Leadership and the UK health service

This paper explores future leadership requirements for health services in t he context of relevant leadership theory and the changing environment for h ealth services in the UK. The output of leadership research is both prolifi c and confusing. and its applicability to health services management uncert ain especially in the context of constraints on the strategic managerial be haviour and choices of public service managers. The introduction of general management to the UK NHS in the 1980s, followed by an internal market for healthcare in 1990, should have provided the opportunity for managers to wo rk differently and to create personal space for leadership. However, it is not known whether sustainable, new ways of leadership working have emerged although it is reasonable to hypothesise from studies elsewhere that a numb er of contextual and behavioural leadership models are likely to be found i n the NHS. Although management researchers have explored networking and ref erred to the impact of the external environment of leadership, insufficient importance has been attached to-date to the impact of future trends in hea lth services on the leadership of change in the health sector. The paper ar gues that in future health services leadership will require much more than traditional networking with other organisations and groups and will need to focus on developing and securing external agreement to an agenda for posit ive change, turning the apparent constraints of the external environment, d etermined primarily by government policies, into opportunities. In other wo rds the demands of external or contextual leadership will increase forcing a stronger focus on having to achieve change through others. (C) 2000 Elsev ier Science Ireland Ltd. All rights reserved.