Discussion roundup: what is good leadership in the NHS?

Effective leaders motivate people across the NHS to drive change. Photograph: Christopher Thomond for the Guardian

David Welbourn, deputy director, Centre for Health Enterprise, Cass Business School: "If we look at the role of a board director as a specific category of leader, their duties are laid down in the corporate code of conduct, and good leadership starts from there."

Stephen Brooks, specialist in people, change and leadership at PA Consulting Group: "Leadership is also about establishing the values and ethos of the organisation that provide the framework for decision making by others."

Jane-Claire Judson, national director for Diabetes UK Scotland and a Health Foundation Generation Q fellow: "Leadership is often about being self aware and aware of the mix of skills around you and how to bring out the best in them across a team."

Simon Gilby, chief executive of Wirral Community NHS trust: "I think a key thing for a good leader is to ensure they have people, inside the organisation and external to it, who will tell them the truth – not what they think you want to hear."

Jan Filochowski, chief executive of Great Ormond Street Hospital for Children NHS foundation trust and author of Too Good To Fail?: "The failing organisations I have gone into have typically suffered from this defect. The truth is either ignored or worse concealed. For me the worst fault in a manager is not getting things wrong but not owning up to doing so. We all get things wrong. My favourite adjective for what a good manager will be is 'imperfect'."

Karen Lynas, deputy managing director and head of programmes and practice team, NHS Leadership Academy: "One of the roles of a leader in the NHS, at whatever level they work is to understand the emotional labour required of NHS staff and be hugely invested in providing the right environment for them."

David Welbourn: "Good leadership is independent of organisation, sector and industry."

Jane-Claire Judson: "Working in the third sector we see ourselves as unique too with motivations that differ from the NHS, the wider pubic sector and from the private sector. However, a lot of the discussions around leadership are similar – trust, honesty, dealing with a shifting context and ambiguity, caring for our staff and volunteers whilst also getting through the day to day."

Jan Filochowski: "We often talk of leadership as an inherent quality, and in my view it is dangerous to do so. It needs to be learnt and it must be based on having good management skills. We need more good managers, then we will produce more good leaders."

Karen Lynas: "Good management isn't always the foundation to good leadership but I agree we need to train and develop our leaders. We should not assume that the skills they require are inherent, or can be picked up on the job anymore than we would expect that of a clinical or a finance manager."

Stephen Brooks: "I was shocked that people in senior leadership roles confessed to me that they could not remember when they last had any leadership training."

Paul Taylor, head of engagement and organisational development at NHS Employers: "We should be helping front line staff and all those working to support them in their roles to feel equipped to make decisions and see themselves as leaders in their own right. At the more senior levels, we need to help leaders to lead differently in this new system with much more of a focus on partnerships and collaboration."

Katy Steward, assistant director, leadership development, and Sarah Goodson, senior consultant, leadership development, at the King's Fund: "The issue is really one of developing good relationships between NEDs [non-executive directors] and governors, having the right conversations and knowing when to influence the agenda in the annual cycle of the board business. Governors need to be seen as a positive resource not an unnecessary evil."

David Welbourn: "I cannot think of any failure at this level that wasn't caused either by the hubris of a board that failed to engage with the realities of its context, or alternatively, abdicated its responsibility to others, because it didn't have either the skills or courage to make its own decisions."

Jan Filochowski: "Power is of course distributed between boards, execs, the clinical body, governors and others, but leadership is a bit different. It's about understanding that power distribution and orchestrating it to the most positive effect. Easily said, I know but very hard and skilful to do."

Karen Lynas: "We have thousands of leaders in the NHS, if we want to make a difference we need development support that is significant enough to reach all of them ... We are blessed with some great leaders in the NHS and we would be well served by recognising them more."

David Walker, contributing editor, Public Leaders Network: "Many NHS people shy away from 'politics' but as, for example, NHS bodies have to get closer to elected local government, their engagement with councillors will have to increase. Health and wellbeing boards, whatever they may do, are going to be 'political' and require NHS leaders to add to their repertoire advocacy and representational skills."

Jackie Leigh, a senior lecturer at the University of Salford, programme leader for the MSc Leadership and Management for Healthcare Practice: "We need to learn from the patient and staff stories of where excellent leadership is taking place and what makes the leadership excellent."

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