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I doubt the possibility of producing generic NHS leaders. To begin, the NHS has at least two types of organisation - the foreground characterised by chaos, and the background characterised by bureaucracy. In the foreground organisation, where the delivery of services to patients occurs, a role of leader is attractor, the central calming role whilst all around her is chaos relating to the nature of patient care - the uncertainty, spontaneous, eclectic responses to a patient - whilst in the background organisation there is a focus on the transactional aspects of leadership - systems, records, compliance, regulation, accounting. Often the background organisation seems to adopt a superior hierarchical position to the foreground organisation - generally a recipe for low achievement and poor standards - thus elevating the transactional role over the adaptive role needed in the foreground. We can see the results of this with a focus on background issues, such as compliance with accounting or not meeting targets, and not on foreground issues , such as successful treatment for over 1 million people a day. These two organisations require different leadership abilities in certain respects, although the same abilities in their behaviour that promotes commitment and trust. Unhappily, some successful leaders in the foreground organisation seek promotion to organisations in the background, which requires a different style. Little wonder that there are vacancies at critical points on the ladder as there is an expectation that people will want to climb the ladder, rather than an expectation that we need leaders of different styles for different purposes.
Derek Mowbray, from Linkedin