1. Leading from the middle: Constrained realities of clinical leadership in healthcare organisations By Marin and Waring (2012)

2. Key points Healthcare organisations attempting to Increase leadership capacity Notably in ‘lower-status’ staff Creating frontline leaders is seen as a means of improving the quality of healthcare Interview of 23 staff based in UK operating theatres Given new titles as ‘team leaders’

3. Results Participants were familiar with leadership theory But Felt constrained by management and hierarchy within the organisation As ‘leaders’, staff felt that they actually had no influence on any change within their areas

4. Discussion…… What needs to change in order for healthcare organisations to drive this new ‘breed’ of leaders to make change ?

5. Thinking points….. Do all organisations have the capacity to ‘look’ at themselves and identify what needs to change? If this involves financial investment…..can organisational wide changes actually happen? Do ‘old style’ ‘leaders’ need to move on? As healthcare is driven by public demand, politics and policy drivers, are these key stakeholders constraining change?