How the Healthcare Leadership Model has been developed

Introduction Text:
The Healthcare Leadership Model has been developed by the NHS Leadership Academy, working with Korn Ferry Hay Group and colleagues from the Open University.

It is an evidence-based research model that reflects:

  • the values of the NHS
  • what we know about effective leadership
  • what we have learned from the Leadership Framework (2011), and
  • what our patients and communities are now asking from us as leaders.

This below explains how the model was developed and gives more information on how the research was carried out.

Secondary Research (March – April 2013)

The aim of the secondary research was to:

  • understand what existing research has already said about leadership more generally, and
  • help identify what then needs to be different for healthcare, for the NHS, and for the NHS in the current environment.

John Storey and Richard Holti of the Open University, working with Hay Group, carried out a review of current literature and research on leadership models and behaviours, including international as well as private-sector learning. You can download Holti and Storey’s paper here: Towards a New Model of Leadership (2013)

Hay Group then developed Storey and Holti’s findings into a draft behavioural model. As part of this stage, Hay Group drew on the following:

  • their own knowledge of leadership in the NHS and elsewhere
  • comparison of research data with health system competency models in Hay Group’s competency database
  • analysis of NHS leaders’ assessment data
  • analysis of the differences in behaviours between line managers and senior individual professionals.

Primary Research (April – June 2013)

The aim of the primary research stage was to identify sample leadership behaviours at different levels of intensity and sophistication using the draft model created from the secondary research. This stage consisted of two sets of interviews:

  • strategic interviews with people who have extensive experience of leaders in the NHS
  • interviews with leaders across the NHS at a variety of levels to gather detailed examples of how they lead and how this delivers results.

The sample of interviewees for both sets of interviews was selected by the NHS Leadership Academy working with their Local Leadership Academies (LLAs). The strategic interviews were carried out by staff in the NHS. Hay Group assessors carried out the interviews with leaders, using a focused interview technique. Hay Group then coded all the interviews against the draft leadership model, and carried out a thematic analysis.

Drafting (June 2013)

The aim of the drafting stage was to take everything we had learned from the previous two stages to create a more refined draft. The format we used was a ‘concept formation’ workshop, attended by the NHS Leadership Academy and Hay Group. Here we brought the various data points together to produce a ‘working draft’ of the leadership model. The data points included:

  • the themes from Holti and Storey’s research paper
  • data sets from both sets of interviews
  • data with health system competency models in the Hay Group competency database, and
  • thematic analysis of NHS leaders’ assessment data.

In particular, we used evidence from the interviews to produce the leadership behaviour descriptions you see in the model.

Testing (June – August 2013)

The aim of the testing stage was to check with the intended audience of the model (staff in healthcare) that it would be relevant and user-friendly across various roles and contexts. This stage consisted of a number of focus groups, conducted by the NHS Leadership Academy and LDPs, involving a cross-section of staff at various levels working in various contexts. Additional stakeholders, such as colleagues in clinical professional bodies and those working in education, were also invited to provide feedback on the draft model.

The NHS Leadership Academy then analysed and themed the feedback from the focus groups. The feedback was overwhelmingly positive, and improvement points (largely relating to the most accessible language for the model) were acted upon in an updated version of the draft model. This then went through a plain English review, with relevant amendments made.

Finishing (August – October 2013)

The final stage was to finalise ‘version 1/version 2013’ of the Healthcare Leadership Model. This stage consisted of colleagues from Hay Group incorporating the final feedback into a final version of the model, which was signed off by the NHS Leadership Academy. The Academy then worked with designers to produce relevant graphics and finalise the design of the PDF document.

Limitations and plans to keep the model refreshed