What is it?
It is an evidence-based research model that reflects:
- the values of the NHS
- what we know about effective leadership
- what we have learned from the Leadership Framework (2011)
- what our patients and communities are now asking from us as leaders.
The below explains how the model was developed and information on how the research was carried out.
Secondary Research (March – April 2013)
The aim of the secondary research was to:
- understand what existing research has already said about leadership more generally, and
- help identify what then needs to be different for healthcare, for the NHS, and for the NHS in the current environment.
John Storey and Richard Holti of the Open University, working with Korn Ferry Hay Group, carried out a review of current literature and research on leadership models and behaviours, including international as well as private-sector learning. You can view Holti and Storey’s paper here: Towards a New Model of Leadership (2013)
Korn Ferry Hay Group then developed their findings into a draft behavioural model, and drew on the following:
- their own knowledge of leadership in the NHS and elsewhere
- comparison of research data with health system competency models in Korn Ferry Hay Group’s competency database
- analysis of NHS leaders’ assessment data
- analysis of the differences in behaviours between line managers and senior individual professionals.
Primary Research (April – June 2013)
The aim of the primary research stage was to identify sample leadership behaviours at different levels of intensity and sophistication using the draft model created from the secondary research. This stage consisted of two sets of interviews:
- strategic interviews with people who have extensive experience of leaders in the NHS
- interviews with leaders across the NHS at a variety of levels to gather detailed examples of how they lead and how this delivers results.
The sample of interviewees for both sets of interviews was selected by the NHS Leadership Academy working with their Local Leadership Academies. The strategic interviews were carried out by staff in the NHS. Korn Ferry Hay Group assessors carried out the interviews with leaders, using a focused interview technique. Korn Ferry Hay Group then coded all the interviews against the draft leadership model, and carried out a thematic analysis.
Drafting (June 2013)
The aim of the drafting stage was to take everything we had learned from the previous two stages to create a more refined draft. The format we used was a ‘concept formation’ workshop, attended by the NHS Leadership Academy and Hay Group. Here we brought the various data points together to produce a ‘working draft’ of the leadership model. The data points included:
- the themes from Holti and Storey’s research paper
- data sets from both sets of interviews
- data with health system competency models in the Korn Ferry Hay Group competency database, and
- thematic analysis of NHS leaders’ assessment data.
In particular, we used evidence from the interviews to produce the leadership behaviour descriptions you see in the model.
Testing (June – August 2013)
The aim of the testing stage was to check with the intended audience of the model (staff in healthcare) that it would be relevant and user-friendly across various roles and contexts. This stage consisted of a number of focus groups, conducted by the NHS Leadership Academy and Regional Leadership Academies, involving a cross-section of staff at various levels working in various contexts. Additional stakeholders, such as colleagues in clinical professional bodies and those working in education, were also invited to provide feedback on the draft model.
The NHS Leadership Academy then analysed and themed the feedback from the focus groups. The feedback was overwhelmingly positive, and improvement points (largely relating to the most accessible language for the model) were acted upon in an updated version of the draft model. This then went through a plain English review, with relevant amendments made.
Finishing (August – October 2013)
The final stage was to finalise ‘version 1/version 2013’ of the Healthcare Leadership Model. This stage consisted of colleagues from Hay Group incorporating the final feedback into a final version of the model, which was signed off by the NHS Leadership Academy. The Academy then worked with designers to produce relevant graphics and finalise the design.
Limitations and plans to keep the model refreshed
The Healthcare Leadership Model (2013) is an evidence-based model which was created using the process described in ‘How the Healthcare Leadership Model has been developed’.
In a different economic climate, the NHS Leadership Academy may have chosen to invest more heavily in a wider number of staff interviews to create the first version of the model. However, we have taken the view that the most cost-effective and productive path to take was to interview a small sample of leaders (49 in total) in 2013, and to use this data with the secondary research to create ‘version 1’ of the model.
The intention therefore is not that this model is ‘set in stone’ or still be appropriate for healthcare staff in the future. Instead, the intention is to make ongoing updates to the model, to make sure it remains as relevant to staff in two or five years’ time, as it is to them today. The process of updating the model will be likely to follow a shortened version of its initial research process, taking into account any major new pieces of secondary research and by conducting future sets of interviews and focus groups.
This more flexible and innovative approach will result in future versions being available over the next few years. You could describe this as being similar to the software updates on a smartphone: people can get all the benefits of being able to update their software, while keeping a ‘core’ product that remains recognisable, rather than having a ‘static’ product which quickly becomes out of date. In the same way, we intend the Healthcare Leadership Model to adapt and be regularly updated to provide healthcare staff with the most relevant leadership support today and in the future.
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