1. What is Shared Leadership? Leadership is not restricted to those who hold designated leadership roles Pearce and Conger A dynamic, interactive influencing process among individuals in groups There is a collective shared responsibility for success of the organisation and its services Acts of leadership can come from any individual in the organisation, as appropriate, at different times Self-leadership : feeling confident to contribute and act Emphasises teamwork and collaboration; objective is to lead one another to achieve group goals

2. What is Leadership? “A process whereby an individual influences a group of individuals to achieve a common goal” Peter Northouse

3. The leadership problem There are many examples of poor practice and system failure within health and care where a lack of leadership – at an individual, collective and system level – has been identified as an important factor. For example, we’ve seen this week that the care being delivered in your clinics may not be optimal and that the system itself has been built up over many years and not been designed to meet with patients needs. With the economic and other challenges facing the Malawi Health Service it will be imperative that frontline staff have the leadership knowledge, skills and behaviours to drive radical service redesign and improvement.

4. But I’m not a leader.... Why me? Patients and their family expect clinicians to use their knowledge and experience to contribute to the effective and efficient provision of healthcare. Leadership is not restricted to people who hold designated leadership roles. Acts of leadership can come from anyone in the organisation.

5. Leadership for CO and midwives is Leadership in Malawi is about delivering high quality services to patients by: Demonstrating personal qualities Working with others Managing services Improving services Setting direction

6. The CLCF Domains – there are 5 which describe the breadth of leadership behaviours Elements – manageable components which are subsets of each domain Competences – 4 statements which describe the leadership behaviours underpinning each elements

7. Domain 1 1.Demonstrating Personal Qualities 1.1 Developing self awareness 1.2 Managing yourself 1.3 Continuing personal development 1.4 Acting with integrity

8. Elements x 4 For example Effective leaders need to draw upon their values, strengths and abilities to deliver high standards of care. This requires leaders to demonstrate competence in the areas of: Element 1.1 Developing self awareness

9. Contextual descriptors 1. Demonstrating Personal Qualities 1.1 Developing self awareness And the context is staff... Recognise and articulate their own values and principles, understanding how these may differ from those of other individuals and groups Identify their own strengths and limitations, the impact of their behaviour on others, and the effect of stress on their own behaviour Identify their own emotions and prejudices and understand how these can affect their judgment and behaviour Obtain, analyse and act on feedback from a variety of sources.

10. Gruen RL, Pearson SD & Brennan TA. JAMA (2004); 291: 94-98

11. Stages of Leadership Development Stage 4 Stage 3 Stage 2 Stage 1 Stage 1 Own practice/Immediate team Stage 2 Whole service/Across teams Stage 3 Across services/Wider organisation Stage 4 Whole organisation/Wider healthcare system

12. What motivated you to train as a CO or midwife?: Part 1 – working in pairs (2 X 3 mins each = 6 mins) discuss Part 2 – working as a group (4) discuss = 4 mins Exercise 1 - Leadership and you! 1 McBain, R., Ghobadian, A., Switzer, J., Wilton, P., Woodman, P. and Pearson, G. (2012) The Business Benefits of Management and Leadership Development. London: Chartered Management Institute

13. Self assessment Part 3 – consider what you bought into practice. Now…. What did you learn about yourself? What would you do differently? What leadership would you need to maximise the opportunities you identified in your audits? - Working in Pairs = 8 mins - Working in groups = 4 mins - Plenary = 10 mins Exercise 1 - Leadership and you! Warning! Nominate 1 person to feedback

14. CLCF booklet handouts Working in groups - 1 CLCF domain per group Step 1 Review the practical examples e.g student, practitioner, experienced practitioner Are the generic examples suited to Malawi Are the discipline specific examples relevant, Can they be tweaked/altered or need a lot of change Can you write an example? Step 2 Review the learning and development activity. Is it suitable? Exercise 2 – Making the CLCF real!

15. What are the top 2- 3 challenges facing obstetrics and neonatal care today? Step 1 take a domain of the CLCF. Thinking about these challenges and what you have learned earlier, what leadership activity/behaviours can you do to address these? Working in small groups use the handout = 15 mins Step 2 feedback in plenary = 15 mins Exercise 3 – Taking the Leadership challenge! Warning! Listen to feedback very carefully I will ask you to comment

16. r Change will not come if we wait for some other person or some other time. We are the ones we've been waiting for. We are the change that we seek.

17. A recently published report 1 found that: The average spend on management and leadership development (MLD) in high performing organisations is £1738 per year/ per manager (compared to £1275 for low performing organisations). Accredited qualifications were rated by individuals as having the most impact upon their management/leadership performance. The highest performing organisations had higher performing and more effective leaders A strategic approach to MLD is required for it to be successful, i.e. commitment to MLD driven by CEO and senior management, the need for HR practices which reinforce leadership development, e.g. leadership succession planning and competency frameworks Building evidence 1 McBain, R., Ghobadian, A., Switzer, J., Wilton, P., Woodman, P. and Pearson, G. (2012) The Business Benefits of Management and Leadership Development. London: Chartered Management Institute Change will not come if we wait for some other person or some other time. We are the ones we've been waiting for. We are the change that we seek.

18. How can this be achieved? "Never doubt that a small group of thoughtful, concerned citizens can change the world. Indeed it is the only thing that ever has.“ Margaret Mead