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Leadership - other support

Policy and reports

This section includes key strategic and standard documents which shape the current policy framework for clinical governance. The items below are specific to leadership. For the overarching national standards and strategies please refer to the four country overviews -  England, Northern Ireland, Scotland and Wales.

The documents are listed in date order. The most recent publications appear at the top of the list.

Some of the resources on this page are in PDF format - see how to access PDF files.

Patient-centered leadership: rediscovering our purpose (2013)
This report from the King’s Fund summarises the main findings of the Francis Inquiry into the failings of care at Mid Staffordshire in relation to NHS leadership and culture. It sets out what needs to be done to avoid similar failures in future, focusing on the role of three key 'lines of defence' against poor-quality care: frontline clinical teams, the boards leading NHS organisations, and national organisations responsible for overseeing the commissioning, regulation and provision of care. It also highlights the lessons that can be learnt from the experiences of high-performing health care organisations in other countries that have succeeded in developing effective leadership and a culture that puts patients' needs first.

The Mid Staffordshire NHS Foundation Trust Public Enquiry (2013)
This Inquiry examined the commissioning, supervisory and regulatory organisations in relation to their monitoring role at Mid Staffordshire NHS Foundation Trust between January 2005 and March 2009. It considered why the serious problems at the Trust were not identified and acted on sooner, and identified important lessons to be learnt for the future of patient care. "Good leadership must be visible, receptive, insightful and outward looking. Leadership and managerial skills are not the same but both are required. Leadership skills are required to be shared at all levels in an organisation, from board to ward, and all staff must be empowered to use their own judgement in providing the best possible care for patients." See: Volume three, chapter 24 - Leadership in Health care (PDF 2.7MB).

Mid Staffordshire NHS Foundation Trust Public Inquiry Report. Response of the Royal College of Nursing (2013( (PDF 640KB)
This report outlines the RCN's response to many of the 290 recommendations in the seminal report and sets out the work the RCN has already undertaken, and what it believes should be done next, to ensure the failings at Stafford Hospital are never repeated. See also: Executive sumary (PDF 336KB).

Leadership and engagement for improvement in the NHS (2012)
This King's Fund report makes the case for engaging staff, patients and boards and for building relationships across systems of care. "To make engagement a reality requires action at all levels, from the NHS Commissioning Board to the teams delivering care for patients. It also requires commitment to training and development of clinical staff in leadership skills from early in their careers. The unifying vision for every leader should be engaging for improvement with a clear focus on improving patient care and population health outcomes."

How can leaders influence a safety culture? (2012)
In this thought paper, Dr Michael Leonard and Dr Allan Frankel explore how effective leadership and organisational fairness are essential for patient safety within healthcare services. They discuss how leaders can influence their organisations to help create a robust safety culture.

What's leadership got to do with it? Exploring links between quality improvement and leadership in the NHS (2011)
This Health Foundation report presents a detailed account of a two-year study which involved an in-depth evaluation of the Health Foundation's leadership programme including an exploration of the links between leadership and quality improvement (QI). It contains insights into how leadership development can support QI in the NHS and provides new ways of understanding the nature of this improvement work.

Leading Better Care
Leading Better Care (LBC) - delivering for patients supports senior charge nurses, midwives and team leaders by providing facilitation, support, development and educational opportunities to help them achieve high quality, person centred safe and efficient care for every patient first time and every time.

The senior charge nurse (SCN) / midwife review which was undertaken in Scotland arose from the need to create a modern leadership role as highlighted in 'Delivering care, enabling health', and to enable senior charge nurses to maximise their contribution to delivering the safe and effective patient care set out in 'Better health, better care'. The review, which involved stakeholder consultation, a literature review and an SCN activity analysis, points to the benefits of having a consistent framework for Senior Charge Nurses in hospitals across NHS Scotland. See: Leading better care: report of the Senior Charge Nurse Review and Clinical Quality Indicators Project (2008).

The report of the Leading Better Care conference for 2013 celebrates the work of the LBC to date, and looks at the factors that might help or hinder future developments - see NES Evidence into Practice: Leading Better Care (LBC) - Delivering for patients. Unlocking the next stage of the journey (PDF 3.9MB).

Connecting diversity with leadership (2010)
This briefing brings together evidence from within the NHS and externally to support trusts and their leaders to use their roles to embed diversity within their organisations and effectively respond to the current regulatory climate.

Putting quality first in the boardroom (2010)
This report from the King's Fund and the Burdett Trust for Nursing set out to ‘bring the ward to the board’, emphasising the role of the nurse executive in ensuring that boards are as fully engaged with the clinical quality agenda as they are with financial performance. Building on the findings of From Ward to Board, this report is based on observations of nurse executives and their boards at six NHS trusts. It examines why clinical quality has the potential to be marginalised in the boardroom, and considers the dynamics of the boardroom and the role of the nurse executive.

Future of leadership (2009) (PDF 417.9KB)
This report is based on interviews with members of NHS Confederation and other health leaders and explores two important questions: what are the real issues with NHS leadership and what solutions can best be provided by central or regional action.