Thus this theory is considered as a social exchange process based on the power and reward system. This book is essential for nursing, health and social care students taking modules on leadership, management and transition to practice in their final year, as well as for newly qualified professionals or those seeking to refresh their However there were some areas where significant action is needed for improvement. Different leadership theories that are developed since 1920s are listed below: Barnard (1938) for 'prescriptives': Ghiselli and Wald & Doty (1954) for the 'descriptives'. The Concept of Leadership in the Health Care Sector, Leadership, Suleyman Davut Göker, IntechOpen, DOI: 10.5772/intechopen.76133. After that, you could go on to do postgraduate study, such as a Master’s degree. Each of the department had a head person above them under whose guidance all mangers used to work. Thus the overall performance of the organization depends upon the behaviour of leaders with their followers. Leadership and management are often compared under the same platform. Thus, further research is needed to build the evidence on the relationships between targeted training and professional development interventions, individual competence of leaders from health management and clinical backgrounds and organisational performance. All work is written to order. Skill, on the other hand, refers to the possession of the capacity to successfully carry out physical or cognitive tasks to achieve a specific outcome [54], while an attitude refers to “a relatively enduring organisation of beliefs, feelings, and behavioural tendencies towards socially significant objects, groups, events or symbols “([55] p. 150). According to Gunderman R. (2009), healthcare leaders should understand the nature of the organization where they work and should work in harmony with physicians, nurses, technologists, administrators and other members of organization. In the health care sector, the term ‘leadership’ is closely associated, and often used interchangeably, with ‘management’. Two-Factor Theory It aims to analyse the causes of workers’ motivation and satisfaction in work. Health and Social Care and Leadership and Management of Care Service 23 Areas These standards have been developed specifically for those working in leading and health and social care … On the other hand, such training or professional development interventions can be targeted at strengthening the collective capabilities of the entire management and leadership workforce to achieve ‘leadership development’ [78]. less than quarter of staff agreed that senior managers involve staff in important decisions and only 22% agreed that communication between staff and senior management is effective. Leadership in the healthcare context aims to influence practitioners towards the achievement of the common goal of quality patient care. Thus it can be said from the above definitions that leadership is enacted through relationships with others i.e. Although transformational leadership skills are highly desirable for effective functioning of an organisation, many management theorists like Bass, Avoliio and Goodheim (1987) think that transformational leadership alone can cause problem in long time. While in terms of staff engagement mixed results were seen. Several leadership theories have emerged over the past suggesting practical applications of leadership and its concept. (Marquis and Huston 2009). This thing worked as an incentive amongst all of us and thus we became more enthusiastic towards our work. The transactional leader sets goals, gives direction and uses rewards to strengthen employee's behaviour towards meeting or exceeding established goals (McGuire and Kennerly 2006). Notwithstanding the crucial place of training and professional development in health management and leadership, evidence of the impact of such development interventions on competence and performance is limited and contentious. Thus, while the distinction between management and leadership arises from the differences in roles and functions, the reality is that a role is often unconsciously chosen and not outlined explicitly in the organisation [36]. Login to your personal dashboard for more detailed statistics on your publications. It is still questionable whether an individual could have all the traits for being a leader. This is evident in the growing interests in the concepts of health management and leadership, especially since the turn of the century, as reflected in the prevalence of studies on health management and leadership across different countries. Strong and competent management and leadership workforces are thus required to navigate the sector through the complex web of interacting factors and lead reforms for effective and efficient health care delivery. Factors outside the health care environment, such as changing population demographics, economic factors, globalisation, government policies, and advancement in medical and information technologies, also exert profound influences on the health sector [7, 8, 9]. In this survey 156,000 employees from all 391 NHS trusts in England responded to a questionnaire asking about their views and experience of working with the NHS. The term ‘proficiency’, or ‘competence level’, refers to the level of expertise for a particular competency. He had good interactions with everybody in the team and always used to motivate us. Thus it is seen that the two leadership approaches i.e. The focus on transformational (and transactional) leadership was also identified in a systematic review performed by Gilmartin and D’Aunno (2007), examining health care leadership research from 1989 to 2005. Hollingsworth (1999) suggests fundamental differences between leaders and managers. 'In transformational leadership leaders motivate their followers by transcending their own self interests, elevating their needs and making them aware of the mission of larger entity of the organisation where they belong'. Both training approaches have been recognised as important in strengthening the capabilities of the management and leadership workforce [75, 76], especially in complex systems like health [74]. It articulates a vision for betterment of the healthcare services and thus allows one to work for raising the standards of care and treatment. 1 Leadership and Leadership Development in Health Care: The Evidence Base Professor Michael West The King’s Fund and Lancaster University Management School Kirsten Armit, Dr Lola Loewenthal Faculty of Medical Leadership Transactional theory of leadership is based on leading people by the virtue of management position held in the organizational hierarchy. Such roles are usually performed in collaboration with non-clinical management or leadership roles and functions. Thus, managers (generalist trained managers, professional health service managers) fill management roles, perform management functions and provide leadership. Capability refers to the process which allows individuals to demonstrate or express the required competencies on their jobs; it is the ease with which the required competencies can be accessed, deployed, or applied by individuals [59]. Effective leadership is required to lead and drive changes at all levels of the health system to actualise the goals of the ongoing reforms in health care organisations. The health care industry is adapting to rapid changes in privacy laws, policy and regulation, requiring organizations to revisit their governance styles. The development of all individual towards their potential is one of the goals of transformational leadership. Effective leadership is required to lead and drive changes at all levels of the health system to actualise the goals of the ongoing reforms in health care organisations. Relevant to this discourse is making a distinction between leadership and management. The people who work in healthcare organizations as leaders should understand the needs of the people they work with and should motivate them in order to increase their performance. they will be allowed to go home 1 hour early. The use of personal qualities (such as charisma, influencing skills and communication) needs to be equally balanced by high levels of understanding and personal insight. The health care sector is complex, characterised by constant changes and reforms. Brief introduction to this section that descibes Open Access especially from an IntechOpen perspective, Want to get in touch? Thus a transformational leader is 'the catalyst for creating new innovative organisational paradigms' (Murphy 2005 :135). Our team is growing all the time, so we’re always on the lookout for smart people who want to help us reshape the world of scientific publishing. According to the survey more than 200,000 staff people told they liked working with NHS. transformational and transactional approach are different from each other. The following case study is based on my experience of working at a Multinational Pharmaceutical company, Zydus-Cadila healthcare limited, India. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. He was very professional at work while very jovial and friendly at home. According to me, the leadership approach in this organisation contained both transactional as well as transformational concepts of leadership theories. Thus the healthcare managers require leadership theories and put them in practice to make it work effectively. So he can be described as a perfect example of 'transformational' leader. (Vandenberghe et al. He was never after rewards from the company. Transformational leaders inspire the followers and motivate them to exercise leadership by encouraging their belief that have the potential to achieve high aims. For example, people like Hitler, Churchill, Mussolini, Mao Tse Tung and The Reverend Moon have been perceived as charismatic leaders in the past but in today's modern era it will be difficult to call them as 'transformational' leaders. They are usually good orators and share their imaginary ideas with followers to create a common purpose. Along with this it also manufactures various animal health products and cosmeceuticals. Here the emphasis is on personal attributes and qualities as opposed to that of traditional source of authority and power or target driven incentives derived from business culture (Jumaa 2005). Effective leadership is therefore necessary for the smooth functioning of healthcare organization. Registered Data Controller No: Z1821391. Intelligence, initiative and self-assurance. Following his instructions we all went and did our report writing work. According to Bass (1990:19), "leadership is an interaction between two or more members of the group that often involves a structuring or restructuring of the situations, perceptions and expectations of the members." The purpose of competency identification and assessment in most cases is to inform the development of competency frameworks which are used to assess performance, identify gaps in proficiency and target appropriate training and development opportunities. Disclaimer: This work has been submitted by a university student. Do you have a 2:1 degree or higher? Competency refers to the knowledge, skills, and attitudes which health leaders require for effective performance in roles [10, 50, 51], and can be improved with training and development interventions [51]. As a leader or aspiring leader in health or social care practice you will have the opportunity to further develop your knowledge of leadership and management theories and strategies, enabling you to ethically manage people and The chapter examines the concept of leadership in the health care sector within the context of the recent drive by health care organisations to identify essential competencies and training required by health management and leadership workforces for effective performance in roles. Thus, this section presents an overview of the concept of leadership in the health care sector, drawing upon both management and leadership as both terms are seen as being relevant to health care services. As PhD students, we found it difficult to access the research we needed, so we decided to create a new Open Access publisher that levels the playing field for scientists across the world. In other words, while some competencies may be similar across most health contexts, the competence level (proficiency) required to demonstrate them will vary from one management level or organisational setting to another. Thus, an approach to leadership development, which focuses on leaders as complete individuals (as against the current practice of concentrating on specific behaviours), has been advocated to ensure holistic leadership development [83]. He was very supportive at work and had a vision for company's success. By Reuben Olugbenga Ayeleke, Annette Dunham, Nicola North and Katharine Wallis, Submitted: December 17th 2017Reviewed: March 2nd 2018Published: September 19th 2018. In the light of this, different training and professional development strategies are currently being used to address identified gaps in proficiencies, develop new competencies and improve existing ones. Contingency (or situational) theory emerged in the early 1960s due to inability of previous theories to explain different aspects of leader behaviour [36]. Do healthcare mangers need leadership theories? Capacity, on the other hand, refers to the power or ability of individuals to hold or possess the required competencies at a level considered sufficient for a role [59]. The other type of manager under whom we were working is completely opposite of the above mentioned manager. Transformational leadership is widely supported leadership approach for healthcare. Individualised consideration. About 3% said they had been discriminated against their ethnic background. Leadership in the health care sector is spread across management and clinical workforces, creating peculiar challenges. How can we improve workers performance, through tighter control or by increasing autonomy and empowerment? An analysis of transformational leadership style in North America has shown qualities of integrity and honesty all strengthen by strong core of moral and ethical values (Bashor 2000). Knowledge has been described as a demonstration of the awareness or understanding of the concepts, theories, guidelines, or principles required to successfully perform a task [52, 53, 54]. 1. Such strategies include formal training and professional development in the form of structured academic programmes [74], and informal training approaches such as coaching, mentoring, role modelling, work-based or contextual learning and experiential learning [74, 75]. *Address all correspondence to: r.ayeleke@auckland.ac.nz. Contact our London head office or media team here. To date our community has made over 100 million downloads. The hospitals and health care units have been in demand where the most vulnerable people, children and older people are exploited. One important outcome of transformational leadership is ‘empowerment’, which entails sharing of leadership process between the leader and the followers [34, 42]. This document aims to address some of the issues they face but cannot cover all relevant material. In other words, a competent health manager or leader possesses the requisite knowledge, skills and attitudes that enable him or her to manage or lead effectively. To see how leadership and management roles overlap, follow the link to page 23, Leadership for personalisation and social inclusion in mental health. An added challenge to leadership development is that leadership is spread across health management and clinical workforces; while some clinical leaders may work in management roles, for others leadership is exercised from a clinical position. Reference this. According to Bass and colleagues, the transformational leader will fail without the traditional management skills. The results of the survey showed that job satisfaction remained high among most of the staff. HeadquartersIntechOpen Limited5 Princes Gate Court,London, SW7 2QJ,UNITED KINGDOM. In the health care sector, approaches and priorities may differ for health management and clinical leadership development. We share our knowledge and peer-reveiwed research papers with libraries, scientific and engineering societies, and also work with corporate R&D departments and government entities. This feature is consistent with the original idea of Burns that leadership may be exhibited by anyone in the organisation in any type of position [42]. In this article, I will discuss the predominant models and theories of management and leadership including Lewin’s leadership styles, trait theory and Belbin’s Team Roles. It’s based on principles of collaboration, unobstructed discovery, and, most importantly, scientific progression. Thus the transactional theory of leadership has a very narrow focus and the leader can have a high self interest which may eventually lead to disturbance in the organisational structure. Contingency theory is based on the premise that the behaviour exhibited by a leader varies, depending on the prevailing circumstance or situation [41, 42, 43, 44]. Although certain competencies may be common to most health contexts, in practice they are likely to be demonstrated differently, depending on certain factors such as management levels and sectors [5, 11, 14, 21]. Considering leadership in healthcare it is seen from the example of NHS in the UK that the combination of both 'transactional' and 'transformational leadership' theory may be the most efficacious for an organisation. Current interests in health management and leadership are, however, geared towards identification and assessment of essential competencies (that is knowledge, skills, and attitudes) required by health managers and leaders for effective performance in roles. The following topics are different from, but important to, the functions of assessment, planning, implementation and evaluation. they are transactional, while leaders do the right things i.e. The authors declare that they have no known conflict of interest. These are categorised in 3 areas mainly: However the trait theory has certain weakness and problems like; the traits are very difficult to define accurately or to understand fully; many exceptional leaders do not possess all identified leadership traits; it cannot be concluded that a person is better or worse as a manager or leader only by possessing one or two traits. 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