Hardacre, Jeanne E. (2011) Exploring the links between leadership and improvement in the UK National Health Service. PhD thesis, University of Warwick.

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Abstract

Whilst the need for leadership in healthcare is well-recognised, there is still a lack of
understanding about how leadership contributes to improving healthcare services. The
body of knowledge concerning improvement has grown significantly in recent years,
but evidence about links between leadership and health services improvement
remains poor, especially within the UK National Health Service. It remains unclear how
and why leadership is important to service improvement.
This thesis describes aspects of a broader study commissioned by The Health
Foundation. Firstly, the work aimed to explore the extent to which different types of
service improvement require different types of leadership behaviour. Secondly, it
aimed to investigate the nature of any links between leadership behaviour and
improving services. The work draws on theoretical models and concepts of leadership
and improvement in the literature, as well as empirical research in these areas. A
typology of healthcare improvement was developed in order to classify different types
of improvement work. Data about leadership behaviours were derived from semistructured
interviews and using Q-Sort methodology.
The study provides insights into which aspects of leadership are used for different
types of improvement work. It makes an original and NHS-specific contribution to the
literature, providing empirical evidence of how NHS leadership is associated with
service improvement. Results highlight the importance of the relational aspects of
leadership behaviour in improving NHS services, reinforcing trends in the literature
which promote shared and distributed leadership approaches. A model of
improvement leadership is proposed, based on the concept of ‘interdependence’. This
model could provide the basis for an alternative emphasis in developing leadership in
healthcare organisations, away from teaching skills to individuals, towards a collective,
team-based approach to leading services with a shared purpose.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management R Medicine > RA Public aspects of medicine
Library of Congress Subject Headings (LCSH):	Great Britain. National Health Service -- Management, Health services administration -- Great Britain, Leadership
Official Date:	November 2011
Dates:	Date Event November 2011 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Williams, Sharon, Dr.
Extent:	359 leaves : charts.
Language:	eng

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