I critique the evidence base
In episode 16 of ‘Transformational Thinking for Health Leaders’, I critique the evidence base for health leadership in light of the the new England National Health Service (NHS) 10-year Plan. This has a specific goal of ‘great leadership in healthcare’. Co-incidentally, a new systematic umbrella review by Juliette Phillipson et al has just been published in BMJ leader– this is a review of reviews and so its conclusions are particularly important.
The lack of rigorous evidence for most leadership development interventions
Unfortunately most leadership development courses and programmes (unlike coaching psychology practice!) are not underpinned by rigorous evidence.
Competency frameworks do not directly translate to improved leadership behaviours. Too often – as I’ve been surprised to encounter when working with hundreds of health leaders over the last 10 years– there has been a reliance on unevidenced or outdated methods to train and nurture health leadership talent in the UK and beyond. Health Leaders are doing the best they can but I believe they need much more nuanced support based on rigorous evidence to fully achieve their potential.
A systematic umbrella review is a massive undertaking!
The authors state that whilst effective clinical leadership in healthcare has been recognised as a vital component in healthcare efficiency, there is a lack of systematic evidence supporting the clinical and organisational level impact and return on investment – and that we still do not yet have consensus on the most effective educational methods or content to support leadership development.
Almost 70% of the population included in the reviews were doctors, 50% nurses and over 45% healthcare managers or leaders. They don’t mention public health specifically- and public health has unique, discipline specific requirements.
The majority of reviews reported that included studies had universally or predominantly positive outcomes.
Coaching is one of the most effective interventions
Experiential learning and the use of coaching and or mentoring were associated with greatest leadership outcomes.
The authors also note that there is a lack of a shared theoretical foundation in leadership training, and that few studies explicitly reference underpinning leadership theory.
Listen to Podcast
Listen to the full podcast ‘Transformational Thinking for Health Leaders’ here.
The England NHS 10 year plan
Whilst leaders can cognitively know the science of great leadership, ultimately we need them to consciously choose behaviours in the workplace on a moment-by-moment basis: this demands that every health leader knows and consciously works to expand their ‘psychological growth edge’.
For most leaders, achieving this level of psychological sophistication requires a fundamental rewiring of their neural networks as the leader gradually progresses through various stages of adult development and sense-making.
To achieve world-class leadership in the NHS in England and in a wide range of other contexts globally, we need experts who are able to expand leaders’ development, using a wide range of psychologically-sound approaches to behaviour change and achievement of potential.
Coaching Psychology focuses on potential, performance and wellbeing in the workplace
Coaching psychology is a discipline within psychology which focuses on potential, performance and wellbeing in the workplace: I believe it is the most theory-grounded and evidence-based way to enable leaders to develop the psychological flexibility, meta-cognitive skills, and emotional regulation needed to be fulfil their potential and also to stay well in their roles.
Chartered Coaching Psychologists are experts in the field of leadership development. They are uniquely able to use their training to identify on a moment-by-moment basis with each individual client “What core biopsychosocial processes (ie an individual’s biological and psychological processes plus effecting change within the wider system) should be targeted with this specific leader given this goal in this situation, and how can they most efficiently and effectively be changed to best impact the desired outcomes?”.
We need to go further than the NHS 10-year Plan
To develop outstanding health leaders, we must go beyond the Plan’s recommendations. There is no ‘upper limit’ to leadership development. However, without ongoing work on psychological flexibility, clinicians and managers cannot become world-class leaders. We can achieve this vision and improve health outcomes in England and beyond by widely integrating coaching psychology into leadership development.
Reflective Questions for Health Leaders
- What has been your experience of leadership development so far?
- How confident do you feel that your health leadership practice is grounded in theory and evidence?
- How do you develop leadership skills in those around you?
- How could you help your organisation to be more evidence-based in its approach to developing health leaders?
- How will you use the systematic umbrella review to best effect?
Dr Fiona Day is a Chartered Coaching Psychologist accredited by the British Psychological Society, and by EMCC as a Master Practitioner Coach & Mentor. She has experience as a system and Board-level medical and public health leader. Fiona focuses on coaching medical and public health leaders, and also trains health leaders in coaching and mentoring skills at EMCC EQA Foundation Level. Get 3 hours of FREE CPD with Fiona’s ‘Health Career Success Programme’ here, and listen to her podcast ‘Transformational Thinking for Health Leaders’ here.
