker would result in immediate diagnosis, treatment and rapid discharge, avoiding the need for anovernight stay. He estimated that approximately 22 per cent of current non-elective admissions with at least oneovernight stay could be managed in this way with a potential saving to the NHS of up to £350 million annually, as aconservative estimate. Dr S published these clinical scenarios in the Directory of Ambulatory Emergency Care forAdults which was adopted as one of the national quality indicators and is well supported by professional bodies as amodel of care which is deliverable. All scenarios in the directory have evidence for the concept and the evidencebase for effectiveness and safety is building over time. Dr S now also has a role as Clinical Lead of the EmergencyCare Intensive Support Team in which he supports and encourages others to transform their clinical practice inemergency services. He estimates that 60-70 per cent of units have already changed their practice and have startedto implement the concept of ambulatory emergency care as described within the Directory.

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5. Setting Direction

Effective leadership requires individuals to contribute to the strategy and aspirations of the organisation andact in a manner consistent with its values. To do so, they must demonstrate effectiveness in:

• Identifying the Contexts for Change

• Applying Knowledge and Evidence

• Making Decisions

• Evaluating Impact.


5. Setting Direction5.1 Identifying the Contexts for Change

Leaders identify the contexts for change: beingaware of the range of factors to be taken into account.

Competent leaders:

• Demonstrate awareness of the political, social,technical, economic, organisational and professionalenvironment

• Understand and interpret relevant legislation andaccountability frameworks

• Anticipate and prepare for the future by scanningfor ideas, best practice and emerging trends that willhave an impact on health outcomes

• Develop and communicate aspirations.

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Understands the range of factors which determine why changes are made.

Identifies the external and internal drivers of change and communicates the rationale forchange to others.

Actively seeks to learn about external factors which will impact on services. Interprets themeaning of these for services and incorporates them into service plans and actions.

Synthesises knowledge from a broad range of sources. Identifies future challenges andimperatives that will create the need for change and move the organisation and the widerhealthcare system in new directions. Influences the context for change in the best interestsof services and service users.



5. Setting Direction5.2 Applying Knowledge and Evidence

Leaders apply knowledge and evidence: gatheringinformation to produce an evidence-based challengeto systems and processes in order to identifyopportunities for service improvements.

Competent leaders:

• Use appropriate methods to gather data andinformation

• Carry out analysis against an evidence-based criteriaset

• Use information to challenge existing practices andprocesses

• Influence others to use knowledge and evidence toachieve best practice.

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Gathers data and information about aspects of the service, analyses evidence and uses thisknowledge to suggest changes that will improve services in the future.

Obtains and analyses information about services and pathways to inform future direction.Supports and encourages others to use knowledge and evidence to inform decisions aboutthe future of services.

Understands the complex interdependencies across a range of services. Applies knowledge to set future direction.

Uses knowledge, evidence and experience of national and international developments inhealth and social care to influence the future development of health and care services.



5. Setting Direction5.3 Making Decisions

Leaders make decisions: using their values, and theevidence, to make good decisions.

Competent leaders:

• Participate in and contribute to organisationaldecision-making processes

• Act in a manner consistent with the values andpriorities of their organisation and profession

• Educate and inform key people who influence andmake decisions

• Contribute their unique perspective to team,department, system and organisational decisions.

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Consults with others and contributes to decisions about the future direction/vision of theirservice.

Involves key people and groups in making decisions. Actively engages in formal andinformal decision-making processes about the future of services.

Remains accountable for making timely decisions in complex situations. Modifies decisionsand flexes direction when faced with new information or changing circumstances.

Ensures that corporate decision-making is rigorous and takes account of the full range offactors impinging on the future direction of the organisation and the wider healthcaresystem. Can operate without all the facts. Takes unpopular decisions when in the bestinterests of health and care in the long term.



5. Setting Direction5.4 Evaluating Impact

Leaders evaluate impact: measuring and evaluatingoutcomes, taking corrective action where necessaryand by being held to account for their decisions.

Competent leaders:

• Test and evaluate new service options

• Standardise and promote new approaches

• Overcome barriers to implementation

• Formally and informally disseminate good practice.

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Assesses the effects of change on service delivery and patient outcomes. Makes recommendations for future improvements.

Evaluates and embeds approaches and working methods which have proved to beeffective into the working practices of teams and individuals.

Identifies gains which can be applied elsewhere in the organisation and incorporates these intooperational/business plans. Disseminates learning from changes which have been introduced.

Synthesises learning arising from changes which have been introduced and incorporatesthese into strategic plans. Shares learning with the wider health and care community.



5. Setting DirectionGeneric behaviours observed if individual is not yet demonstrating this domain:• Unaware of political, social, technical, economic, organisational factors that impact on the future of the

service /organisation• Does not use an evidence-base for decision-making• Makes poor decisions about the future• Fails to evaluate the impact of previous decisions and actions.

Examples in Practice for Setting Direction:

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Learning and Development Coordinator D learned of new national guidance regarding information governancewhich required all staff to undertake annual training in data protection. D had been aware of high profile caseswhere data protection measures had been inadequate and reported in the press, from sectors other than the NHS,and understood the importance of training to prevent similar occurrences within her trust. D identified thatcompliance with training in data protection in the trust was only 13 per cent and agreed a target to increase this to95 per cent over an eight month period. She introduced mandatory training to achieve this. She regularlymonitored attendance rates, updated managers with statistical data about uptake and worked hard to raiseawareness of the importance of training. After just six months the compliance rate reached 64 per cent and wasexpected to reach the target on time. As a result of this initiative, the uptake of statutory training overall increasedacross the trust, and training has been reconfigured to achieve even higher attendance rates.

Falls Lead K realised that the local ambulance service was ideal for identifying people prone to falling. Fromfeedback he received from physiotherapists and the falls team, he constructed a questionnaire to collect details ofthe patient and their fall. When they deal with a person who has fallen, all of the ambulance officers now fax aform to the falls team, which assesses patients and refers them to physiotherapy as needed. Providingphysiotherapy for these patients led to the number of repeat falls being reduced, close to 4,000 fewer falls victims ayear. Comprehensive risk assessments have been effective in eliminating a lot of trolley waits, bed days and returnvisits to hospital. This reduction in falls has saved the ambulance service more than £400,000 in 18 months, moneythat has been redirected into improving existing services.

Clinical services lead V is working for a community health service and has become aware that a new contract toprovide a service to tackle adult obesity among the borough’s ethnically diverse communities was being put out totender. He led work with physiotherapists, dietitians, psychologists, sports medicine clinicians and a local charity todevelop and submit a joint bid. This focused its business case on addressing obesity through community-basedactivity, optimising integrated models of care and achieving long-term financial advantages through ill-healthprevention to demonstrate value and cost-effectiveness. The central initiative within the proposal was forprofessional staff to train lay community figures within the charity to provide information on exercise to clients, andfor outcome measures to be implemented at the start and end of the programme. The joint bid was awarded atender for a year.

Dr K is a senior partner in a GP practice which had been one of the first wave pathfinder consortia for GPcommissioning. He identified the need for clinicians from across a range of professions to develop a new kind ofcollegiate network outside existing membership organisations, which would share learning and best practice duringthe early stages of GP commissioning. He was concerned that the development and implementation of GPcommissioning should be done in a way which accurately reflected policy and which used the experience ofclinicians. Dr K took on the additional role of National Clinical Commissioning Network Lead and, over a period of10 months, identified 400 clinical leaders from across the country and supported them to become activeparticipants in the network which was used to exchange views, share success stories and information about localchallenges. Stories about how services had been changed and improved through GP commissioning could beaccessed via the network very quickly, providing rapid feedback on progress, and a collective voice for primary careto speak directly to policy makers. Dr K’s success in this venture is based upon high credibility amongst his clinicalcolleagues, the respect he has earned from others, and his accessibility to those he supports within the network.

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6. Creating the Vision

Effective leadership involves creating a compelling vision for the future, and communicating this within andacross organisations. This requires individuals to demonstrate effectiveness in:

• Developing the Vision for the Organisation

• Influencing the Vision of the Wider Healthcare System

• Communicating the Vision

• Embodying the Vision.


6. Creating the Vision6.1 Developing the Vision for the Organisation

Those in senior positional leadership roles develop thevision for the organisation, looking to the future todetermine the direction for the organisation. They:

• Actively engage with colleagues and key influencers,including patients and public, about the future ofthe organisation

• Broadly scan and analyse the full range of factorsthat will impact upon the organisation, to createlikely scenarios for its future

• Create a vision which is bold, innovative andreflects the core values of the NHS

• Continuously ensure that the organisation’s vision iscompatible with future developments within thewider healthcare system.

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Actively engages a diverse range of key stakeholders in creating a bold, innovative, sharedvision which reflects the future needs and aspirations of the population and the futuredirection of health and care services. Thinks broadly and aligns the vision to the NHS corevalues and the values of the wider healthcare system.



6. Creating the Vision6.2 Influencing the Vision of the WiderHealthcare System

Those in senior positional leadership roles work withpartners across organisations to influence the visionof the wider healthcare system. They:

• Seek opportunities to engage in debate about thefuture of health and care related services

• Work in partnership with others in the healthcaresystem to develop a shared vision

• Negotiate compromises in the interests of betterpatient services

• Influence key decision-makers who determine futuregovernment policy that impacts on the NHS and itsservices.

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Actively participates in and leads on debates about the future of health, wellbeing andrelated services. Manages political interests, balancing tensions between organisationalaspirations and the wider environment. Shapes and influences local, regional and nationalhealth priorities and agendas.



6. Creating the Vision6.3 Communicating the Vision

Those in senior positional leadership rolescommunicate the vision and motivate others towork towards achieving it. They:

• Communicate their ideas and enthusiasm about thefuture of the organisation and its servicesconfidently and in a way which engages and inspiresothers

• Express the vision clearly, unambiguously andvigorously

• Ensure that stakeholders within and beyond theimmediate organisation are aware of the vision andany likely impact it may have on them

• Take time to build critical support for the vision andensure it is shared and owned by those who will becommunicating it.

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Clearly communicates the vision in a way that engages and empowers others. Uses enthusiasm and energy to inspire others and encourage joint ownership of the vision.Anticipates and constructively addresses challenge.



6. Creating the Vision6.4 Embodying the Vision

Those in senior positional leadership roles embodythe vision by behaving in ways which are entirelyconsistent with the vision and values of theorganisation. They:

• Act as a role model, behaving in a manner whichreflects the values and principles inherent in thevision

• Demonstrate confidence, self belief, tenacity andintegrity in pursuing the vision

• Challenge behaviours which are not consistent withthe vision

• Identify symbols, rituals and routines within theorganisation which are not consistent with thevision, and replace them with ones that are.

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Consistently displays passion for the vision and demonstrates personal commitment to itthrough their day-to-day actions. Uses personal credibility to act as a convincing advocatefor the vision.



6. Creating the VisionGeneric behaviours observed if individual is not yet demonstrating this domain:• Does not involve others in creating and defining the vision• Does not align their vision with the wider health and care agenda• Misses opportunities to communicate and share understanding of the vision with others• Lacks enthusiasm and commitment for driving the vision.

Examples in Practice for Creating the Vision:

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While the prime responsibility for Creating the Vision rests with senior leaders, it is expected that staff at all stageswill contribute to the vision of the organisation by offering their perspective and professional judgment. Staff atstages 1 and 2 are often those closest to patients and service users which puts them in a unique position to ensurethat patients’ best interests are represented in the organisation’s vision.

Deputy Director of Nursing Quality & Workforce has been working with the Executive team to help determinewhether the existing vision for her area remained relevant in the light of future changes to the way the NHS wouldoperate. This involved conducting a gap analysis to identify where her team needed to be both in the short andlonger-term and establish whether the existing vision and strategy was suitable for achieving organisational goals.Reviews were organised and different stakeholder groups were encouraged to contribute to determining whatservices should be provided to patients and how the services should be structured and run. Deputy Director ofNursing Quality & Workforce helped the groups consider the interdependencies between nursing, social servicesand the local authority and how this impacted on the provision of future services. She identified that far more focusneeded to be placed on quality and safety than had been the case in the past. She involved her staff in developingvalue and culture statements for the service to align them with the future vision and strategy. She also set up aninnovative and experimental Chief Executive blog which allowed staff to receive regular updates on the strategy.This proved to be a successful initiative as it enabled staff to access and respond to real-time messages from theChief Executive about the future of the organisation.

Director of Primary Care Improvement X has worked with the executive team on the formulation of a primary careand community services vision for the future. She outlined how she helped review the strategy ensuring that itaccounted for key themes such as patient empowerment, quality, prevention and leadership. She spent timespeaking to staff to share a national perspective on issues. Ten road shows were conducted to support local deliveryand make the strategy relevant within a regional context. Using her knowledge acquired through going to events,making visits and attending small meetings she was able to provide a unique holistic perspective on the NHS thatdemonstrated her understanding of issues at the grassroots level. Director of Primary Improvement X showedresilience when answering objections relating to issues such as uncertainty about the future and reframed them in away that made others aware of the need, and encouraged them, to take appropriate risks and operate outside oftheir comfort zones.

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7. Delivering the Strategy

Effective leadership involves delivering the strategy by developing and agreeing strategic plans that placepatient care at the heart of the service, and ensuring that these are translated into achievable operationalplans. This requires individuals to demonstrate effectiveness in:

• Framing the Strategy

• Developing the Strategy

• Developing the Strategy

• Embedding the Strategy.


7. Delivering the Strategy7.1 Framing the Strategy

Those in senior positional leadership roles identifystrategic options for the organisation and draw upon awide range of information, knowledge and experiencein order to frame the strategy. They:

• Take account of the culture, history and long termunderlying issues for the organisation

• Use sound organisational theory to inform thedevelopment of strategy

• Identify best practice which can be applied to theorganisation

• Identify strategic options which will deliver theorganisation’s vision.

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Critically reviews relevant thinking, ideas and best practice and applies whole systemsthinking in order to conceptualise a strategy in line with the vision.



7. Delivering the Strategy7.2 Developing the Strategy

Those in senior positional leadership roles engage withcolleagues and key stakeholders to develop theorganisation’s strategy. They:

• Engage with key individuals and groups to formulatestrategic plans to meet the vision

• Strive to understand others’ agendas, motivationsand drivers in order to develop strategy which issustainable

• Create strategic plans which are challenging yetrealistic and achievable

• Identify and mitigate uncertainties and risksassociated with strategic choices.

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Integrates the views of a broad range of stakeholders to develop a coherent, joined up andsustainable strategy. Assesses organisational readiness for change. Manages the risks,political sensitivities and environmental uncertainties involved.



7. Delivering the Strategy7.3 Implementing the Strategy

Those in senior positional leadership roles areentrepreneurial in that they organise, manage andassume the risks of the organisation in order toimplement the strategy. They:

• Ensure that strategic plans are translated intoworkable operational plans, identifying risks, criticalsuccess factors and evaluation measures

• Identify and strengthen organisational capabilitiesrequired to deliver the strategy

• Establish clear accountability for the delivery of allelements of the strategy, hold people to accountand expect to be held to account themselves

• Respond quickly and decisively to developmentswhich require a change in strategy.

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Responds constructively to challenge. Puts systems, structures, processes, resources andplans in place to deliver the strategy. Establishes accountabilities and holds people in local,regional, and national structures to account for jointly delivering strategic and operationalplans. Demonstrates flexibility when changes required.



7. Delivering the Strategy7.4 Embedding the Strategy

Those in senior positional leadership roles embed thestrategy, ensuring that strategic plans are achievedand sustained. They:

• Support and inspire others responsible for deliveringstrategic and operational plans, helping them toovercome obstacles and challenges, and to remainfocused

• Create a consultative organisational culture tosupport delivery of the strategy and to drivestrategic change within the wider healthcare system

• Establish a climate of transparency and trust whereresults are discussed openly

• Monitor and evaluate strategic outcomes, makingadjustments to ensure sustainability of the strategy.

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Enables and supports the conditions and culture needed to sustain changes integral to thesuccessful delivery of the strategy. Keeps momentum alive by reinforcing key messages,monitoring progress and recognising where the strategy has been embraced by others.Evaluates outcomes and uses learnings to adapt strategic and operational plans.



7. Delivering the StrategyGeneric behaviours observed if individual is not yet demonstrating this domain:• Does not align the strategy with local, national and/or wider health care system requirements• Works to develop the strategy in isolation without input or feedback from others• Absolves oneself of responsibility for holding others to account• Fails to enable an organisational culture that embraces the strategy.

Examples in Practice for Delivering the Strategy:

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While the ultimate accountability for Delivering the Strategy rests with senior leaders, the actual delivery of strategyis undertaken by everyone in the organisation and it is everyone’s responsibility to ensure that their plans andactions are in line with and contribute to the organisation’s goals.

Associate Medical Director R took steps to ensure that his organisation was compliant with the Chief Executive’sstrategy to meet new national policy guidelines around best practice in delivering high quality patient care. This initiative was important as the reputation of the organisation was linked to a successful outcome. A number ofprocesses and procedures were identified as being below standard. A particular issue that proved to be challengingwas getting commitment to implement basic procedures such as using World Health Organisation (WHO)checklists. A climate existed where staff failed to recognise the importance of the issue and in some cases felt thatthe matter was not pertinent to their circumstances. Associate Medical Director R used meetings to reinforce hismessage, presented statistical results, shared real stories highlighting the impact of non-compliance on patients andencouraged professional teams to work together as a single integrated unit. His approach resonated with his targetaudience and contributed to compliance data improving with 95 per cent of WHO checklists being used effectivelyby staff. However, a further area for improvement was identified which was making effective use of checklists atthe patient checkout stage. Associate Medical Director R took prompt action and, with the support of his teams,considered devolving the checkout stage of the process to middle grade doctors and theatre staff or anaesthetistsas a possible solution. Ultimately the option chosen was successful and his overall approach was highly valued bythe Chief Executive.

Chief Executive Officer P has adopted a long term perspective on issues when reconfiguring maternity services in hisregion. Reconfiguration of maternity services involved moving from thirteen sites down to eight sites as part of arationalisation process. The rationale for this reconfiguration of services was to provide a better overall service to thecommunity and save lives as well as reduce waste. Chief Executive Officer P spent time acknowledging concernsand the perspectives of different parties in various forums. He needed to be particularly sensitive given that thedecision had a significant political dimension to it. Constituents for eight Members of Parliament (MPs) wrote toParliament and the press saying that they were unhappy about the prospect of losing their local maternity unit as aresult of the proposed reconfiguration. Chief Executive Officer P’s approach was to spend time consulting with theMPs, the local community and other interested parties and lay out the case for change based on ethical argumentsaround patient safety as well as by providing a sound business and financial rationale for his approach. ChiefExecutive Officer P described how he communicated his views in an open and honest manner and showed awillingness to meet community representatives face-to-face to discuss issues as well as face cross examination fromthe media on television. All of these actions built credibility and trust with stakeholders and ensured the processwas viewed as being consultative in nature, transparent and fair. Key to building partnerships was spending timeliaising and engaging with the wider public service and local authorities. This included finding outcomes that wouldbe of benefit to all parties and would in turn help drive the initiative forward with broad support.


AcknowledgementsThe NLC would like to thank the many individuals who have contributed to development of the NHSLeadership Framework:

Department of HealthJan Sobieraj, Director of LeadershipStephen Collins, Deputy Director of Talent and LeadershipAnne Hackett*, Workforce Leadership Team - Policy Lead

Elizabeth Manero, Lay advisorMike Medas, Lay advisor

SHA Leadership Leads#: Martin Lewis, Caroline Wigley,Peter Lees, Deborah McKenzie, Elaine Readhead, RachelMunton, Amanda Grindall

National Leadership CouncilDr Mark Goldman, Programme Lead, Clinical LeadershipWorkstream Theresa Nelson*, Programme Director, Clinical LeadershipWorkstream Kim Orlandini*, Programme Manager, Clinical LeadershipWorkstreamSimon Bird, Associate Director, Top Leaders WorkstreamKaren Lynas, Programme Director, Top Leaders WorkstreamDeborah Chafer#, Programme Director, Emerging LeadersWorkstreamPaul Harrison#, Programme Director, Inclusion WorkstreamCaroline Stanger#, Programme Director, GP CommissioningWorkstreamDavid Baron, Programme Director Provision Workstream

Rachel Abraham, Associate Director of Education, ImperialCollege London

Christine Bamford, Director of Leadership Development,National Leadership and Innovation Agency for Healthcare,Wales

Louise Barden, Secretariat, NLC

Maree Barnett, Head of Non-Medical Revalidation, DH

Amit Bose, Policy Manager, Dental and Eye Care, DH

Andrew Butcher, Director, Workforce Strategy, Skills forHealth

Chris Caldwell, Assistant Director of Education andOrganisational Development/Assistant Chief Nurse, GreatOrmond Street Hospital for Children NHS Trust, London

Ingrid Clayden, Director for Health Workforce, Scottish Government

John Cowie, Deputy Director - Health Workforce, Scottish Government

Alison Croad, Policy Officer, Health Professions Council

Marc Davis, Associate Programme Director, CommissioningLeadership, NLC

Carolyn Davison, Emerging Leader (Nurse Consultant), NLC

David Hutton, Nursing Adviser, Nursing and MidwiferyPolicy and Standards, Nursing and Midwifery Council

Peter Gregg, Head of Education and Training Unit,Department of Health and Social Services, Northern Ireland

Patricia Hamilton, Director of Medical Education, DH

Lisa Hughes, Allied Health Professions Manager, DH

Mark Humble, Leadership Development Manager, LondonSHA

Rachel Kirkwood, Accreditation Pilot Lead, NLC/NHS WestMidlands

Penny Lewis, LeAD Manager E-learning for Healthcare,Tony and Penny Lewis Associates

Hazel Mackenzie, Health Workforce, Scottish Government

Rona McCandlish, Midwifery Professional Advisor, DH

Deborah McKenzie, Leadership Lead, London SHA

Claire Marshall, Emerging Leader (Head of PhysiotherapyServices), NLC

Debbie Mellor, Deputy Director, Workforce Education, DH

David Murphy, Senior Leadership and OrganisationDevelopment Manager, National Leadership InnovationAgency for Health Care

Simon Plint, GP Senior Clinical Advisor/Dean of MedicalCommissioning Workforce, Education & Leadership, DHMMC Team/South Central SHA

Jerry Read, Project Lead Oral Health, DH

Patricia Saunders, Programme Manager, NHS MedicalDirectorate, DH

National Leadership Council Clinical Leadership Framework and Accreditation Steering Board*

*indicates someone who also sits on the Steering Board, but is categorised under a different group above.# indicates someone who is also a SHA Leadership Lead, but is categorised under a different group above.


Leadership Framework Development Team, NHS Institute for Innovation and Improvement

Sue Mortlock*, Head of Board Development

Paul W Long*, Project Director, CLCF Project

Professor John Clark*, Director of Medical Leadership

Professor Peter Spurgeon*, Project Director, EEMLProject

Sue Balderson, Project Advisor

Tracy Lonetto*, Project Manager, CLCF Project

Sabhia Sheikh, Associate, Board Development

And colleagues from Right Management

Organisations and groups consulted

Allied Health Professions Federation

Ambulance Service Education Leads

Ambulance Training College

Ambulance Trust CEs Group

Ambulance Trust National HR Directors Group

Association of British Dispensing Opticians

Association of Clinical Scientists (ACS)

Association of Optometrists

Association of Professional Music Therapists

British and Irish Orthoptic Society

British Association of Art Therapists

British Association of Dramatherapists

British Association of Prosthetists and Orthotists

British Dental Association

British Dietetic Association

British Healthcare Trades Association (BHTA) OrthoticsSection

British Psychoanalytic Council

Centre for Pharmacy Postgraduate Education

Chartered Society of Physiotherapy

College of Occupational Therapists

College of Operating Department Practitioners

College of Optometrists

College of Paramedics

Department for Health and Social Services, Wales

Department of Health and Community Care, Scotland

Department of Health, England

Department of Health, Social Services and Public Safety,Northern Ireland

Federation of Healthcare Scientists

Federation of Ophthalmic and Dispensing Opticians

General Dental Council

General Medical Council

General Optical Council

General Pharmaceutical Council

Health Professions Council

Institute of Biomedical Science

Lead Midwife for Education Strategic Reference Group

Local Supervising Authority Midwifery Officers

Midwifery 2020

National Leadership Council Clinical LeadershipFramework and Accreditation Steering Board

National Leadership Council, England

National Skills Academy for Social Care

NHS Institute for Innovation and Improvement

Nursing and Midwifery Council

Royal College of Midwives

Royal College of Nursing

Royal College of Speech and Language Therapists

Royal Pharmaceutical Society of Great Britain

Skills for Health

Social Care Institute for Excellence

The British Psychological Society

The Council of Deans of Health

The Council of University Heads of Pharmacy

The Dental Schools Council

The Institute of Chiropodists & Podiatrists

The Society & College of Radiographers

The Society of Chiropodists & Podiatrists


Relevant readingThis document is designed to be read and used in conjunction with relevant professional and servicedocuments such as policy, curricula guidance, standards and frameworks related to education andtraining, learning and development activity and performance assessment tools. A selection is included below:

British Association of Arts Therapists, Suggestions from council on curriculum content

British Dietetic Association (2008) Curriculum framework for the pre-registration education and training of dietitians

British and Irish Orthoptic Society (2008) BIOS guidelines for implementing preceptorship

British and Irish Orthoptic Society HNS KSF - outline for Orthoptist Band 5

British Psychological Society (2010) Clinical Psychology Leadership Development Framework July 2010

Charan, R, S Drotter and J Noel (2001) The Leadership Pipeline: How to Build the Leadership Powered Company

Chartered Society of Physiotherapy (2011) CSP Physiotherapy Framework

Chartered Society of Physiotherapy (2011) CSP Learning & Development Principles

College of Occupational Therapists (2006) Post Qualifying Framework: A Resource for Occupational Therapists

College of Occupational Therapists (2009 revised edition) The College of Occupational Therapists’ CurriculumGuidance for Pre-Registration Education

College of Operating Department Practitioners (2009) BSc in Operating Department Practice Curriculum Document

College of Optometrists (2009) Scheme for Registration Trainee Handbook 2009

College of Optometrists (2009) Assessment Framework Optometrists

College of Paramedics (2008) Paramedic Curriculum Guidance and Competence Framework, 2nd edition

Committee of Postgraduate Dental Deans and Directors (2006) A Curriculum for UK Dental Foundation ProgrammeTraining

College of Podiatrists and the Society of Chiropodists and Podiatrists (2008) Regulations and guidance for theaccreditation of pre-registration education programmes in Podiatry leading to eligibility for membership of TheSociety of Chiropodists and Podiatrists Handbook, Edition 2

Department of Health (2010) The NHS Knowledge and Skills Framework (NHS KSF) and the Development ReviewProcess

Department of Health (2008) High Quality Care for All: NHS Next Stage Review Final Report

Department of Health (2010) Equity and Excellence: Liberating the NHS (White Paper)

Department of Health (2009) Transforming Community Services: Enabling New Patterns of Provision

Department of Health (2010) Modernising Scientific Careers: The UK Way Forward

Department of Health (2010) Planning and Developing the NHS Workforce: The National Framework

Department of Health (2010) Building a Safe and Confident Future: Implementing the Recommendations of theSocial Work Task Force

Department of Health (2010) Pharmacy in England: Building On Strengths – Delivering the Future (White Paper)

Department of Health (2008) Modernising Allied Health Professions (AHP) Careers: a Competence-based CareerFramework


Department of Health (2010) Preceptorship Framework for Newly Registered Nurses, Midwives and Allied HealthProfessionals

General Dental Council (2010) Outcomes for Registration

General Medical Council (2009) Tomorrow’s Doctors: Outcomes and Standards for Undergraduate MedicalEducation

Gitsham, M. (2009) Developing the Global Leaders of Tomorrow. Ashridge Business School and the EuropeanAcademy of Business in Society

Gronn, P. (2008) The Future of Distributed Leadership, Journal of Educational Administration, 46(2), 141-58

Hartley, J. and Bennington, J. (2010) Leadership for Healthcare. Policy Press: Bristol

Health Professions Council (2009) Standards of Education and Training

Health Professions Council (Various) Standards of Proficiency

Health Professions Council (2008) Standards of Conduct, Performance and Ethics

Health Professions Council (2005) Standards for Continuing Professional Development July 2005

Heifetz, R. and Laurie, D. (2009) Review: The Work of Leadership by Heifetz and Laurie. The Welsh NHSConfederation

Midwifery 2010 Midwifery 2020 – Delivering Expectations

MMC Inquiry (2008) Aspiring to Excellence: Final Report of the Independent Enquiry into Modernising MedicalCareers

Mott MacDonald (2010) Literature Review: Leadership Frameworks. Mott MacDonald: Bolton

National Skills Academy Social Care (2009) Leadership and Management Prospectus

National Skills Academy Social Care (2010) Overview and Key Messages May 2010

NHS Institute for Innovation and Improvement (2006) NHS Leadership Qualities Framework

NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2010) Medical LeadershipCompetency Framework, 3rd edition

NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2010) Shared Leadership:Underpinning of the MLCF

NHS Scotland (2009) Delivering Quality Through Leadership: NHS Scotland Leadership Development Strategy

Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education: draft for consultation

Royal College of Speech and Language Therapists (2007) Speech and Language Therapy Competency Frameworkto Guide Transition to Full RCSLT Membership

Royal College of Speech and Language Therapists CPD Framework - Human and Financial Leadership andResource Management

Skills for Care and Development (2009) Health and Social Care – National Occupational Standards

Skills for Health, Shape a Quality Nursing Workforce

Society and College of Radiographers (2007) Learning and Development Framework for Clinical Imaging andOncology

Society and College of Radiographers (2010) Education and Professional Development Strategy: New Directions

Society and College of Radiographers (2005) A Framework for Professional Leadership in Clinical Imaging andRadiotherapy and Oncology Services


Spurgeon, P., Clark. J., and Ham, C. (2011) Medical Leadership: From the Dark Side to Centre Stage, OxfordRadcliffe Press: Oxford

Stanton, E., Lemer, C. and Mountford, J. (eds) (2010) Clinical Leadership: Bridging the divide. Quay Books: London

Tamkin, P., Pearson, G., Hirsh, W. and Constable, S. (2010) Exceeding Expectation: the Principles of OutstandingLeadership. The Work Foundation

Wilson, A., Lenssen, G., and Hind, P. (2007) Leadership Qualities and Management Competencies for CorporateResponsibility. Ashridge Business School and the European Academy of Business in Society


Appendix IThe NHS Knowledge and Skills Framework

The NHS Knowledge and Skills Framework (KSF) was re-launched in 2010 in a simplified form, designed to be aflexible tool and adaptable for local use. The new KSF focuses on the core dimensions and links to the NHSLeadership Framework particularly in the areas of communication, personal and people development, serviceimprovement, quality and equality and diversity. The KSF also includes a new optional dimension on managementand leadership (http://www.nhsemployers.org/PayAndContracts/AgendaForChange/KSF/Simplified-KSF/Pages/SimplifiedKSF.aspx) which sets out concisely the knowledge and skills required for leadership across fourlevels of the KSF and so relates well in summary form to the NHS Leadership Framework. It also includes indicatorsto help organisations identify whether the knowledge and skills of the dimension are present in the organisation.

To view a visual representation of what the KSF and the NHS Leadership Framework have in common, pleasevisit: www.nhsleadership.org.uk/framework.asp


App

endi

x II:

The

follo

win

g ta

bles

com

bine

the

indi

catio

n of

beh

avio

urs

at d

iffer

ent

lead

ersh

ip s

tage

s fr

om e

ach

dom

ain

sect

ion.

Ple

ase

refe

r to

the

ful

l dom

ain

page

s fo

r th

e el

emen

t de

scrip

tors

. 1. D

EMO

NST

RA

TIN

G P

ERSO

NA

L Q

UA

LITI

ESEf

fect

ive

lead

ersh

ip r

equi

res

indi

vidu

als

to d

raw

upo

n th

eir

valu

es, s

tren

gths

and

abi

litie

s to

del

iver

hig

h st

anda

rds

of s

ervi

ce. T

o do

so,

the

y m

ust

dem

onst

rate

eff

ectiv

enes

s in

dem

onst

ratin

g se

lf aw

aren

ess,

man

agin

g th

emse

lves

, con

tinui

ng t

heir

pers

onal

dev

elop

men

t an

d ac

ting

with

inte

grity

.

Elem

ent

1O

wn

Prac

tice/

Imm

edia

te T

eam

2W

hole

Ser

vice

/Acr

oss

Team

s3

Acr

oss

Serv

ices

/Wid

er O

rgan

isatio

n4

Who

le O

rgan

isatio

n/W

ider

H

ealth

care

Sys

tem

1.1

Dev

elo

pin

g S

elf

Aw

aren

ess

Refle

cts

on h

ow fa

ctor

s su

ch a

s ow

nva

lues

, pre

judi

ces

and

emot

ions

influ

ence

thei

r jud

gem

ent,

beha

viou

r and

sel

f bel

ief.

Use

s fe

edba

ck fr

om a

ppra

isals

and

othe

rso

urce

s to

con

sider

per

sona

l im

pact

and

chan

ge b

ehav

iour

. U

nder

stan

ds p

erso

nal

sour

ces

of s

tres

s.

App

reci

ates

the

impa

ct t

hey

have

on

othe

rs a

nd t

he im

pact

oth

ers

have

on

them

. Rou

tinel

y se

eks

feed

back

and

adap

ts t

heir

beha

viou

r ap

prop

riate

ly.

Refle

cts

on t

heir

inte

ract

ions

with

a w

ide

and

dive

rse

rang

e of

indi

vidu

als

and

grou

ps f

rom

with

in a

nd b

eyon

d th

eir

imm

edia

te s

ervi

ce/o

rgan

isat

ion.

Cha

lleng

es a

nd r

efre

shes

ow

n va

lues

,be

liefs

, lea

ders

hip

styl

es a

nd a

ppro

ache

s.O

vert

ly r

ole

mod

els

the

givi

ng a

ndre

ceiv

ing

of f

eedb

ack.

Use

s so

phist

icat

ed to

ols

and

sour

ces

toco

ntin

uous

ly le

arn

abou

t the

ir le

ader

ship

impa

ct in

the

wid

er h

ealth

and

car

eco

mm

unity

and

impr

ove

thei

ref

fect

iven

ess

as a

sen

ior l

eade

r.U

nder

stan

ds h

ow p

ress

ures

ass

ocia

ted

with

car

ryin

g ou

t a h

igh

prof

ile ro

le im

pact

on th

em a

nd th

eir p

erfo

rman

ce.

1.2

Man

agin

g Y

ou

rsel

fPl

ans

and

man

ages

ow

n tim

e ef

fect

ivel

yan

d fu

lfils

wor

k re

quire

men

ts a

ndco

mm

itmen

ts to

a h

igh

stan

dard

, with

out

com

prom

ising

ow

n he

alth

and

wel

lbei

ng.

Rem

ains

cal

m a

nd fo

cuse

d un

der p

ress

ure.

Ensu

res

that

ow

n w

ork

plan

s an

dpr

iorit

ies

fit w

ith t

he n

eeds

of

othe

rsin

volv

ed in

del

iver

ing

serv

ices

.D

emon

stra

tes

flexi

bilit

y an

d se

nsiti

vity

to

serv

ice

requ

irem

ents

and

rem

ains

asse

rtiv

e in

pur

suin

g se

rvic

e go

als.

Succ

essf

ully

man

ages

a r

ange

of

pers

onal

and

org

anis

atio

nal d

eman

dsan

d pr

essu

res.

Dem

onst

rate

s te

naci

tyan

d re

silie

nce.

Ove

rcom

es s

etba

cks

whe

re g

oals

can

not

be a

chie

ved

and

quic

kly

refo

cuse

s. I

s vi

sibl

e an

dac

cess

ible

to

othe

rs.

Rem

ains

focu

sed

on s

trat

egic

goa

ls w

hen

face

d w

ith c

ompe

ting

and,

at t

imes

,co

nflic

ting

dem

ands

aris

ing

from

diff

erin

gpr

iorit

ies.

Iden

tifie

s w

here

they

nee

d to

pers

onal

ly g

et in

volv

ed to

ach

ieve

the

mos

t ben

efit

for t

he o

rgan

isatio

n an

dw

ider

hea

lthca

re s

yste

m.

1.3

Co

nti

nu

ing

Per

son

alD

evel

op

men

tTa

kes

resp

onsib

ility

for o

wn

pers

onal

deve

lopm

ent a

nd s

eeks

opp

ortu

nitie

s fo

rle

arni

ng.

Striv

es to

put

lear

ning

into

prac

tice.

Puts

sel

f fo

rwar

d fo

r ch

alle

ngin

gas

sign

men

ts a

nd p

roje

cts

whi

ch w

illde

velo

p st

reng

ths

and

addr

ess

deve

lopm

ent

area

s.

Act

s as

an

exem

plar

for

oth

ers

inm

anag

ing

thei

r co

ntin

uous

per

sona

lde

velo

pmen

t. F

acili

tate

s th

ede

velo

pmen

t of

a le

arni

ng c

ultu

re.

Dev

elop

s th

roug

h sy

stem

atic

ally

sca

nnin

gth

e ex

tern

al e

nviro

nmen

t and

exp

lorin

gle

adin

g ed

ge th

inki

ng a

nd b

est p

ract

ice.

App

lies

lear

ning

to b

uild

and

refr

esh

the

serv

ice.

Tre

ats

chal

leng

e as

a p

ositi

ve fo

rce

for i

mpr

ovem

ent.

1.4

Act

ing

wit

h In

teg

rity

Beha

ves

in a

n op

en, h

ones

t and

incl

usiv

em

anne

r, up

hold

ing

pers

onal

and

orga

nisa

tiona

l eth

ics

and

valu

es.

Show

s re

spec

t for

the

need

s of

oth

ers

and

prom

otes

equ

ality

and

div

ersit

y.

Act

s as

a r

ole

mod

el f

or o

ther

s in

dem

onst

ratin

g in

tegr

ity a

ndin

clus

iven

ess

in a

ll as

pect

s of

the

ir w

ork.

Cha

lleng

es w

here

org

anis

atio

nal v

alue

sar

e co

mpr

omis

ed.

Cre

ates

an

open

, hon

est

and

incl

usiv

ecu

lture

in a

ccor

danc

e w

ith c

lear

prin

cipl

es a

nd v

alue

s. E

nsur

es e

quity

of

acce

ss t

o se

rvic

es a

nd c

reat

es a

nen

viro

nmen

t w

here

peo

ple

from

all

back

grou

nds

can

exce

l.

Ass

ures

sta

ndar

ds o

f int

egrit

y ar

em

aint

aine

d ac

ross

the

serv

ice

and

com

mun

icat

es th

e im

port

ance

of a

lway

sad

optin

g an

eth

ical

and

incl

usiv

e ap

proa

ch.

Gen

eric

beh

avio

urs

ob

serv

ed if

ind

ivid

ual

is n

ot

yet

dem

on

stra

tin

g t

his

do

mai

n:

• D

oes

not

unde

rsta

nd o

wn

emot

ions

or

reco

gnis

e th

e im

pact

of

own

beha

viou

r on

oth

ers

• A

ppro

ache

s ta

sks

in a

dis

orga

nise

d w

ay a

nd p

lans

are

not

rea

listic

• U

nabl

e to

dis

cuss

ow

n st

reng

ths

and

deve

lopm

ent

need

s an

d sp

ends

litt

le t

ime

on d

evel

opm

ent

• D

emon

stra

tes

beha

viou

rs t

hat

are

coun

ter

to c

ore

valu

es o

f op

enne

ss, i

nclu

sive

ness

, ho

nest

y an

deq

ualit

y•

Lac

ks c

onfid

ence

in o

wn

abili

ties

to d

eliv

er r

esul

ts


2. W

OR

KIN

G W

ITH

OTH

ERS

Effe

ctiv

e le

ader

ship

req

uire

s in

divi

dual

s to

wor

k w

ith o

ther

s in

tea

ms

and

netw

orks

to

deliv

er a

nd im

prov

e se

rvic

es. T

his

requ

ires

the

m t

o de

mon

stra

te e

ffec

tiven

ess

inde

velo

ping

net

wor

ks, b

uild

ing

and

mai

ntai

ning

rel

atio

nshi

ps, e

ncou

ragi

ng c

ontr

ibut

ion,

and

wor

king

with

in t

eam

s.

Elem

ent

1O

wn

Prac

tice/

Imm

edia

te T

eam

2W

hole

Ser

vice

/Acr

oss

Team

s3

Acr

oss

Serv

ices

/Wid

er O

rgan

isatio

n4

Who

le O

rgan

isatio

n/W

ider

H

ealth

care

Sys

tem

2.1

Dev

elo

pin

g N

etw

ork

sId

entif

ies

whe

re w

orki

ng a

nd c

oope

ratin

gw

ith o

ther

s ca

n re

sult

in b

ette

r ser

vice

s.En

deav

ours

to w

ork

colla

bora

tivel

y.

Use

s ne

twor

ks t

o br

ing

indi

vidu

als

and

grou

ps t

oget

her

to s

hare

info

rmat

ion

and

reso

urce

s an

d to

ach

ieve

goa

ls.

Iden

tifie

s an

d bu

ilds

effe

ctiv

e ne

twor

ksw

ith a

ran

ge o

f in

fluen

tial s

take

hold

ers

inte

rnal

and

ext

erna

l to

the

orga

nisa

tion.

Wor

ks a

cros

s bo

unda

ries

crea

ting

netw

orks

whi

ch fa

cilit

ate

high

leve

ls of

colla

bora

tion

with

in a

nd a

cros

sor

gani

satio

ns a

nd s

ecto

rs.

2.2

Bu

ildin

g a

nd

Mai

nta

inin

gR

elat

ion

ship

sC

omm

unic

ates

with

and

list

ens

to o

ther

s,re

cogn

ising

diff

eren

t per

spec

tives

.Em

path

ises

and

take

s in

to a

ccou

nt th

ene

eds

and

feel

ings

of o

ther

s. G

ains

and

mai

ntai

ns tr

ust a

nd s

uppo

rt.

Build

s an

d m

aint

ains

rel

atio

nshi

ps w

ith a

rang

e of

indi

vidu

als

invo

lved

inde

liver

ing

the

serv

ice.

Man

ages

sens

itivi

ties

betw

een

indi

vidu

als

and

grou

ps.

Build

s an

d nu

rtur

es t

rust

ing

rela

tions

hips

at a

ll le

vels

with

in a

nd a

cros

s se

rvic

esan

d or

gani

satio

nal b

ound

arie

s.

Build

s an

d m

aint

ains

sus

tain

able

str

ateg

ical

lianc

es a

cros

s th

e sy

stem

and

oth

erse

ctor

s. H

as h

igh

impa

ct w

hen

inte

ract

ing

with

oth

ers

at a

ll le

vels.

2.3

Enco

ura

gin

gC

on

trib

uti

on

Seek

s an

d ac

know

ledg

es th

e vi

ews

and

inpu

t of o

ther

s. S

how

s re

spec

t for

the

cont

ribut

ions

and

cha

lleng

es o

f oth

ers.

Cre

ates

a s

uppo

rtiv

e en

viro

nmen

t w

hich

enco

urag

es o

ther

s to

exp

ress

div

erse

opin

ions

and

eng

age

in d

ecis

ion-

mak

ing.

Con

stru

ctiv

ely

chal

leng

essu

gges

tions

and

rec

onci

les

conf

lictin

gvi

ews.

Inte

grat

es t

he c

ontr

ibut

ions

of

a di

vers

era

nge

of s

take

hold

ers,

bei

ng o

pen

and

hone

st a

bout

the

ext

ent

to w

hich

cont

ribut

ions

can

be

acte

d up

on.

Cre

ates

sys

tem

s w

hich

enc

oura

geco

ntrib

utio

n th

roug

hout

the

orga

nisa

tion.

Invi

tes

cont

ribut

ion

from

diff

eren

t sec

tors

to b

ring

abou

t im

prov

emen

ts.

2.4

Wo

rkin

g w

ith

in T

eam

sU

nder

stan

ds ro

les,

resp

onsib

ilitie

s an

dpu

rpos

e w

ithin

the

team

. A

dopt

s a

colla

bora

tive

appr

oach

and

resp

ects

team

deci

sions

.

Hel

ps le

ad o

ther

s to

war

ds c

omm

ongo

als,

pro

vidi

ng c

lear

obj

ectiv

es a

ndof

ferin

g ap

prop

riate

sup

port

. Sh

ows

awar

enes

s of

tea

m d

ynam

ics

and

acts

to

prom

ote

effe

ctiv

e te

am w

orki

ng.

App

reci

ates

the

eff

orts

of

othe

rs.

Take

s on

rec

ogni

sed

posi

tiona

l lea

ders

hip

role

s w

ithin

the

org

anis

atio

n. B

uild

shi

gh p

erfo

rmin

g in

clus

ive

team

s th

atco

ntrib

ute

to p

rodu

ctiv

e an

d ef

ficie

nthe

alth

and

car

e se

rvic

es.

Prom

otes

auto

nom

y an

d em

pow

erm

ent

and

mai

ntai

ns a

sen

se o

f op

timis

m a

ndco

nfid

ence

.

Con

trib

utes

to a

nd le

ads

seni

or te

ams.

Enab

les

othe

rs to

take

on

lead

ersh

ipre

spon

sibili

ties,

bui

ldin

g hi

gh le

vel

lead

ersh

ip c

apab

ility

and

cap

acity

from

adi

vers

e ra

nge

of b

ackg

roun

ds.

Gen

eric

beh

avio

urs

ob

serv

ed if

ind

ivid

ual

is n

ot

yet

dem

on

stra

tin

g t

his

do

mai

n:

• F

ails

to

netw

ork

with

oth

ers

and/

or a

llow

s re

latio

nshi

ps t

o de

terio

rate

• Fa

ils t

o w

in t

he s

uppo

rt a

nd r

espe

ct o

f ot

hers

• D

oes

not

enco

urag

e ot

hers

to

cont

ribut

e id

eas

• D

oes

not

adop

t a

colla

bora

tive

appr

oach


3. M

AN

AG

ING

SER

VIC

ESEf

fect

ive

lead

ersh

ip r

equi

res

indi

vidu

als

to f

ocus

on

the

succ

ess

of t

he o

rgan

isat

ion(

s) in

whi

ch t

hey

wor

k. T

his

requ

ires

them

to

be e

ffec

tive

in p

lann

ing,

man

agin

g re

sour

ces,

man

agin

g pe

ople

and

man

agin

g pe

rfor

man

ce.

Elem

ent

1O

wn

Prac

tice/

Imm

edia

te T

eam

2W

hole

Ser

vice

/Acr

oss

Team

s3

Acr

oss

Serv

ices

/Wid

er O

rgan

isatio

n4

Who

le O

rgan

isatio

n/W

ider

H

ealth

care

Sys

tem

3.1

Plan

nin

gC

ontr

ibut

es id

eas

to s

ervi

ce p

lans

,in

corp

orat

ing

feed

back

from

oth

ers

-in

clud

ing

a di

vers

e ra

nge

of p

atie

nts,

serv

ice

user

s an

d co

lleag

ues.

Wor

ks c

olla

bora

tivel

y to

dev

elop

busi

ness

cas

es a

nd s

ervi

ce p

lans

tha

tsu

ppor

t or

gani

satio

nal o

bjec

tives

,ap

prai

sing

the

m in

ter

ms

of b

enef

its a

ndris

ks.

Lead

s se

rvic

e de

sign

and

pla

nnin

gpr

oces

ses.

Com

mun

icat

es a

nd k

eeps

othe

rs in

form

ed o

f st

rate

gic

and

oper

atio

nal p

lans

, pro

gres

s an

dou

tcom

es.

Ant

icip

ates

the

impa

ct o

f hea

lth tr

ends

and

deve

lops

str

ateg

ic p

lans

that

will

hav

ea

signi

fican

t im

pact

on

the

orga

nisa

tion

and

wid

er h

ealth

care

sys

tem

. En

sure

sst

rate

gic

obje

ctiv

es a

re tr

ansla

ted

into

oper

atio

nal p

lans

.

3.2

Man

agin

g R

eso

urc

esU

nder

stan

ds w

hat r

esou

rces

are

ava

ilabl

ean

d or

gani

ses

the

appr

opria

te ty

pe a

ndle

vel o

f res

ourc

es re

quire

d to

del

iver

saf

ean

d ef

ficie

nt s

ervi

ces.

Iden

tifie

s re

sour

ce r

equi

rem

ents

asso

ciat

ed w

ith d

eliv

erin

g se

rvic

es.

Man

ages

res

ourc

es a

nd t

akes

act

ion

toen

sure

the

ir ef

fect

ive

and

effic

ient

use

.

Fore

cast

s re

sour

ce r

equi

rem

ents

asso

ciat

ed w

ith d

eliv

erin

g co

mpl

exse

rvic

es e

ffic

ient

ly a

nd e

ffec

tivel

y.M

anag

es r

esou

rces

tak

ing

into

acc

ount

the

impa

ct o

f na

tiona

l and

loca

l pol

icie

san

d co

nstr

aint

s.

Stra

tegi

cally

man

ages

reso

urce

s ac

ross

the

orga

nisa

tion

and

wid

er h

ealth

care

sys

tem

.

3.3

Man

agin

g P

eop

leSu

ppor

ts o

ther

s in

del

iver

ing

high

qua

lity

serv

ices

and

exc

elle

nce

in h

ealth

and

car

e.Pr

ovid

es o

ther

s w

ith c

lear

pur

pose

and

dire

ctio

n. H

elps

oth

ers

in d

evel

opin

gth

eir

role

s an

d re

spon

sibi

litie

s.

Mot

ivat

es a

nd c

oach

es in

divi

dual

s an

dte

ams

to s

tren

gthe

n th

eir

perf

orm

ance

and

assi

st t

hem

with

dev

elop

ing

thei

row

n ca

pabi

litie

s an

d sk

ills.

Alig

nsin

divi

dual

dev

elop

men

t ne

eds

with

serv

ice

goal

s.

Insp

ires

and

supp

orts

lead

ers

to m

obili

sedi

vers

e te

ams

that

are

com

mitt

ed to

and

alig

ned

with

org

anisa

tiona

l val

ues

and

goal

s. E

ngag

es w

ith a

nd in

fluen

ces

seni

orle

ader

s an

d ke

y st

akeh

olde

rs to

del

iver

join

ed u

p se

rvic

es.

3.4

Man

agin

gPe

rfo

rman

ceU

ses

info

rmat

ion

and

data

abo

utpe

rfor

man

ce to

iden

tify

impr

ovem

ents

whi

ch w

ill s

tren

gthe

n se

rvic

es.

Wor

ks w

ith o

ther

s to

set

and

mon

itor

perf

orm

ance

sta

ndar

ds, a

ddre

ssin

g ar

eas

whe

re p

erfo

rman

ce o

bjec

tives

are

not

achi

eved

.

Esta

blis

hes

rigor

ous

perf

orm

ance

mea

sure

s. H

olds

sel

f, in

divi

dual

s an

dte

ams

to a

ccou

nt f

or a

chie

ving

perf

orm

ance

sta

ndar

ds. C

halle

nges

whe

n se

rvic

e ex

pect

atio

ns a

re n

ot b

eing

met

and

tak

es c

orre

ctiv

e ac

tion.

Prom

otes

an

incl

usiv

e cu

lture

that

ena

bles

peop

le to

per

form

to th

eir b

est,

ensu

ring

that

app

ropr

iate

per

form

ance

man

agem

ent s

yste

ms

are

in p

lace

and

that

perf

orm

ance

dat

a is

syst

emat

ical

lyev

alua

ted

and

fed

into

futu

re p

lans

.

Gen

eric

beh

avio

urs

ob

serv

ed if

ind

ivid

ual

is n

ot

yet

dem

on

stra

tin

g t

his

do

mai

n:

• D

isor

gani

sed

or u

nstr

uctu

red

appr

oach

to

plan

ning

• W

aste

s re

sour

ces

or f

ails

to

mon

itor

them

eff

ectiv

ely

• D

oes

not

effe

ctiv

ely

man

age

and

deve

lop

peop

le•

Fai

ls t

o id

entif

y an

d ad

dres

s pe

rfor

man

ce is

sues


4. IM

PRO

VIN

G S

ERV

ICES

Effe

ctiv

e le

ader

ship

req

uire

s in

divi

dual

s to

mak

e a

real

diff

eren

ce t

o pe

ople

’s he

alth

by

deliv

erin

g hi

gh q

ualit

y se

rvic

es a

nd b

y de

velo

ping

impr

ovem

ents

to

serv

ices

. Thi

s re

quire

sth

em t

o de

mon

stra

te e

ffec

tiven

ess

in e

nsur

ing

patie

nt s

afet

y, c

ritic

ally

eva

luat

ing,

enc

oura

ging

impr

ovem

ent

and

inno

vatio

n an

d f

acili

tatin

g tr

ansf

orm

atio

n.

Elem

ent

1O

wn

Prac

tice/

Imm

edia

te T

eam

2W

hole

Ser

vice

/Acr

oss

Team

s3

Acr

oss

Serv

ices

/Wid

er O

rgan

isatio

n4

Who

le O

rgan

isatio

n/W

ider

H

ealth

care

Sys

tem

4.1

Ensu

rin

g P

atie

nt

Safe

tyPu

ts th

e sa

fety

of p

atie

nts

and

serv

ice

user

s at

the

hear

t of t

heir

thin

king

inde

liver

ing

and

impr

ovin

g se

rvic

es.

Take

sac

tion

to re

port

or r

ectif

y sh

ortf

alls

inpa

tient

saf

ety.

Revi

ews

prac

tice

to im

prov

e st

anda

rds

ofpa

tient

saf

ety

and

min

imis

e ris

k.M

onito

rs t

he im

pact

of

serv

ice

chan

geon

pat

ient

saf

ety.

Dev

elop

s an

d m

aint

ains

aud

it an

d ris

km

anag

emen

t sy

stem

s w

hich

will

driv

ese

rvic

e im

prov

emen

t an

d pa

tient

saf

ety.

Cre

ates

a c

ultu

re th

at p

riorit

ises

the

heal

th, s

afet

y an

d se

curit

y of

pat

ient

s an

dse

rvic

e us

ers.

Del

iver

s as

sura

nce

that

patie

nt s

afet

y un

derp

ins

polic

ies,

pro

cess

esan

d sy

stem

s.

4.2

Cri

tica

lly E

valu

atin

gU

ses

feed

back

from

pat

ient

s, c

arer

s an

dse

rvic

e us

ers

to c

ontr

ibut

e to

hea

lthca

reim

prov

emen

ts.

Enga

ges

with

oth

ers

to c

ritic

ally

eva

luat

ese

rvic

es a

nd c

reat

e id

eas

for

impr

ovem

ents

.

Synt

hesi

ses

com

plex

info

rmat

ion

toid

entif

y po

tent

ial i

mpr

ovem

ents

to

serv

ices

. Id

entif

ies

pote

ntia

l bar

riers

to

serv

ice

impr

ovem

ent.

Benc

hmar

ks th

e w

ider

org

anisa

tion

agai

nst e

xam

ples

of b

est p

ract

ice

inhe

alth

care

and

oth

er s

ecto

rs.

Eval

uate

sop

tions

for i

mpr

ovin

g se

rvic

es in

line

with

futu

re a

dvan

ces.

4.3

Enco

ura

gin

gIm

pro

vem

ent

and

Inn

ova

tio

n

Que

stio

ns e

stab

lishe

d pr

actic

es w

hich

do

not a

dd v

alue

. Put

s fo

rwar

d cr

eativ

esu

gges

tions

to im

prov

e th

e qu

ality

of

serv

ice

prov

ided

.

Act

s as

a p

ositi

ve r

ole

mod

el f

orin

nova

tion.

Enc

oura

ges

dial

ogue

and

deba

te in

the

dev

elop

men

t of

new

idea

sw

ith a

wid

e ra

nge

of p

eopl

e.

Cha

lleng

es c

olle

ague

s’ t

hink

ing

to f

ind

bett

er a

nd m

ore

effe

ctiv

e w

ays

ofde

liver

ing

serv

ices

and

qua

lity.

Acc

esse

scr

eativ

ity a

nd in

nova

tion

from

rel

evan

tin

divi

dual

s an

d gr

oups

.

Driv

es a

cul

ture

of i

nnov

atio

n an

dim

prov

emen

t. In

tegr

ates

radi

cal a

ndin

nova

tive

appr

oach

es in

to s

trat

egic

pla

nsto

mak

e th

e N

HS

wor

ld c

lass

in th

epr

ovisi

on o

f hea

lthca

re s

ervi

ces.

4.4

Faci

litat

ing

Tran

sfo

rmat

ion

Art

icul

ates

the

need

for c

hang

es to

proc

esse

s an

d sy

stem

s, a

ckno

wle

dgin

g th

eim

pact

on

peop

le a

nd s

ervi

ces.

Focu

ses

self

and

othe

rs o

n ac

hiev

ing

chan

ges

to s

yste

ms

and

proc

esse

s w

hich

will

lead

to

impr

oved

ser

vice

s.

Ener

gise

s ot

hers

to

driv

e ch

ange

tha

t w

illim

prov

e he

alth

and

car

e se

rvic

es.

Act

ivel

y m

anag

es t

he c

hang

e pr

oces

s,dr

awin

g on

mod

els

of e

ffec

tive

chan

gem

anag

emen

t. R

ecog

nise

s an

d ad

dres

ses

the

impa

ct o

f ch

ange

on

peop

le a

ndse

rvic

es.

Insp

ires

othe

rs to

take

bol

d ac

tion

and

mak

e im

port

ant a

dvan

ces

in h

ow s

ervi

ces

are

deliv

ered

. Re

mov

es o

rgan

isatio

nal

obst

acle

s to

cha

nge

and

crea

tes

new

stru

ctur

es a

nd p

roce

sses

to fa

cilit

ate

tran

sfor

mat

ion.

Gen

eric

beh

avio

urs

ob

serv

ed if

ind

ivid

ual

is n

ot

yet

dem

on

stra

tin

g t

his

do

mai

n:

• O

verlo

oks

the

need

to

put

patie

nts

at t

he f

oref

ront

of

thei

r th

inki

ng•

Doe

s no

t qu

estio

n/ev

alua

te c

urre

nt p

roce

sses

and

pra

ctic

es•

Mai

ntai

ns t

he s

tatu

s qu

o an

d st

icks

with

tra

ditio

nal o

utda

ted

way

s of

doi

ng t

hing

s•

Fai

ls t

o im

plem

ent

chan

ge o

r im

plem

ents

cha

nge

for

chan

ge’s

sake


5. S

ETTI

NG

DIR

ECTI

ON

Effe

ctiv

e le

ader

ship

req

uire

s in

divi

dual

s to

con

trib

ute

to t

he s

trat

egy

and

aspi

ratio

ns o

f th

e or

gani

satio

n an

d ac

t in

a m

anne

r co

nsis

tent

with

its

valu

es. T

his

requ

ires

them

to

dem

onst

rate

eff

ectiv

enes

s in

iden

tifyi

ng t

he c

onte

xts

for

chan

ge, a

pply

ing

know

ledg

e an

d ev

iden

ce, m

akin

g de

cisi

ons,

and

eva

luat

ing

impa

ct.

Elem

ent

1O

wn

Prac

tice/

Imm

edia

te T

eam

2W

hole

Ser

vice

/Acr

oss

Team

s3

Acr

oss

Serv

ices

/Wid

er O

rgan

isatio

n4

Who

le O

rgan

isatio

n/W

ider

H

ealth

care

Sys

tem

5.1

Iden

tify

ing

th

eC

on

text

s fo

r C

han

ge

Und

erst

ands

the

rang

e of

fact

ors

whi

chde

term

ine

why

cha

nges

are

mad

e.Id

entif

ies

the

exte

rnal

and

inte

rnal

driv

ers

of c

hang

e an

d co

mm

unic

ates

the

ratio

nale

for

cha

nge

to o

ther

s.

Act

ivel

y se

eks

to le

arn

abou

t ex

tern

alfa

ctor

s w

hich

will

impa

ct o

n se

rvic

es.

Inte

rpre

ts t

he m

eani

ng o

f th

ese

for

serv

ices

and

inco

rpor

ates

the

m in

tose

rvic

e pl

ans

and

actio

ns.

Synt

hesis

es k

now

ledg

e fr

om a

bro

adra

nge

of s

ourc

es.

Iden

tifie

s fu

ture

chal

leng

es a

nd im

pera

tives

that

will

cre

ate

the

need

for c

hang

e an

d m

ove

the

orga

nisa

tion

and

the

wid

er h

ealth

care

syst

em in

new

dire

ctio

ns. I

nflu

ence

s th

eco

ntex

t for

cha

nge

in th

e be

st in

tere

sts

ofse

rvic

es a

nd s

ervi

ce u

sers

.

5.2

Ap

ply

ing

Kn

ow

led

ge

and

Evid

ence

Gat

hers

dat

a an

d in

form

atio

n ab

out

aspe

cts

of th

e se

rvic

e, a

naly

ses

evid

ence

and

uses

this

know

ledg

e to

sug

gest

chan

ges

that

will

impr

ove

serv

ices

in th

efu

ture

.

Obt

ains

and

ana

lyse

s in

form

atio

n ab

out

serv

ices

and

pat

hway

s to

info

rm f

utur

edi

rect

ion.

Sup

port

s an

d en

cour

ages

othe

rs t

o us

e kn

owle

dge

and

evid

ence

to in

form

dec

isio

ns a

bout

the

fut

ure

ofse

rvic

es.

Und

erst

ands

the

com

plex

inte

rdep

ende

ncie

s ac

ross

a r

ange

of

serv

ices

. A

pplie

s kn

owle

dge

to s

etfu

ture

dire

ctio

n.

Use

s kn

owle

dge,

evi

denc

e an

dex

perie

nce

of n

atio

nal a

nd in

tern

atio

nal

deve

lopm

ents

in h

ealth

and

soc

ial c

are

toin

fluen

ce th

e fu

ture

dev

elop

men

t of

heal

th a

nd c

are

serv

ices

.

5.3

Mak

ing

Dec

isio

ns

Con

sults

with

oth

ers

and

cont

ribut

es to

deci

sions

abo

ut th

e fu

ture

dire

ctio

n/vi

sion

of th

eir s

ervi

ce.

Invo

lves

key

peo

ple

and

grou

ps in

mak

ing

deci

sion

s. A

ctiv

ely

enga

ges

info

rmal

and

info

rmal

dec

isio

n-m

akin

gpr

oces

ses

abou

t th

e fu

ture

of

serv

ices

.

Rem

ains

acc

ount

able

for

mak

ing

timel

yde

cisi

ons

in c

ompl

ex s

ituat

ions

. M

odifi

esde

cisi

ons

and

flexe

s di

rect

ion

whe

nfa

ced

with

new

info

rmat

ion

or c

hang

ing

circ

umst

ance

s.

Ensu

res

that

cor

pora

te d

ecisi

on-m

akin

g is

rigor

ous

and

take

s ac

coun

t of t

he fu

llra

nge

of fa

ctor

s im

ping

ing

on th

e fu

ture

dire

ctio

n of

the

orga

nisa

tion

and

the

wid

er h

ealth

care

sys

tem

. Can

ope

rate

with

out a

ll th

e fa

cts.

Tak

es u

npop

ular

deci

sions

whe

n in

the

best

inte

rest

s of

heal

th a

nd c

are

in th

e lo

ng te

rm.

5.4

Eval

uat

ing

Imp

act

Ass

esse

s th

e ef

fect

s of

cha

nge

on s

ervi

cede

liver

y an

d pa

tient

out

com

es.

Mak

esre

com

men

datio

ns fo

r fut

ure

impr

ovem

ents

.

Eval

uate

s an

d em

beds

app

roac

hes

and

wor

king

met

hods

whi

ch h

ave

prov

ed t

obe

eff

ectiv

e in

to t

he w

orki

ng p

ract

ices

of t

eam

s an

d in

divi

dual

s.

Iden

tifie

s ga

ins

whi

ch c

an b

e ap

plie

del

sew

here

in t

he o

rgan

isat

ion

and

inco

rpor

ates

the

se in

to o

pera

tiona

l/bu

sine

ss p

lans

. Dis

sem

inat

es le

arni

ngfr

om c

hang

es w

hich

hav

e be

enin

trod

uced

.

Synt

hesis

es le

arni

ng a

risin

g fr

om c

hang

esw

hich

hav

e be

en in

trod

uced

and

inco

rpor

ates

thes

e in

to s

trat

egic

pla

ns.

Shar

es le

arni

ng w

ith th

e w

ider

hea

lth a

ndca

re c

omm

unity

.

Gen

eric

beh

avio

urs

ob

serv

ed if

ind

ivid

ual

is n

ot

yet

dem

on

stra

tin

g t

his

do

mai

n:

• U

naw

are

of p

oliti

cal,

soci

al, t

echn

ical

, eco

nom

ic, o

rgan

isat

iona

l fac

tors

tha

t im

pact

on

the

futu

re o

fth

e se

rvic

e/or

gani

satio

n•

Doe

s no

t us

e an

evi

denc

e-ba

se f

or d

ecis

ion-

mak

ing

• M

akes

poo

r de

cisi

ons

abou

t th

e fu

ture

• F

ails

to

eval

uate

the

impa

ct o

f pr

evio

us d

ecis

ions

and

act

ions


6. C

REA

TIN

G T

HE

VIS

ION

Thos

e in

sen

ior

posi

tiona

l lea

ders

hip

role

s cr

eate

a c

ompe

lling

vis

ion

for

the

futu

re, a

nd c

omm

unic

ate

this

with

in a

nd a

cros

s or

gani

satio

ns. T

his

requ

ires

them

to

dem

onst

rate

effe

ctiv

enes

s in

dev

elop

ing

the

visi

on f

or t

he o

rgan

isat

ion,

influ

enci

ng t

he v

isio

n of

the

wid

er h

ealth

care

sys

tem

, com

mun

icat

ing

the

visi

on a

nd e

mbo

dyin

g th

e vi

sion

.

Elem

ent

ELEM

ENT

DES

CR

IPTO

RS

(see

als

o p

ages

43-

47)

4W

hole

Org

anis

atio

n/W

ider

Hea

lthca

re S

yste

m

6.1

Dev

elo

pin

g t

he

Vis

ion

for

the

Org

anis

atio

n•

Act

ivel

y en

gage

with

col

leag

ues

and

key

influ

ence

rs, i

nclu

ding

pat

ient

s an

d pu

blic

,ab

out t

he fu

ture

of t

he o

rgan

isatio

n

•Br

oadl

y sc

an a

nd a

naly

se th

e fu

ll ra

nge

of fa

ctor

s th

at w

ill im

pact

upo

n th

eor

gani

satio

n, to

cre

ate

likel

y sc

enar

ios

for i

ts fu

ture

•C

reat

e a

visio

n w

hich

is b

old,

inno

vativ

e a

nd re

flect

s th

e co

re v

alue

s of

the

NH

S

•C

ontin

uous

ly e

nsur

es th

at th

e or

gani

satio

n’s

visio

n is

com

patib

le w

ith fu

ture

deve

lopm

ents

with

in th

e w

ider

hea

lthca

re s

yste

m

Act

ivel

y en

gage

s ke

y st

akeh

olde

rs in

cre

atin

g a

bold

, inn

ovat

ive,

sha

red

visio

n w

hich

refle

cts

the

futu

re n

eeds

and

asp

iratio

ns o

f the

pop

ulat

ion

and

the

futu

re d

irect

ion

ofhe

alth

care

. Th

inks

bro

adly

and

alig

ns th

e vi

sion

to th

e N

HS

core

val

ues

and

the

valu

es o

fth

e w

ider

hea

lthca

re s

yste

m.

6.2

Infl

uen

cin

g V

isio

n in

th

eW

ider

Hea

lth

care

Sys

tem

•Se

ek o

ppor

tuni

ties

to e

ngag

e in

deb

ate

abou

t the

futu

re o

f hea

lth a

nd c

are

rela

ted

serv

ices

•W

ork

in p

artn

ersh

ip w

ith o

ther

s in

the

heal

thca

re s

yste

m to

dev

elop

a s

hare

d vi

sion

•N

egot

iate

com

prom

ises

in th

e in

tere

sts

of b

ette

r pat

ient

ser

vice

s

•In

fluen

ce k

ey d

ecisi

on-m

aker

s w

ho d

eter

min

e fu

ture

gov

ernm

ent p

olic

y th

at im

pact

son

the

NH

S an

d its

ser

vice

s

Act

ivel

y pa

rtic

ipat

es in

and

lead

s on

deb

ates

abo

ut th

e fu

ture

of h

ealth

, wel

lbei

ng a

ndre

late

d se

rvic

es.

Man

ages

pol

itica

l int

eres

ts, b

alan

cing

tens

ions

bet

wee

n or

gani

satio

nal

aspi

ratio

ns a

nd th

e w

ider

env

ironm

ent.

Sha

pes

and

influ

ence

s lo

cal,

regi

onal

and

natio

nal h

ealth

prio

ritie

s an

d ag

enda

s.

6.3

Co

mm

un

icat

ing

th

eV

isio

n•

Com

mun

icat

e th

eir i

deas

and

ent

husia

sm a

bout

the

futu

re o

f the

org

anisa

tion

and

itsse

rvic

es c

onfid

ently

and

in a

way

whi

ch e

ngag

es a

nd in

spire

s ot

hers

•Ex

pres

s th

e vi

sion

clea

rly, u

nam

bigu

ously

and

vig

orou

sly

•En

sure

that

sta

keho

lder

s w

ithin

and

bey

ond

the

imm

edia

te o

rgan

isatio

n ar

e aw

are

ofth

e vi

sion

and

any

likel

y im

pact

it m

ay h

ave

on th

em

•Ta

ke ti

me

to b

uild

crit

ical

sup

port

for t

he v

ision

and

ens

ure

it is

shar

ed a

nd o

wne

d by

thos

e w

ho w

ill b

e co

mm

unic

atin

g it

Cle

arly

com

mun

icat

es th

e vi

sion

in a

way

that

eng

ages

and

em

pow

ers

othe

rs.

Use

sen

thus

iasm

and

ene

rgy

to in

spire

oth

ers

and

enco

urag

e jo

int o

wne

rshi

p of

the

visio

n.A

ntic

ipat

es a

nd c

onst

ruct

ivel

y ad

dres

ses

chal

leng

e.

6.4

Emb

od

yin

g t

he

Vis

ion

•A

ct a

s a

role

mod

el, b

ehav

ing

in a

man

ner w

hich

refle

cts

the

valu

es a

nd p

rinci

ples

inhe

rent

in th

e vi

sion

•D

emon

stra

te c

onfid

ence

, sel

f bel

ief,

tena

city

and

inte

grity

in p

ursu

ing

the

visio

n

•C

halle

nge

beha

viou

rs w

hich

are

not

con

siste

nt w

ith th

e vi

sion

•Id

entif

y sy

mbo

ls, ri

tual

s an

d ro

utin

es w

ithin

the

orga

nisa

tion

whi

ch a

re n

ot c

onsis

tent

with

the

visio

n, a

nd re

plac

e th

em w

ith o

nes

that

are

Con

siste

ntly

disp

lays

pas

sion

for t

he v

ision

and

dem

onst

rate

s pe

rson

al c

omm

itmen

t to

itth

roug

h th

eir d

ay-t

o-da

y ac

tions

. Use

s pe

rson

al c

redi

bilit

y to

act

as

a co

nvin

cing

advo

cate

for t

he v

ision

.

Gen

eric

beh

avio

urs

ob

serv

ed if

ind

ivid

ual

is n

ot

yet

dem

on

stra

tin

g t

his

do

mai

n:

• D

oes

not

invo

lve

othe

rs in

cre

atin

g an

d de

finin

g th

e vi

sion

• D

oes

not

alig

n th

eir

visi

on w

ith t

he w

ider

hea

lth a

nd c

are

agen

da•

Mis

ses

oppo

rtun

ities

to

com

mun

icat

e an

d sh

are

unde

rsta

ndin

g of

the

vis

ion

with

oth

ers

• L

acks

ent

husi

asm

and

com

mitm

ent

for

driv

ing

the

visi

on


7. D

ELIV

ERIN

G T

HE

STRA

TEG

YTh

ose

in s

enio

r pos

ition

al le

ader

ship

role

s de

liver

the

stra

tegi

c vi

sion

by d

evel

opin

g an

d ag

reei

ng s

trat

egic

pla

ns th

at p

lace

pat

ient

car

e at

the

hear

t of t

he s

ervi

ce, a

nd e

nsur

ing

that

thes

e ar

e tr

ansla

ted

into

ach

ieva

ble

oper

atio

nal p

lans

. Thi

s re

quire

s th

em to

dem

onst

rate

eff

ectiv

enes

s in

fram

ing

the

stra

tegy

, dev

elop

ing

the

stra

tegy

, im

plem

entin

g th

e st

rate

gy, a

nd e

mbe

ddin

g th

e st

rate

gy.

Elem

ent

ELEM

ENT

DES

CR

IPTO

RS

(see

als

o p

ages

49-

53)

4W

hole

Org

anis

atio

n/W

ider

Hea

lthca

re S

yste

m

7.1

Fram

ing

th

e St

rate

gy

•Ta

ke a

ccou

nt o

f the

cul

ture

, hist

ory

and

long

term

und

erly

ing

issue

s fo

r the

org

anisa

tion

•U

se s

ound

org

anisa

tiona

l the

ory

to in

form

the

deve

lopm

ent o

f str

ateg

y

•Id

entif

y be

st p

ract

ice

whi

ch c

an b

e ap

plie

d to

the

orga

nisa

tion

•Id

entif

y st

rate

gic

optio

ns w

hich

will

del

iver

the

orga

nisa

tion’

s vi

sion

Crit

ical

ly re

view

s re

leva

nt th

inki

ng, i

deas

and

bes

t pra

ctic

e an

d ap

plie

s w

hole

sys

tem

sth

inki

ng in

ord

er to

con

cept

ualis

e a

stra

tegy

in li

ne w

ith th

e vi

sion.

7.2

Dev

elo

pin

g t

he

Stra

teg

y•

Enga

ge w

ith k

ey in

divi

dual

s an

d gr

oups

to fo

rmul

ate

stra

tegi

c pl

ans

to m

eet t

he v

ision

•St

rive

to u

nder

stan

d ot

hers

’ ag

enda

s, m

otiv

atio

ns a

nd d

river

s in

ord

er to

dev

elop

stra

tegy

whi

ch is

sus

tain

able

•C

reat

e st

rate

gic

plan

s w

hich

are

cha

lleng

ing

yet r

ealis

tic a

nd a

chie

vabl

e

•Id

entif

y an

d m

itiga

te u

ncer

tain

ties

and

risks

ass

ocia

ted

with

str

ateg

ic c

hoic

es

Inte

grat

es th

e vi

ews

of a

bro

ad ra

nge

of s

take

hold

ers

to d

evel

op a

coh

eren

t, jo

ined

up

and

sust

aina

ble

stra

tegy

. A

sses

ses

orga

nisa

tiona

l rea

dine

ss fo

r cha

nge.

Man

ages

the

risks

, pol

itica

l sen

sitiv

ities

and

env

ironm

enta

l unc

erta

intie

s in

volv

ed.

7.3

Imp

lem

enti

ng

th

eSt

rate

gy

•En

sure

that

str

ateg

ic p

lans

are

tran

slate

d in

to w

orka

ble

oper

atio

nal p

lans

, ide

ntify

ing

risks

, crit

ical

suc

cess

fact

ors

and

eval

uatio

n m

easu

res

•Id

entif

y an

d st

reng

then

org

anisa

tiona

l cap

abili

ties

requ

ired

to d

eliv

er th

e st

rate

gy

•Es

tabl

ish c

lear

acc

ount

abili

ty fo

r the

del

iver

y of

all

elem

ents

of t

he s

trat

egy,

hol

d pe

ople

to a

ccou

nt a

nd e

xpec

t to

be h

eld

to a

ccou

nt th

emse

lves

•Re

spon

d qu

ickl

y an

d de

cisiv

ely

to d

evel

opm

ents

whi

ch re

quire

a c

hang

e in

str

ateg

y

Resp

onds

con

stru

ctiv

ely

to c

halle

nge.

Put

s sy

stem

s, s

truc

ture

s, p

roce

sses

, res

ourc

es a

ndpl

ans

in p

lace

to d

eliv

er th

e st

rate

gy.

Esta

blish

es a

ccou

ntab

ilitie

s an

d ho

lds

peop

le in

loca

l, re

gion

al, a

nd n

atio

nal s

truc

ture

s to

acc

ount

for j

oint

ly d

eliv

erin

g st

rate

gic

and

oper

atio

nal p

lans

. D

emon

stra

tes

flexi

bilit

y w

hen

chan

ges

requ

ired.

7.4

Emb

edd

ing

th

e St

rate

gy

•Su

ppor

t and

insp

ire o

ther

s re

spon

sible

for d

eliv

erin

g st

rate

gic

and

oper

atio

nal p

lans

,he

lpin

g th

em to

ove

rcom

e ob

stac

les

and

chal

leng

es, a

nd to

rem

ain

focu

sed

•C

reat

e a

cons

ulta

tive

orga

nisa

tiona

l cul

ture

to s

uppo

rt d

eliv

ery

of th

e st

rate

gy a

nd to

driv

e st

rate

gic

chan

ge w

ithin

the

wid

er h

ealth

care

sys

tem

•Es

tabl

ish a

clim

ate

of tr

ansp

aren

cy a

nd tr

ust w

here

resu

lts a

re d

iscus

sed

open

ly

•M

onito

r and

eva

luat

e st

rate

gic

outc

omes

, mak

ing

adju

stm

ents

to e

nsur

e su

stai

nabi

lity

of th

e st

rate

gy

Enab

les

and

supp

orts

the

cond

ition

s an

d cu

lture

nee

ded

to s

usta

in c

hang

es in

tegr

al to

the

succ

essf

ul d

eliv

ery

of th

e st

rate

gy.

Kee

ps m

omen

tum

aliv

e by

rein

forc

ing

key

mes

sage

s, m

onito

ring

prog

ress

and

reco

gnisi

ng w

here

the

stra

tegy

has

bee

n em

brac

edby

oth

ers.

Eva

luat

es o

utco

mes

and

use

s le

arni

ngs

to a

dapt

str

ateg

ic a

nd o

pera

tiona

lpl

ans.

Gen

eric

beh

avio

urs

ob

serv

ed if

ind

ivid

ual

is n

ot

yet

dem

on

stra

tin

g t

his

do

mai

n:

• D

oes

not

alig

n th

e st

rate

gy w

ith lo

cal,

natio

nal a

nd/o

r w

ider

hea

lth c

are

syst

em r

equi

rem

ents

• W

orks

to

deve

lop

the

stra

tegy

in is

olat

ion

with

out

inpu

t or

fee

dbac

k fr

om o

ther

s•

Abs

olve

s on

esel

f of

res

pons

ibili

ty f

or h

oldi

ng o

ther

s to

acc

ount

• F

ails

to

enab

le a

n or

gani

satio

nal c

ultu

re t

hat

embr

aces

the

str

ateg

y

Documents

64175 Leadership Framework:Layout 1 - NHS North West