1. Top Leader diagnostic results for London June 2011 Agenda item 9 Reform Group 5 Sept 11

2. NHS Top Leaders was created to: Manage the talent pipeline for senior positions Support the NHS to have the right leaders, in the right place, at the right time Be spoilt for choice when recruiting to senior posts Help move us closer to senior leaders being more representative of the communities they serve Develop a community of purpose – leaders mobilised for QIPP Nurture our next generation of senior leaders

3. The Top Leaders Diagnostic was developed to support identification of individual and collective leadership development needs

4. The Top Leaders Diagnostic offers a comprehensive view of each participants leadership based on a range of indicators Verbal & Numerical ReasoningLeadership StylesOrganisational Climate NHS Top Leaders 360Team Type / Derailers

5. Leadership styles Participative - consensus, involving, listening Affiliative – people first, avoid conflict, relationships Coaching – development, support, feedback Pace Setting – accomplishment, high standards, little collaboration Directive – compliance, monitoring, consequences Visionary – long term direction, keep on track Organisational Climate FlexibilityResponsibilityStandardsRewardsClarityTeam Commitment Competencies Leadership Essence Passionate about patient care InclusivityStrategic Thinking Entrepreneurial leadership InfluencingPartnership WorkingResilience Diagnostic elements

7. All 6 styles are valid and have a role to play. When over-used some can have a negative impact.

8. Overall findings to date show that our leaders are resilient and determined: We have leaders who are intellectually robust Our leaders are tough minded and self-confident By using pacesetting, our leaders demonstrate they are prepared to get involved, set standards, role model and drive projects/results through Our leaders are values-driven, committed to making a difference, and this is not profession-dependent

9. However the diagnostic suggests...... We have a pre-dominant Pacesetting style across all of the data set so far. The implication is that the majority of leaders are not mixing this with a wide enough range of other styles, which could result in staff feeling disempowered The majority of leaders (65%) are not creating strongly motivational work climates Whilst a pacesetting style ensures delivery it can result in staff feeling left behind That Leaders exhibit an absence of attention to detail and focus on completion of tasks

10. Pace-setting has enabled us to transform the NHS in the last decade However, we need to be aware that: Culture defines leadership. Edgar H Schein

11. Important to acknowledge... Its a team game Need a safe defence, creative midfield and ruthless attack

12. NHS in London: Range of Leadership Styles being used Dominant Styles Used: Extensive:4 or more styles Broad:3 styles Limited:2 styles Narrow:1 or no styles

13. NHS in London: Organisational climate being created

14. Summary – the Climate the NHS Leaders in London are creating for others

15. The Top Leaders programme offers support for individuals Top Leaders Core programme (4 days + 2 days + intervening learning sets) Exec coaching (4 funded sessions with coach from NHSI coaching register) Action Learning sets available, facilitated by Dr David Ashton Masterclasses – August: Commercial Acumen (2 days), September: Alan Milburn, October: Mark Britnell (International perspectives), November: Sally Davies Bursary scheme available for bespoke interventions One to one development support - working with people on a one to one basis about what this means for them in practice Communities of Practice (4 active – Communications, Medicine, Finance and Strategy) Mentor brokering (we help match suitable people) Other activities in place now include peer-mentoring scheme with ACEVO

16. A key component of the solution is to support leaders to use pacesetting with a wider range of styles

17. The changes in the NHS mean that we need to be more adaptable as leaders Patient/carer expectations of the NHS are on the rise (quality, access…..) Demand is increasing and resources are reducing so we need to do more with the same/less In consequence – The need for effective distributed leadership is increasing – Pathway networking/service mergers mean that partnership working is expanding – We need to use a wide range of leadership styles to deliver

18. Proposed next steps for London Share the analysis and reflections on the unique circumstances that existed which led to these findings and how we retain all thats good in our leadership whilst adapting to the new world in which we will deliver healthcare Form a reference group from the leaders who have completed the diagnostic – seek their views on tailored support that will help them make the shifts identified Develop and run workshops/masterclasses to help individuals and teams understand how to flex their leadership styles Incorporate modules on leadership style, its impact and how to adapt it, into all NHSL leadership programmes Develop and deliver a support package to meet the needs identified by the reference group Ensure that leaders at all levels understand how to adapt their ways of working to enable appropriate use of styles beyond pace-setting

19. Discussion