The NHS Leadership Academy works with a world-class expert faculty of global business leaders, educators and practitioners. Our programme participants are offered unique opportunities to learn from and talk with each of them. Here, John Deffenbaugh, faculty member, discusses distributed leadership, the return of heroic leadership and how the NHS could benefit from them.
Hero leaders made a comeback in 2016. They never really went away. Trump, Johnson, Sturgeon, Farage, Merkel. We would be in a different place were it not for the decisions of these leaders. There are also hero leaders in the NHS – the HSJ places NHS hero leaders at the fore with its annual Top Chief Executive issue, and no doubt many scan the rankings to see where they’re placed.
The Great Man school has been around since the dawn of leadership. Sadly, too many great men rather than women have predominated through the ages, but it is today that a woman is the anchor of Europe, Angela Merkel. And through the ages it is some of the great women who have given their names to remarkable periods of time: the Elizabethan and Victorian ages.
Sidney Hook wrote about the Hero in History in 1943, in an epoch shaped by – for better or worse – hero leaders: Roosevelt, Churchill, Stalin, Hitler, De Gaulle, Mussolini, Eisenhower, Rommel, Montgomery. Were these eventful men, or event-making men? Hook made a distinction:
- The eventful man is one who happens to be at the right place at the right time and, due to his position, makes important decisions or appears to make them. He comes into the limelight because he is part of larger events which are important. He may be borne to power by forces beyond his control, his conduct may be determined by pressures about him, yet it was he who was obliged to make the decision.
- The event-making man, on the contrary, is actually able to control the events to a degree and drives society in the direction which he wishes it to go. He is a genius, one who by his outstanding characteristics of intelligence, will, and ability to influence other people, has an actual capacity to accomplish his purposes. He is much more than a pawn in the game.
I’m already on dangerous ground with the gender issue, so I might as well carry on. Back to the list above from 2016: I would judge Johnson and Farage to be eventful men. It is too early to place Sturgeon. Trump and Merkel, I would place them as event-making leaders, though as Enoch Powell observed, “All political careers end in failure”. 2017 might settle Merkel’s, while Trump has four years to achieve his.
There has understandably been an anti-hero approach to NHS leadership over recent years. Indeed, the King’s Fund leadership report in 2011 was subtitled “No more heroes”. Heroes can lead to cults and lack of sustainability – not something the NHS needs right now. What has taken its place is oft referred to as distributed or collective leadership – the latter in a reference to the Communist way of distributing power within an organisational structure. Not that I’m making any comparisons here between the NHS and structures in a socialist state.
Neither school of leadership – the great leader nor distributed leadership – is wholly satisfactory. Rather, let’s morph them into a style specific to the NHS. Three traits come to mind:
- First, a compelling narrative. Not something tacky like “Take back control” or “Make America Great Again”, but rather something which catalyses doctors to change, along with system partners
- Second, eyes up into the system, not just down in order to keep on the treadmill of pacesetting leadership. Yes, keep a grip on the ops, but spend time leading, not getting in the way of reports
- Third, trust staff. Think Nordstrom and their only rule: “Use best judgement in all situations. There will be no additional rules”. Wow, what if the NHS worked this way!?!
When we elect heroes, we are trusting in their judgement, intelligence, balance. The next four years will be interesting.