NHS Scotland Leadership Qualities Framework
NHS ies(“being”)Guidance NotesJuly 2014
NHS ScotlandLeadershipQualitiesFrameworkContents1: Introduction to the Framework1- Why we need a Leadership Framework- Overview of the Framework- Review of the Framework2: Using the Framework53: The Leadership Behaviours6-SummaryPersonal qualitiesService excellenceFuture focusGuidance Notes for NHS Scotland Leadership Qualities Framework / July 2014
1: Introduction to the FrameworkWhy we need a "Leadership Framework"Our leaders and managers are operating within a context of change and complexity. Thedevelopment of individuals in leader and manager roles, as well as of leadership teams, takeplace within the strategic context in which they operate, i.e., their particular part of theorganisation, across their whole organisation, as well as across health and social care inScotland.This context influences the priorities and challenges each individual faces in their role. Itshapes what they are required to focus on in their leadership role, i.e., service objectives,quality improvements, performance targets. However, how individuals and teams lead - interms of values, behaviours, attitudes, and mindset - is at least as important as what theydeliver in the leadership role. In other words, how leaders act and behave can help make orbreak delivery of the change agenda in health.Having a consistent NHS Scotland-wide Leadership Framework provides clarity about: Why effective leadership and management is important to the delivery of highquality health and social care services What is expected of individuals, teams and organisations in terms of deliveringeffective leadership and management (the "what") The values, behaviours and attitudes of leaders and managers which underpineffective leadership and management (the "how")It can be used to underpin personal and team development plans, as well as leadership andorganisational development activities, thereby ensuring alignment and consistency betweenorganisational purpose / focus and individual, team and organisational development.Overview of the NHS Scotland Leadership Qualities Framework 1The original NHS Scotland Leadership Qualities Framework was developed by the leadershipteam (precursor to the National Leadership Unit) in the Scottish Executive HealthDirectorates, on behalf of NHS Scotland. It was launched along with Delivery throughLeadership (Scottish Executive, 2005).2 The review of Delivery through Leadership in 2008confirmed that stakeholders agreed with having a framework of leadership qualities andbehaviours. They also felt that the particular qualities and behaviours were still largelyappropriate, with some modifications.1“Delivering Quality through Leadership”, NHS Scotland (June 2009), Section 3 & Appendix 2"Delivery through Leadership”, Scottish Executive (2005), the NHS Scotland leadership development strategy,2005-082Guidance Notes for NHS Scotland Leadership Qualities Framework / July 20141
The NHS Scotland Leadership Qualities Framework was amended in 2008-9, as shown inFigures 1 & 2. While the amended framework comprised the same clusters of leadershipbehaviours, it was re-drawn to put a focus on "personal qualities". There was also some rewording in line with a "culture and diversity check". The amended Framework waslaunched along with Delivering Quality through Leadership (Scottish Government, 2009), theleadership development framework for NHS Scotland, 2009-2012.The personal qualities are re-positioned at the heart of the leadership framework,supporting the notion of authentic leadership. Resilience in particular is a critical personalquality for NHS leaders who need to be able to manage upwards as well as across theorganisation, to manage ambiguity, to take difficult decisions and to have conversationswhich they may find challenging.Leaders in the NHS have to cope with the paradox of the leadership role: Striking the balance between a long-term focus on health improvement with theshort-term imperative of meeting HEAT targets; Managing the tension between innovation and risk; and, Managing corporate governance and performance while being supportive, engagingpeople and enabling others to develop.These themes apply equally to leadership at all levels - from the top in the ScottishGovernment and the Boards through to the front line. There is a need for a consistency ofapproach across all levels.The model of ‘heroic leadership’ is no longer appropriate. What is required is ‘engagingleadership’:“a commitment to building shared visions with a range of different internal andexternal stakeholder [which] exploits the diversity of perspectives and the wealth ofexperiences, strengths and potential that exists within the organisation, and withpartners and other stakeholders”.3In essence, it is a model of leadership which focuses on building capacity and capability inpeople and organisations. It is leadership which is underpinned by the shared NHS andpublic service values of: quality of service; equity of access; respect for diversity; mutualityand partnership; integrity; and, consistency.3Beverley Alimo-Metcalfe & John Alban-Metcalfe (September 2008), Engaging Leadership – Creatingorganisations that maximise the potential of their people, CIPD Research Insight, p.12.Guidance Notes for NHS Scotland Leadership Qualities Framework / July 20142
Figure 1: NHS Scotland Leadership Qualities FrameworkThe broad change contextwithin which leaders in NHSScotland operate sets thescene for leadershipdevelopment.The challenges of the leadershiprole (at all levels) comprise:Personalqualities(“being”)Service objectives, i.e., whatleaders are required to do – as setout in local PerformanceManagement (PM) processes.Role-specific knowledge andskills, i.e., what leaders need toknow to do their role – as set outin the Knowledge & SkillsFramework (KSF) or PersonalDevelopment Plans for seniormanagers.The leadership qualities andbehaviours that are required todeliver the challenges facingleaders in NHS Scotland, withpersonal qualities at the heart.See figure 2Note: Extract from “Delivering Quality through Leadership”, NHS Scotland Leadership Developmentstrategy (2009), section 2.In setting out this Framework, we recognise that: Leadership development takes place within the strategic context in which ourleaders are operating. The detail is outlined in Section 2.0 of Delivering Qualitythrough Leadership.4 This sets the scene for leadership development. The leadership role is defined and linked to local processes including performancemanagement, personal development planning and application of the Knowledge andSkills Framework (KSF). This sets out the "what" of leadership. A set of leadership qualities and behaviours which we need our leaders todemonstrate in how they deliver their role. These set out the "how" of leadership. Leadership development does not take place in isolation but is critically linked toother processes, locally and nationally - such as performance management, personaldevelopment planning, eKSF. We need development approaches that concentrate on both leadershipdevelopment, i.e., enhancing collective leadership capability, as well as leaderdevelopment, i.e., enhancing the development of individual leaders.4An updated outline of the context is provided in "Leadership Matters", following the review in 2012 of thenational strategy for leadership development which was conducted alongside the engagement exercise for"Everyone Matters: 2020 Workforce Vision" (Scottish Government, 2013).Guidance Notes for NHS Scotland Leadership Qualities Framework / July 20143
Review of the NHS Scotland Leadership Qualities FrameworkAlongside the review of the NHS Scotland leadership development strategy during 2012, apragmatic decision was taken to adopt the "NHS Leadership Framework" (developed in NHSEngland) and its accompanying 360 feedback tool. However, this framework has now beenreplaced by the "Healthcare Leadership Model" (from April 2014) and the feedback tool hasceased to exist.As a contingency measure for 2014-15, therefore, we have returned to using the NHSScotland Leadership Qualities Framework (as outlined in this document). We have madean interim arrangement with Pilat HR Solutions who are providing access to the 360 feedback tool which is based on the NHS Scotland Leadership Qualities Framework.During this interim period, we will be working with colleagues across health and social carein Scotland on the development of a new leadership framework which reflects our changingcontext. (For information on progress with the new framework, please contactnlu@nes.scot.nhs.uk)The development of a new framework is being undertaken in the context of theimplementation of: "Everyone Matters: the 2020 Workforce Vision (Scottish Government, 2013) The Scottish Government Leadership & Management Policy Statement and thesupporting leadership and management development strategic document,"Leadership Matters" (to be published, 2014) Health and Social Care integration Public services reform and collaboration across Scotland Strategy for building leadership capacity in Scotland's social services, 2013-2015(SSSC, 2014)Guidance Notes for NHS Scotland Leadership Qualities Framework / July 20144
2: Using the FrameworkIn using the Framework, bear in mind the following: Developing leadership capabilities out of context is seen as insufficient on its own. It iscrucial to develop the leader in the role and in full recognition of the complexities oftheir context too. Focus in particular on those capabilities and behaviours which a leader needs todevelop - or to build upon - in order to lead well in their particular situation as well as inthe wider context of health and social care in Scotland. Be aware of how these capabilities and behaviours are related to, and under-pinned by,our values (as outlined in Everyone Matters: 2020 Workforce Vision for NHS Scotland). In how we develop our leaders and managers, pay attention to fundamentalmanagement skills and processes, as well as personal capabilities and values aroundself-awareness, learning and reflective practice. Make explicit the links between the Leadership Framework and the associatedleadership behaviours and other developmental frameworks / tools, such as the NHSKnowledge & Skills Framework. Ensure that the application of the leadership qualities is linked with other processes,including performance management and personal development planning (as outlined infigure 1).The overall framework (Figure 1) and the leadership qualities (see Figure 2) provide a basisfor further local development to support:Recruitment and assessment:-Developing role profiles and person specifications to recruit leaders-Identifying which of the leadership behaviours are critical to the effective delivery ofa particular leadership role, at a particular time-Focusing on several key leadership behaviours in a recruitment or assessmentprocessPersonal and team development planning and review:-Focusing on which of the leadership behaviours are critical to the person'sperformance, in their role, at this time and over the coming year(s)-Making use of the 360 feedback tool to support personal developmentDesign of leadership development initiatives:-Focusing on the development of particular leadership behaviours, for individualparticipants-Focusing on the development of team leadership behavioursGuidance Notes for NHS Scotland Leadership Qualities Framework / July 20145
3: The Leadership BehavioursThe set of leadership behaviours or qualities, summarised in Figure 2, has been drawn froma wide range of NHS, public sector, private sector and contemporary academic thinking andmodels.It recognises the need for consistent use of positive behaviours by leaders, i.e., thatperformance is not simply about getting things done regardless of how. Fully effectiveperformance requires balancing what needs to be done with how it gets done. It should beused as part of the performance review and personal development planning processes.Figure 2: Summary of leadership qualitiesAchievingresultsPersonal governancePersonal managementSetting thedirectionSeeking understandingCreating andmaking choicesDevelopingcapability& capacitywithpartnersLeadingchangeThe detail of the leadership behaviours is summarised in the pages following (pages 7-14).There is an on-line 360 feedback diagnostic tool available to support the use anddevelopment of the leadership qualities and behaviours. See separate documentationrelating to the use of the 360 feedback diagnostic tool.Guidance Notes for NHS Scotland Leadership Qualities Framework / July 20146
Personal QualitiesThe Personal Qualities are deliberately positioned at the heart of the framework ofleadership behaviours, supporting the notion of authentic leadership. Resilience inparticular is a critical personal quality for NHS leaders who, working within a politicalcontext, need to be able to manage upwards as well as across the organisation, to manageambiguity, to take difficult decisions and have conversations they may find challenging.Commitment to service excellence.Integrity and honesty.Account for performance.PersonalqualitiesEngage with others in decisionmaking.Develop team and self.Personal governanceSelf-awarenessPersonal managementSelf management & resilienceSeeking understandingChampion and live the NHS values.Asking the difficult & challengingquestions proactivelyListening empathetically tounderstandMaintaining a contemporaryknowledge of good practice."Personal Governance" is one of the personal qualities. A "Code of Personal Governance" isoutlined (on page 15) and provides a code of practice for all leaders and managers in NHSScotland. This "Code" provides a measure against which individuals can test their decisionsand actions. It also provides reassurance to all those served by NHS Scotland of theprofessional standards leaders and managers use in making complex and balancedjudgements.The "Code" was based on work done (originally in 2005) by the Institute of HealthcareManagement and the NHS Confederation to support the development of similar Codeselsewhere in the NHS.Please note: It is likely that the "Code" will be updated as part of the ongoingimplementation of Everyone Matters: 2020 Workforce Vision (2013). Managers should alsoconsult the NHS Scotland Staff Governance dance Notes for NHS Scotland Leadership Qualities Framework / July 20147
PersonalqualitiesPersonal governancePersonal QualitiesPersonal managementSeeking understandingPersonal governance (also see Code of Personal Governance, p15)Behaviour statements in 360 toolDescriptorsCommitment to serviceexcellence.Integrity and honesty.Account forperformance.Engage with others indecision-making.Develop team and self.See examples ofleadership behaviours intable below.1. Makes decisions based on patients’ / clients’ needs.2. Encourage and give recognition to service excellence.3. Act with honesty and integrity.4. Open and transparent in communication.5. Respect confidentiality of information.6. Take responsibility for own performance.7. Take responsibility for team’s performance.8. Model and promote collaborative working.9. Work with others to create a shared vision.10. Build and develop effective teams.11. Take responsibility for personal development.12. Understand and value cultural differences.Positive behavioursNegative behavioursCommitmentto serviceexcellence. Puts patients’ / clients’ needs at theheart of decision-making. Challenges decisions which are notbased on patients’ / clients’ needs. Recognises and rewards excellence. Celebrates success. Diagnoses and tackles poorperformance and providesappropriate support. Makes decisions which are notcentred on patients’ / clients’ needsand does not consider the patient /client point of view. Tolerates poor practice and does nottackle poor performance. Takes a punitive approach to poorperformance, giving no support.Integrity andhonesty. Is truthful and honest in dealing withpeople. Takes an open approach to issues. Creates a climate of openness inwhich people can say ‘no’ asappropriate. Respects confidentiality ofinformation consistently. Checks out and tackles issuespotentially involving dishonesty. Behaves in a deceptive, dishonest, ormanipulative way. Hides and encrypts information sothat it is not readily available to thosewho need it. Expects others simply to agree andnot question actions. Leaks or inappropriately sharesconfidential information. Flaunts or ignores issues potentiallyrelating to dishonesty.8Guidance Notes for NHS Scotland Leadership Qualities Framework / July 2014
Personal Governance, continued/ Positive behavioursNegative behavioursAccount forperformance. Accepts responsibility andaccountability. Gives credit where credit is due. Challenges micro-management whereit is not needed. Gives clear, concise, timelyexplanations – so that there are nosurprises. Ensures information is organised toexplain good and poor performanceclearly. Does not take on responsibility. Takes credit for others’ work. Promotes a culture of dependency. Withholds or is late in providinginformation. Information about performance ispoorly organised or not provided atall.Engage withothers indecisionmaking. Promotes a spirit of co-operation andinter-dependency. Seeks first to understand. Encourages meaningful dialogue atthe earliest opportunity. Develops a shared vision. Is flexible in approach. Is suspicious of others and promotesdependency. Seeks first to be understood. Decision-making takes place withincliques. Does not share information or viewswith others so that they are left out ofthe decision-making. Is rigid and imposes change.Develop team Builds self-belief and promotes a ‘cando’ attitude.and self. Gives others freedom to makedecisions within given authority. Lets go of control, enabling others totake calculated risks. Inspires trust. Values everyone as individuals andrespects differences. Uses inclusive language. Understands and values culturaldifferences. Shows willingness to change and learnfrom mistakes. Encourages behaviour which isconsistent with all of the above andchallenges those whose behaviour isnot. Undermines other people’sconfidence. Concerned to retain ultimate controlat all costs. Operates with complex andcontrolling systems of accountability. Is manipulative. Expects everyone to be ‘the same’,i.e., does not respect diversity. Uses discriminatory language. Is unaware or ignorant of diversityand equality. Acts as if they know it all. Behaviour which is inappropriate isnot challenged.9Guidance Notes for NHS Scotland Leadership Qualities Framework / July 2014
Personal managementBehaviour statements in 360 toolDescriptorsSelf-awareness.Self management &resilience.Champion and live theNHS values.See examples ofleadership behaviours intable below.13. Show understanding of own strengths and developmentneeds.14. Seek feedback on own performance and act on it.15. Recognise and manage own emotions.16. Recognise emotions in others and help them managethem.17. Come across as positive and enthusiastic.18. Behave consistently with the NHS values.19. Does what s/he says they will do.Positive behavioursNegative behavioursSelfawareness. Takes the time to reflect. Values honest feedback. Is realistic about strengths anddevelopment needs Seeks out feedback and supportwhere needed. Does not seek out feedback. Does not admit to their weaknessesor development needs. Has unrealistic expectations of selfand others. Does not ask for help or support, triesto go it alone.Selfmanagement& resilience. Adopts a positive and enthusiasticapproach. Is consistently fair in dealing withothers. Is responsible and constructive. Demonstrates warmth and is easy toapproach. Demons
These themes apply equally to leadership at all levels - from the top in the Scottish Government and the Boards through to the front line. There is a need for a consistency of approach across all levels. The model of ‘heroic leadership’ is no longer appropriate. What is required is ‘engaging leadership’: “a commitment to building shared visions with a range of different internal and .
NHS Long Term Plan Implementation Framework I 3 Introduction to the NHS Long Term Plan Implementation Framework 1.1 The NHS Long Term Plan, published in January 2019, set out a 10-year practical programme of phased improvements to NHS services and outcomes, including a
Public Health Adviser, Public Health Observatory, NHS Health Scotland. Mhairi McGowan: Women’s Aid/ASSIST. Nicola Merrin: Policy Officer, Victim Support Scotland. Justina Murray: Chief Officer, South West Scotland Community Justice Authority. Dr Mark Robinson: Senior Public Health Information Manager, Public Health
bunchberry dr nhs wms amb . burgundy ln nhs wms twl . burkwood dr nhs wms amb . burning tree st chs wms twl . burnock dr chs wms mbe . burr ridge rd nhs nms twl . burrwood ave nhs nms ang . burrwood st nhs nms ang . burt dr chs cms lce
of NHS Direct, and led the team preparing New Labour's first White Paper, The New NHS: Modern, dependable, which laid the foundations and structure for the current NHS reform programme. He was a member of the top management board of the NHS for 12 years, between 1988 and 2000. His earlier career included 23 years in NHS management,
The leadership qualities in this guide are organized by the NHSI Leadership Framework's three clusters (personal qualities, setting direction and delivering the service) comprising 13 key attributes that improvement leaders can demonstrate in their everyday work (see Table 1). These leadership qualities are cross-cutting for all improvement
Accessible Travel Annual Delivery Plan 2021-22 Transport Scotland 4 Finally, I would like to take this opportunity to pay particular thanks to the Mobility and Access Committee for Scotland (MACS), Disability Equality Scotland (DES) and all the members of our Accessible Travel Steering Group. All of whom have
It is now referenced in the Mandate to NHS England, the NHS Planning Guidance and the CCG Improvement and Assessment Framework. The RightCare programme includes the Commissioning for Value packs and tools, the NHS Atlas series and a number of casebooks. NHS England has committed significant funding to rolling out the RightCare
16.02.2018 Colin Harris, Sutherland Hussey Harris, Glasgow 23.02.2018 Shadi Rahbaran & Ursula Hürzeler, Rahbaran Hürzeler Architekten, Basel 02.03.2018 Carl Turner, Carl Turner Architects (cancelled for snow storm) 09.03.2018 Mary Duggan, Mary Duggan Architects, London 16.03.2018 Jaime Font, Mesura, Barcelona
