Version 1.0
     Healthcare
     Leadership Model
     The nine dimensions of 
     leadership behaviour
     www.leadershipacademy.nhs.uk
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           Publisher: NHS Leadership Academy, No. 3 The Embankment, Sovereign Street, Leeds, West Yorkshire, LS1 4BJ, England.
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           NHS Leadership Academy (2013), The Healthcare Leadership Model, version 1.0, Leeds: NHS Leadership Academy.
         2   www.leadershipacademy.nhs.uk
                           Introduction
                           Who the model is for                                                                    The structure of the model                                                               leaders’ thoughts and result in effective leadership 
                                                                                                                                                                                                            behaviour. They are written in the ‘first person’ (Do 
                           The Healthcare Leadership Model is to help those                                        The Healthcare Leadership Model is made up of nine                                       I . . . ?), but are not meant to be answered with a 
                           who work in health and care to become better                                            ‘leadership dimensions’, each of which has its own                                       simple ‘yes’ or ‘no’. Instead, they should help you 
                           leaders. It is useful for everyone – whether you have                                   page in this document. There is a brief description of                                   explore your intentions and motivations, and see 
                           formal leadership responsibility or not, if you work                                    what the dimension is about and why it is important,                                     where your strengths and areas for development 
                           in a clinical or other service setting, and if you work                                 and a section that says ‘what it is not’ to provide                                      may lie.  You may also want to think about what 
                           with a team of five people or 5,000. It describes                                       further clarity.                                                                         evidence you could provide to support your answers.
                           the things you can see leaders doing at work and is                                     For each dimension, leadership behaviours are shown 
                                                                                                                                                                                                                          1
                           organised in a way that helps everyone to see how                                                                                                                                Research  has shown that all nine dimensions of the 
                           they can develop as a leader. It applies equally to the                                 on a four-part scale which ranges from ‘essential’                                       model are important in an individual’s leadership 
                           whole variety of roles and care settings that exist                                     through ‘proficient’ and ‘strong’ to ‘exemplary’.                                        role. However, the type of job you have, the needs of 
                           within health and care.                                                                 Although the complexity and sophistication of the                                        the people you work with, and the context of your 
                                                                                                                   behaviours increase as we move up the scale, the                                         role within your organisation will all affect which 
                           We want to help you understand how your                                                 scale is not tied to particular job roles or levels. So                                  dimensions are most important for you to use and 
                           leadership behaviours affect the culture and climate                                    people in junior roles may find themselves to be                                         develop.
                           you, your colleagues, and teams work in. Whether                                        within the ‘strong’ or ‘exemplary’ parts of the scale, 
                           you work directly with patients and service users                                       and senior staff may find themselves in the ‘essential’ 
                           or not, you will realise what you do and how you                                        or ‘proficient’ parts. Similarly, you may find where                                     The importance of personal qualities
                           behave will affect the experiences of patients and                                      you judge yourself to be may vary depending on 
                           service users of your organisation, the quality of care                                 the dimension itself. For example, you may be                                            ‘…the most important element… comes from a 
                           provided, and the reputation of the organisation                                        mostly ‘strong’ in a few dimensions, ‘exemplary’ in                                      combination of emotional expressiveness, self-
                           itself. The nature and effect of a positive leadership                                  one, and ‘essential’ or ‘proficient’ in others. This                                     confidence, self-determination and freedom from 
                                                                                                                                                                                                                                      2
                           style can be summed up as:                                                              may be appropriate depending on your job role, or                                        internal conflict’
                                                                                                                   it may show that there are areas that need some                                          The way that we manage ourselves is a central part 
                           Leadership that emphasises care for staff                                               development or that are a particular strength.
                           and high-quality support services                                                                                                                                                of being an effective leader. It is vital to recognise 
                                            Satisfied, loyal, productive and engaged employees                     Within these scales, the leadership behaviours                                           that personal qualities like self-awareness, self-
                                                                                                                   themselves are presented as a series of questions.                                       confidence, self-control, self-knowledge, personal 
                                                 High-quality, compassionate care                                  The questions are short descriptions of what the                                         reflection, resilience and determination are the 
                                                       Valued care services and patient satisfaction               leadership dimension looks like at each part of                                          foundation of how we behave. Being aware of your 
                                                             Successful healthcare organisations                   the scale. These are the questions that guide                                            strengths and limitations in these areas will have a 
                                                             and a highly regarded service
                           Figure 1 : The nature and effect of a positive leadership style
                           1 Please see Appendix 1 for more information on the research behind the Healthcare Leadership Model.
                           2 Bass, B.M (1992), in M. Syrett and C. Hogg (Editors), Frontiers of Leadership. Oxford: Blackwell.                                                                                                                    www.leadershipacademy.nhs.uk   3
                                Figure 2 : The impact of personal qualities on the experience of care
                                                                                                                                                                                                                                                    behaviours and more fully understand their 
                                          Greater self-awareness,                                                                                                                                                                                   leadership development. Please visit  
                                      self- control, self-knowledge,                         More effective leadership                         Productive, care-focused and                       Increasingly positive experience 
                                      determination, resilience and                                   behaviours                                 engaged climate in teams                                 of care and service                       www.leadershipacademy.nhs.uk/leadershipmodel  
                                          other personal qualities                                                                                                                                                                                  for up-to-date information on these tools, as well as 
                                direct effect on how you behave and interact with                                                         and training programme materials and criteria.                                                            other supporting materials.
                                others, and they with you. Without this awareness,                                                        However, for personal use we are also developing                                                          We would be very interested to hear from anyone 
                                it will be much more difficult (if not impossible) to                                                     other tools that will more directly help you apply                                                        using the Healthcare Leadership Model in their work 
                                behave in the way research has shown that good                                                            the Healthcare Leadership Model. For example, a                                                           and are planning to collect examples of best practice 
                                leaders do. This, in turn, will have a direct impact                                                      self-assessment tool and a 360-degree feedback tool                                                       so that we can share these more widely. If you are 
                                on your colleagues, any team you work in, and the                                                         are in development and will have a greater focus                                                          interested in sharing how you are using the model, 
                                overall culture and climate within the team as well as                                                    on helping individuals to assess their leadership                                                         please contact us at  
                                within the organisation. Whether you work directly                                                                                                                                                                  leadershipmodel@leadershipacademy.nhs.uk.
                                with patients and service users or not, this can affect 
                                the care experience they have. Working positively on                                                                     Leading with care                                                        Evaluating information                                                               Connecting our service 
                                these personal qualities will lead to a focus on care                                                                    (p6)                                                                     (p7)                                                                                 (p8)
                                and high-quality services for patients and service                                                                                                  Sharing the vision 
                                users, their carers and their families (see Figure 2).                                                                                              (p9)
                                While personal qualities have not been separately 
                                highlighted in the Healthcare Leadership Model, you 
                                will find them throughout the various dimensions. 
                                It is important to realise that areas identified for 
                                development within the model may be as much 
                                about how you manage yourself as about how you 
                                manage your behaviour and relate to other people.
                                How to use this document
                                The document illustrates the leadership behaviours                                                                                                                TM                                                                     TM                                                                    TM
                                expected for all staff in healthcare, so you can use 
                                it to help you think about your own leadership 
                                behaviours. It will also help you carry out appraisals,                                                                                                      Influencing for results                                                                                                    Developing capability 
                                and to write documents such as personal and                                                                                                                  (p13)                                                                                                                      (p12)
                                professional development plans, recruitment criteria                                                                             Engaging the team                                                                Inspiring shared purpose                      Holding to account 
                                and processes, educational standards and curricula                                                                               (p10)                                                                            (p5)                                          (p11)
                                                                                                                                          Figure 3 : The nine dimensions of the Healthcare Leadership Model
                          4   www.leadershipacademy.nhs.uk