Understand professional management and leadership in health and social care services

Handout 9: What makes a leader effective?

Learning outcome 3/Assessment criteria 3.1, 3.2

Trait theory suggests that leadership qualities can be innate (‘Great Man’ theories, for instance) and that certain ‘great’ people born with leadership traits are more likely to be effective leaders (Northouse, 2009). However, currently there is more of a focus on interactions and relationships between leaders and their followers as well as on the impact of workplace situations and context on leadership effectiveness (Bernhard and Walsh, 2006).

The behaviour of those in leadership roles in health and social care settings is now seen as important in determining leader effectiveness because it impacts the motivation, attitudes and values of the various members of their teams. Most leadership theorists would agree that a leader’s behaviour is the most influential or pivotal factor in swaying team members’ commitment and work performance.

More specifically, the relationship between the leader and team members is critical to the leader’s effectiveness. Eagly (2005) argues that the leader/follower relationship should be a reciprocal one based on trust and respect, with leaders influencing followers and vice versa. A reciprocal, respectful and trusting relationship is achieved when the leader acts with integrity, honesty, positivity, confidence and commitment. A good rapport is developed through:

  • listening
  • consultation
  • involvement
  • explanation of why as well as what needs to be done
  • a professional and not a personal focus when relating to others.

The extent to which effective leaders are born with or acquire leadership qualities and skills remains a subject open to debate. What is clear is that a person does need certain qualities and skills for leadership. Qualities refer to attitudes and behaviours; skills refer to knowledge and methods of working.

Maxwell (1999) identified 21 ‘indispensible’ qualities of a leader (see Table 1).

Table 1: Maxwell’s indispensable qualities of a leader

Character / Focus / Relationships
Charisma / Generosity / Responsibility
Commitment / Initiative / Security
Communication / Listening / Self-discipline
Competence / Passion / Servanthood
Courage / Positive attitude / Teachability
Discernment / Problem solving / Vision

(Source: Maxwell, J.C. (1999) The 21 Indispensible Qualities of a Leader: Becoming the person others will want to follow. Nashville: Thomas Nelson)

The NHS Institute for Innovation and Improvement (2005) analysed the leadership qualities and skills of 150 chief executive and directors, and used this information to design the NHS Leadership Qualities Framework. This is based on 15 key leadership qualities that are arranged into three core areas of leadership:

  1. Setting direction
  2. Delivering services
  3. Personal qualities.

Skills for Care have also mapped leadership and management standards for social care to underpin the Skills for Care Leadership and Management strategy (Skills for Care, 2008). This outlines six functional areas/standards:

  1. Managing self/ personal skills
  2. Providing direction
  3. Facilitating change
  4. Working with people
  5. Using resources
  6. Achieving results.

Effective leaders need vision, energy, authority and strategic direction. Yet according to Goffee and Jones (2000), leaders must also:

  • be able to show/expose their vulnerability to demonstrate their humanness/ approachability
  • use intuition/emotional intelligence to identify when and how to act
  • empathise fully/realistically
  • show/capitalise on their own uniqueness.
References

Bernhard, L. Walsh, M. (2006) Leadership: The key to the professionalization of nursing. St Louis: Mosby

Eagly, A.H. (2005) ‘Achieving relational authenticity in leadership: Does gender matter?’, Leadership Quarterly, 16: 459–474

Goffee, R. Jones, G. (2000) ‘Authentic leadership. Excite others to exceptional performance’. Leadership Excellence, 26(7): 17

Maxwell, J.C. (1999) The 21 Indispensible Qualities of a Leader: Becoming the person others will want to follow. Nashville: Thomas Nelson

NHS Institute for Innovation and Improvement (2005), NHS Leadership Qualities Framework (accessed at

Northouse, P.G. (2009) Leadership: Theory and Practice. Thousand Oaks: Sage Publications

Skills for Care (2008) Leadership and Management Strategy Update 2008: Transforming Adult Social Care. Leeds: Skills for Care