A challenging and inclusive approach to leadership is what we need

I have been chief executive at Bolton Foundation Trust for over two years now. Our organisation has recently endured a prolonged period of turbulence and distress but we have recovered well, and are fully compliant again on all fronts.

• HSJ100 marks seismic change in NHS leadership
• BME women must be courageous to break down the NHS’ concrete ceilings
• The NHS requires a national clinical leadership talent management pipeline

Factors that worked

There have been two crucial factors, in my view that have led to that success; an excellent, committed leadership team and widespread clinical and non-clinical staff engagement throughout the trust.

In the early months of the trust’s difficult period, I spent many hours meeting face to face with lots of different groups of staff to explain the reasons behind the financial deterioration of the trust and Monitor’s intervention. This was time well spent as it gave me an opportunity to explain how we were going to deal with our problems.

I used this opportunity to appeal to the consultant staff in particular to get involved and encouraged them to use the systems we had introduced around patient level costing thus implementing service line management with good clinical leadership. As a result, we developed high levels of clinical engagement, which subsequently resulted in significant levels of savings from clinical areas, and importantly without adversely impacting on the quality or safety of patient care.

I learned very early on in my career the importance of the relationship between well-developed, motivated and engaged staff and excellent patient outcomes. This requires above all, visibility and effective communication at every level. It also requires a constant, consistent and very visible recognition of the effort put in by NHS staff on a day to day basis.

’As well as supportive, my approach is also very positive and, constructively challenging’

The staff are the people who inspire me; so whenever I receive praise for a member of staff I seek them out in their place of work to personally congratulate them. We have also developed a multitude of reward and recognition events.

These simple gestures demonstrate the power of thanks and recognition. This makes a massive difference to people and how they feel and, how they go about their work.

However, as well as supportive, my approach is also very positive and, constructively challenging. Like many NHS leaders I am ambitious for the best possible care for our patients and consequently strive for high performance on all levels.

I strongly believe in distributing the leadership challenge, but in doing this it’s important to set clear but attainable objectives and to be consistent in holding staff to account against their delivery. At Bolton we have developed robust frameworks to enable this but there is always more to do and keeping our staff well developed is also a key requirement.

What it takes

What does it take to get to the top?

In order to reach the top I think my female colleagues need resilience, self-belief and tenacity.

Personally, I have admired and taken my inspiration from colleagues who have resisted the traditional autocratic style of leadership which we unfortunately all still experience in the NHS.

These colleagues have tended to be nurse or therapy team leaders and usually women with a style that is much more collaborative and inclusive.

’It is perfectly possible to get great results from a supportive and nurturing approach’

I now know it is perfectly possible to get great results from a supportive and nurturing approach but it has to be authentic, consistent and to be combined with a clear vision, cascaded objectives and a framework to ensure delivery.

Above all, pay attention to your team; select according to the values you believe in and then support and develop them well.

Jackie Bene is chief executive and clinician at Bolton Foundation Trust