© 2011 NHS Leadership Academy. All rights reserved.
The Leadership Framework is published on behalf of the NHS Leadership Academy by NHS Institute forInnovation and Improvement, Coventry House, University of Warwick Campus, Coventry, CV4 7AL.
Publisher: NHS Institute for Innovation and Improvement, Coventry House, University of Warwick Campus,Coventry, CV4 7AL.
This publication may be reproduced and circulated free of charge for non-commercial purposes only by andbetween NHS-funded organisations in England, Scotland, Wales and Northern Ireland staff, and their relatednetworks and officially contracted third parties. This includes the right to reproduce, distribute and transmit thispublication in any form and by any means, including e-mail, photocopying, microfilming, and recording. No otheruse may be made of this publication or any part of it except with the prior written permission and application forwhich should be in writing and addressed to the Director of Leadership (and marked ‘re. permissions’). Writtenpermission must always be obtained before any part of this publication is stored in a retrieval system of anynature, or electronically. Reproduction and transmission of this publication must be accurate, must not be used inany misleading context and must always be accompanied by this Copyright Notice.
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The Clinical Leadership Competency Framework was created with the agreement of the NHS Institute forInnovation and Improvement and the Academy of Medical Royal Colleges from the Medical LeadershipCompetency Framework which was created, developed and is owned jointly by the NHS Institute forInnovation and Improvement and the Academy of Medical Royal Colleges.
NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2010) MedicalLeadership Competency Framework, 3rd edition, Coventry: NHS Institute for Innovation and Improvement.
© NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges 2010
Leadership Framework: A Summary 3
The Leadership FrameworkThe Leadership Framework provides a consistent approach to leadership development for staff in health and careirrespective of discipline, role or function, and represents the foundation of leadership behaviour that all staffshould aspire to. Fundamental to its development was a desire to build on existing leadership frameworks usedby different staff groups and create a single overarching leadership framework for all staff in health and care.
In developing the Leadership Framework detailed research and consultation with a wide cross section of staffand stakeholders has been undertaken, including those with a patient perspective and those involved inhealthcare outside the NHS such as professional bodies, academics, regulators and policy makers.
Those consulted embraced the concept of the Leadership Framework because it affords a common andconsistent approach to professional and leadership development, based on shared values and beliefs whichare consistent with the principles and values of the NHS Constitution1.
The Leadership Framework is based on the concept that leadership is not restricted to people who holddesignated leadership roles and where there is a shared responsibility for the success of the organisation,services or care being delivered. Acts of leadership can come from anyone in the organisation and as a modelit emphasises the responsibility of all staff in demonstrating appropriate behaviours, in seeking to contributeto the leadership process and to develop and empower the leadership capacity of colleagues2.
This document provides a summary of the seven domains of the Leadership Framework. A full and web basedversion can be found at www.leadershipacademy.nhs.uk/If
Design and structure of the Leadership FrameworkDelivering services to patients, service users, carers and the public is at the heart of the Leadership Framework.The needs of the people who use services have always been central to healthcare and all staff work hard toimprove services for them. However, if we are going to transform services, acting on what really matters topatients and the public is essential and involves the active participation of patients, carers, communityrepresentatives, community groups and the public in how services are planned, delivered and evaluated3.
The Leadership Framework is comprised of seven domains.Within each domain there are four categories called elementsand each of these elements is further divided into fourdescriptors. These statements describe the leadershipbehaviours, which are underpinned by the relevantknowledge, skills and attributes all staff should be able todemonstrate.
To improve the quality and safety of health and care services,it is essential that staff are competent in each of the five core
leadership domains shown at right: demonstrating personal qualities, working with others, managingservices, improving services, and setting direction. The two other domains of the Leadership Framework,creating the vision and delivering the strategy, focus more on the role and contribution of individual leadersand particularly those in senior positional roles.
1 Department of Health (2010) The NHS Constitution: the NHS belongs to us all. The NHS Constitution can be accessed viahttp://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx
2 NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges (2009) Shared Leadership: Underpinning of theMLCF
3 Patient and Public Engagement, Department of Health (2009) Putting Patients at the Heart of Care: The Vision for Patient and PublicEngagement in Health and Social Care. www.dh.gov.uk/ppe
The word ‘patient’ is used throughout the Leadership Framework to generically cover patients, service users,and all those who receive healthcare. Similarly, the word ‘other’ is used to describe all colleagues from anydiscipline and organisation, as well as patients, service users, carers and the public.
The leadership contextThe application and opportunity to demonstrate leadership will differ and the context in which competence canbe achieved will become more complex and demanding with career progression. We have therefore used fourstages to describe this and to help staff understand their progression and development as a leader. They are:
Stage 1 Own practice/immediate team - is about building personal relationships with patients andcolleagues, often working as part of a multi-disciplinary team. Staff need to recognise problems and workwith others to solve them. The impact of the decisions staff take at this level will be limited in terms of risk.
Stage 2 Whole service/across teams - is about building relationships within and across teams, recognisingproblems and solving them. At this level, staff will need to be more conscious of the risks that their decisionsmay pose for self and others for a successful outcome.
Stage 3 Across services/wider organisation - is about working across teams and departments within thewider organisation. Staff will challenge the appropriateness of solutions to complex problems. The potentialrisk associated with their decisions will have a wider impact on the service.
Stage 4 Whole organisation/healthcare system - is about building broader partnerships across and outsidetraditional organisational boundaries that are sustainable and replicable. At this level leaders will be dealingwith multi-faceted problems and coming up with innovative solutions to those problems. They may lead at anational/international level and would be required to participate in whole systems thinking, finding new waysof working and leading transformational change. Their decisions may have significant impact on thereputation of the NHS and outcomes and would be critical to the future of the NHS.
Leadership Framework: A Summary4
Leadership Framework: A Summary 5
Application of the LeadershipFramework and supporting toolsThe Leadership Framework is designed to enable staff to understand their progression as a leader and tosupport fostering and developing talent. There are many ways it can be applied, for example:
• To raise awareness that effective leadership is needed across the whole organisation
• To underpin a talent management strategy
• As part of an existing leadership development programme
• To inform the design and commissioning of training and development programmes
• To develop individual leadership skills
• As part of team development
• To enhance existing appraisal systems
• To inform an organisation’s recruitment and retention processes.
To assist users the full and web based version have a suite of indicators across a variety of work placesituations which illustrate the type of activity staff could be demonstrating relevant to each element and stageas well as examples of behaviours if they are not.
Supporting toolsA self assessment and 360° feedback tool support the Leadership Framework; in addition an onlinedevelopment module signposts development opportunities for each of the seven domains. The 360° is apowerful tool to help individuals identify where their leadership strengths and development needs lie. The process includes getting confidential feedback from line managers, peers and direct reports. As a result, itgives an individual an insight into other people’s perceptions of their leadership abilities and behaviour.
To assist with integrating the competences into postgraduate curricula and learningexperiences, there is the LeAD e-learning resource which is available on theNational Learning Management System and through e-Learning for Healthcare(www.e-lfh.org.uk/LeAD).
The Clinical Leadership Competency Framework and the Medical Leadership Competency Framework are alsoavailable to specifically provide staff with clinically based examples in practice and learning and developmentscenarios across the five core domains shared with the Leadership Framework.
A summary version of the Leadership Framework follows, which includes the domains, elementsand descriptors. Work-place indicators that demonstrate the practical application of the frameworkat the four stages are included as tables in the back of the document. The examples in practice arenot included, however these are available in the full document as well as on the website(www.leadershipacademy.nhs.uk/If).
Leadership Framework: A Summary6
1. Demonstrating Personal Qualities
1.1 Developing self awareness
1. Recognise and articulate their own value and principles, understanding how these may differ from those of other individuals andgroups
2. Identify their own strengths and limitations, the impact of their behaviour on others, and the effect of stress on their own behaviour
3. Identify their own emotions and prejudices and understand how these can affect their judgement and behaviour
4. Obtain, analyse and act on feedback from a variety of sources
1.2 Managing yourself
1. Manage the impact of their emotions on their behaviour with consideration of the impact on others
2. Are reliable in meeting their responsibilities and commitments to consistently high standards
3. Ensure that their plans and actions are flexible, and take account of the needs and work patterns of others
4. Plan their workload and activities to fulfil work requirements and commitments, without compromising their own health
1.3 Continuing personal development
1. Actively seek opportunities and challenge for personal learning and development
2. Acknowledge mistakes and treat them as learning opportunities
3. Participate in continuing professional development activities
4. Change their behaviour in the light of feedback and reflection
1.4 Acting with integrity
1. Uphold personal and professional ethics and values, taking into account the values of the organisation and respecting the culture,beliefs and abilities of individuals
2. Communicate effectively with individuals, appreciating their social, cultural, religious and ethnic backgrounds and their age,gender and abilities
3. Value, respect and promote equality and diversity
4. Take appropriate action if ethics and values are compromised
Effective leadership requires individuals to draw upon their values, strengths and abilities to deliver high standards of service. To
do so, they must demonstrate effectiveness in:
• Developing self awareness by being aware of their own values, principles, and assumptions, and by being able to learn
from experiences
• Managing yourself by organising and managing themselves while taking account of the needs and priorities of others
• Continuing personal development by learning through participating in continuing professional development and from
experience and feedback
• Acting with integrity by behaving in an open, honest and ethical manner.
Leadership Framework: A Summary 7
2. Working with Others
2.1 Developing networks
1. Identify opportunities where working with patients and colleagues in the clinical setting can bring added benefits
2. Create opportunities to bring individuals and groups together to achieve goals
3. Promote the sharing of information and resources
4. Actively seek the views of others
2.2 Building and maintaining relationships
1. Listen to others and recognise different perspectives
2. Empathise and take into account the needs and feelings of others
3. Communicate effectively with individuals and groups, and act as a positive role model
4. Gain and maintain the trust and support of colleagues
2.3 Encouraging contribution
1. Provide encouragement, and the opportunity for people to engage in decision-making and to challenge constructively
2. Respect, value and acknowledge the roles, contributions and expertise of others
3. Employ strategies to manage conflict of interests and differences of opinion
4. Keep the focus of contribution on delivering and improving services to patients
2.4 Working within teams
1. Have a clear sense of their role, responsibilities and purpose within the team
2. Adopt a team approach, acknowledging and appreciating efforts, contributions and compromises
3. Recognise the common purpose of the team and respect team decisions
4. Are willing to lead a team, involving the right people at the right time
Effective leadership requires individuals to work with others in teams and networks to deliver and improve services. To do so,
they must demonstrate effectiveness in:
• Developing networks by working in partnership with patients, carers, service users and their representatives, and
colleagues within and across systems to deliver and improve services
• Building and maintaining relationships by listening, supporting others, gaining trust and showing understanding
• Encouraging contribution by creating an environment where others have the opportunity to contribute
• Working within teams to deliver and improve services.
Leadership Framework: A Summary8
3. Managing Services
3.1 Planning
1. Support plans for clinical services that are part of the strategy for the wider healthcare system
2. Gather feedback from patients, service users and colleagues to help develop plans
3. Contribute their expertise to planning processes
4. Appraise options in terms of benefits and risks
3.2 Managing resources
1. Accurately identify the appropriate type and level of resources required to deliver safe and effective services
2. Ensure services are delivered within allocated resources
3. Minimise waste
4. Take action when resources are not being used efficiently and effectively
3.3 Managing people
1. Provide guidance and direction for others using the skills of team members effectively
2. Review the performance of the team members to ensure that planned services outcomes are met
3. Support team members to develop their roles and responsibilities
4. Support others to provide good patient care and better services
3.4 Managing performance
1. Analyse information from a range of sources about performance
2. Take action to improve performance
3. Take responsibility for tackling difficult issues
4. Build learning from experience into future plans
Effective leadership requires individuals to focus on the success of the organisation(s) in which they work. To do so, they must
be effective in:
• Planning by actively contributing to plans to achieve service goals
• Managing resources by knowing what resources are available and using their influence to ensure that resources are used
efficiently and safely, and reflect the diversity of needs
• Managing people by providing direction, reviewing performance, motivating others, and promoting equality and diversity
• Managing performance by holding themselves and others accountable for service outcomes.
Leadership Framework: A Summary 9
4. Improving Services
4.1 Ensuring patient safety
1. Identify and quantify the risk to patients using information from a range of sources
2. Use evidence, both positive and negative, to identify options
3. Use systematic ways of assessing and minimising risk
4. Monitor the effects and outcomes of change
4.2 Critically evaluating
1. Obtain and act on patient, carer and user feedback and experiences
2. Assess and analyse processes using up-to-date improvement methodologies
3. Identify healthcare improvements and create solutions through collaborative working
4. Appraise options, and plan and take action to implement and evaluate improvements
4.3 Encouraging improvement and innovation
1. Question the status quo
2. Act as a positive role model for innovation
3. Encourage dialogue and debate with a wide range of people
4. Develop creative solutions to transform services and care
4.4 Facilitating transformation
1. Model the change expected
2. Articulate the need for change and its impact on people and services
3. Promote changes leading to systems redesign
6. Motivate and focus a group to accomplish change
Effective leadership requires individuals to make a real difference to people’s health by delivering high quality services and by
developing improvements to services. To do so, they must demonstrate effective in:
• Ensuring patient safety by assessing and managing risk to patients associated with service developments, balancing
economic consideration with the need for patient safety
• Critically evaluating by being able to think analytically, conceptually and to identify where services can be improved,
working individually or as part of a team
• Encouraging improvement and innovation by creating a climate of continuous service improvement
• Facilitating transformation by actively contributing to change processes that lead to improving healthcare.
Leadership Framework: A Summary10
5. Setting Direction
5.1 Identifying the contexts for change
1. Demonstrate awareness of the political, social, technical, economic, organisational and professional environment
2. Understand and interpret relevant legislation and accountability frameworks
3. Anticipate and prepare for the future by scanning for ideas, best practice and emerging trends that will have an impact on healthoutcomes
4. Develop and communicate aspirations
5.2 Applying knowledge and evidence
1. Use appropriate methods to gather data and information
2. Carry out analysis against an evidence-based criteria set
3. Use information to challenge existing practices and processes
4. Influence others to use knowledge and evidence to achieve best practice
5.3 Making decisions
1. Participate in and contribute to organisational decision-making processes
2. Act in a manner consistent with the values and priorities of their organisation and profession
3. Educate and inform key people who influence and make decisions
4. Contribute a clinical perspective to team, department, system and organisational decisions
5.4 Evaluating impact
1. Test and evaluate new service options
2. Standardise and promote new approaches
3. Overcome barriers to implementation
4. Formally and informally disseminate good practice
Effective leadership requires individuals to contribute to the strategy and aspirations of the organisation and act in a manner
consistent with its values. To do so, they must demonstrate effective in:
• Identifying the contexts for change by being aware of the range of factors to be taken into account
• Applying knowledge and evidence by gathering information to produce an evidence-based challenge to systems and
processes in order to identify opportunities for service improvements
• Making decisions using their values, and the evidence, to make good decisions
• Evaluating impact by measuring and evaluating outcomes, taking corrective action where necessary and by being held to
account for their decisions.
Leadership Framework: A Summary 11
6. Creating the Vision
6.1 Developing the vision for the organisation
1. Actively engage with colleagues and key influencers, including patients and public, about the future of the organisation
2. Broadly scan and analyse the full range of factors that will impact upon the organisation, to create likely scenarios for its future
3. Create a vision which is bold, innovative and reflects the core values of the NHS
4. Continuously ensures that the organisation’s vision is compatible with future developments within the wider healthcare system.
6.2 Influencing the vision of the wider healthcare system
1. Seek opportunities to engage in debate about the future of health and care related services
2. Work in partnership with others in the healthcare system to develop a shared vision
3. Negotiate compromises in the interests of better patient services
4. Influence key decision-makers who determine future government policy that impacts on the NHS and its services.
6.3 Communicating the vision
1. Communicate their ideas and enthusiasm about the future of the organisation and its services confidently and in a way whichengages and inspires others
2. Express the vision clearly, unambiguously and vigorously
3. Ensure that stakeholders within and beyond the immediate organisation are aware of the vision and any likely impact it may haveon them
4. Take time to build critical support for the vision and ensure it is shared and owned by those who will be communicating it.
6.4 Embodying the vision
1. Act as a role model, behaving in a manner which reflects the values and principles inherent in the vision
2. Demonstrate confidence, self belief, tenacity and integrity in pursuing the vision
3. Challenge behaviours which are not consistent with the vision
4. Identify symbols, rituals and routines within the organisation which are not consistent with the vision, and replace them withones that are.
Effective leadership involves creating a compelling vision for the future, and communicating this within and across
organisations. This requires individuals to demonstrate effectiveness in:
• Developing the vision of the organisation, looking to the future to determine the direction for the organisation
• Influencing the vision of the wider healthcare system by working with partners across organisations
• Communicating the vision and motivating others to work towards achieving it
• Embodying the vision by behaving in ways which are consistent with the vision and values of the organisation.
Leadership Framework: A Summary12
7. Delivering the Strategy
7.1 Framing the strategy
1. Take account of the culture, history and long term underlying issues for the organisation
2. Use sound organisational theory to inform the development of strategy
3. Identify best practice which can be applied to the organisation
4. Identify strategic options which will deliver the organisation’s vision
7.2 Developing the strategy
1. Engage with key individuals and groups to formulate strategic plans to meet the vision
2. Strive to understand others’ agendas, motivations and drivers in order to develop strategy which is sustainable
3. Create strategic plans which are challenging yet realistic and achievable
4. Identify and mitigate uncertainties and risks associated with strategic choices
7.3 Implementing the strategy
1. Ensure that strategic plans are translated into workable operational plans, identifying risks, critical success factors and evaluationmeasures
2. Identify and strengthen organisational capabilities required to deliver the strategy
3. Establish clear accountability for the delivery of all elements of the strategy, hold people to account and expect to be held toaccount themselves
4. Respond quickly and decisively to developments which require a change in strategy
7.4 Embedding the strategy
1. Support and inspire others responsible for delivering strategic and operational plans, helping them to overcome obstacles andchallenges, and to remain focused
2. Create a consultative organisational culture to support delivery of the strategy and to drive strategic change within the widerhealthcare system
3. Establish a climate of transparency and trust where results are discussed openly
4. Monitor and evaluate strategic outcomes, making adjustments to ensure sustainability of the strategy
Effective leadership involves delivering the strategy by developing and agreeing strategic plans that place patient care at the
heart of the service, and ensuring that these are translated into achievable operational plans. This requires individuals to
demonstrate effectiveness in:
• Framing the strategy by identifying strategic options for the organisation and drawing upon a wide range of information,
knowledge and experience
• Developing the strategy by engaging with colleagues and key stakeholders
• Implementing the strategy by organising, managing and assuming the risks of the organisation
• Embedding the strategy by ensuring that strategic plans are achieved and sustained.
Leadership Framework: A Summary 13
1. D
EMO
NST
RA
TIN
G P
ERSO
NA
L Q
UA
LITI
ESEf
fect
ive
lead
ersh
ip r
equi
res
indi
vidu
als
to d
raw
upo
n th
eir
valu
es, s
tren
gths
and
abi
litie
s to
del
iver
hig
h st
anda
rds
of s
ervi
ce. T
o do
so,
the
y m
ust
dem
onst
rate
eff
ectiv
enes
s in
dem
onst
ratin
g se
lf aw
aren
ess,
man
agin
g th
emse
lves
, con
tinui
ng t
heir
pers
onal
dev
elop
men
t an
d ac
ting
with
inte
grity
.
Elem
ent
1O
wn
Prac
tice/
Imm
edia
te T
eam
2W
hole
Ser
vice
/Acr
oss
Team
s3
Acr
oss
Serv
ices
/Wid
er O
rgan
isatio
n4
Who
le O
rgan
isatio
n/W
ider
H
ealth
care
Sys
tem
1.1
Dev
elo
pin
g S
elf
Aw
aren
ess
Refle
cts
on h
ow fa
ctor
s su
ch a
s ow
nva
lues
, pre
judi
ces
and
emot
ions
influ
ence
thei
r jud
gem
ent,
beha
viou
r and
sel
f bel
ief.
Use
s fe
edba
ck fr
om a
ppra
isals
and
othe
rso
urce
s to
con
sider
per
sona
l im
pact
and
chan
ge b
ehav
iour
. U
nder
stan
ds p
erso
nal
sour
ces
of s
tres
s.
App
reci
ates
the
impa
ct t
hey
have
on
othe
rs a
nd t
he im
pact
oth
ers
have
on
them
. Rou
tinel
y se
eks
feed
back
and
adap
ts t
heir
beha
viou
r ap
prop
riate
ly.
Refle
cts
on t
heir
inte
ract
ions
with
a w
ide
and
dive
rse
rang
e of
indi
vidu
als
and
grou
ps f
rom
with
in a
nd b
eyon
d th
eir
imm
edia
te s
ervi
ce/o
rgan
isat
ion.
Cha
lleng
es a
nd r
efre
shes
ow
n va
lues
,be
liefs
, lea
ders
hip
styl
es a
nd a
ppro
ache
s.O
vert
ly r
ole
mod
els
the
givi
ng a
ndre
ceiv
ing
of f
eedb
ack.
Use
s so
phist
icat
ed to
ols
and
sour
ces
toco
ntin
uous
ly le
arn
abou
t the
ir le
ader
ship
impa
ct in
the
wid
er h
ealth
and
car
eco
mm
unity
and
impr
ove
thei
ref
fect
iven
ess
as a
sen
ior l
eade
r.U
nder
stan
ds h
ow p
ress
ures
ass
ocia
ted
with
car
ryin
g ou
t a h
igh
prof
ile ro
le im
pact
on th
em a
nd th
eir p
erfo
rman
ce.
1.2
Man
agin
g Y
ou
rsel
fPl
ans
and
man
ages
ow
n tim
e ef
fect
ivel
yan
d fu
lfils
wor
k re
quire
men
ts a
ndco
mm
itmen
ts to
a h
igh
stan
dard
, with
out
com
prom
ising
ow
n he
alth
and
wel
lbei
ng.
Rem
ains
cal
m a
nd fo
cuse
d un
der p
ress
ure.
Ensu
res
that
ow
n w
ork
plan
s an
dpr
iorit
ies
fit w
ith t
he n
eeds
of
othe
rsin
volv
ed in
del
iver
ing
serv
ices
.D
emon
stra
tes
flexi
bilit
y an
d se
nsiti
vity
to
serv
ice
requ
irem
ents
and
rem
ains
asse
rtiv
e in
pur
suin
g se
rvic
e go
als.
Succ
essf
ully
man
ages
a r
ange
of
pers
onal
and
org
anis
atio
nal d
eman
dsan
d pr
essu
res.
Dem
onst
rate
s te
naci
tyan
d re
silie
nce.
Ove
rcom
es s
etba
cks
whe
re g
oals
can
not
be a
chie
ved
and
quic
kly
refo
cuse
s. I
s vi
sibl
e an
dac
cess
ible
to
othe
rs.
Rem
ains
focu
sed
on s
trat
egic
goa
ls w
hen
face
d w
ith c
ompe
ting
and,
at t
imes
,co
nflic
ting
dem
ands
aris
ing
from
diff
erin
gpr
iorit
ies.
Iden
tifie
s w
here
they
nee
d to
pers
onal
ly g
et in
volv
ed to
ach
ieve
the
mos
t ben
efit
for t
he o
rgan
isatio
n an
dw
ider
hea
lthca
re s
yste
m.
1.3
Co
nti
nu
ing
Per
son
alD
evel
op
men
tTa
kes
resp
onsib
ility
for o
wn
pers
onal
deve
lopm
ent a
nd s
eeks
opp
ortu
nitie
s fo
rle
arni
ng.
Striv
es to
put
lear
ning
into
prac
tice.
Puts
sel
f fo
rwar
d fo
r ch
alle
ngin
gas
sign
men
ts a
nd p
roje
cts
whi
ch w
illde
velo
p st
reng
ths
and
addr
ess
deve
lopm
ent
area
s.
Act
s as
an
exem
plar
for
oth
ers
inm
anag
ing
thei
r co
ntin
uous
per
sona
lde
velo
pmen
t. F
acili
tate
s th
ede
velo
pmen
t of
a le
arni
ng c
ultu
re.
Dev
elop
s th
roug
h sy
stem
atic
ally
sca
nnin
gth
e ex
tern
al e
nviro
nmen
t and
exp
lorin
gle
adin
g ed
ge th
inki
ng a
nd b
est p
ract
ice.
App
lies
lear
ning
to b
uild
and
refr
esh
the
serv
ice.
Tre
ats
chal
leng
e as
a p
ositi
ve fo
rce
for i
mpr
ovem
ent.
1.4
Act
ing
wit
h In
teg
rity
Beha
ves
in a
n op
en, h
ones
t and
incl
usiv
em
anne
r, up
hold
ing
pers
onal
and
orga
nisa
tiona
l eth
ics
and
valu
es.
Show
s re
spec
t for
the
need
s of
oth
ers
and
prom
otes
equ
ality
and
div
ersit
y.
Act
s as
a r
ole
mod
el f
or o
ther
s in
dem
onst
ratin
g in
tegr
ity a
ndin
clus
iven
ess
in a
ll as
pect
s of
the
ir w
ork.
Cha
lleng
es w
here
org
anis
atio
nal v
alue
sar
e co
mpr
omis
ed.
Cre
ates
an
open
, hon
est
and
incl
usiv
ecu
lture
in a
ccor
danc
e w
ith c
lear
prin
cipl
es a
nd v
alue
s. E
nsur
es e
quity
of
acce
ss t
o se
rvic
es a
nd c
reat
es a
nen
viro
nmen
t w
here
peo
ple
from
all
back
grou
nds
can
exce
l.
Ass
ures
sta
ndar
ds o
f int
egrit
y ar
em
aint
aine
d ac
ross
the
serv
ice
and
com
mun
icat
es th
e im
port
ance
of a
lway
sad
optin
g an
eth
ical
and
incl
usiv
e ap
proa
ch.
Gen
eric
beh
avio
urs
ob
serv
ed if
ind
ivid
ual
is n
ot
yet
dem
on
stra
tin
g t
his
do
mai
n:
• D
oes
not
unde
rsta
nd o
wn
emot
ions
or
reco
gnis
e th
e im
pact
of
own
beha
viou
r on
oth
ers
• A
ppro
ache
s ta
sks
in a
dis
orga
nise
d w
ay a
nd p
lans
are
not
rea
listic
• U
nabl
e to
dis
cuss
ow
n st
reng
ths
and
deve
lopm
ent
need
s an
d sp
ends
litt
le t
ime
on d
evel
opm
ent
• D
emon
stra
tes
beha
viou
rs t
hat
are
coun
ter
to c
ore
valu
es o
f op
enne
ss, i
nclu
sive
ness
, ho
nest
y an
deq
ualit
y•
Lac
ks c
onfid
ence
in o
wn
abili
ties
to d
eliv
er r
esul
ts
The
follo
win
g ta
bles
com
bine
the
indi
cato
rsof
beh
avio
urs
at d
iffer
ent l
eade
rshi
p st
ages
from
eac
h do
mai
n se
ctio
n. P
leas
e re
fer t
o th
e fu
ll do
mai
n pa
ges
for t
he e
lem
ent d
escr
ipto
rs.
Leadership Framework: A Summary14
2. W
OR
KIN
G W
ITH
OTH
ERS
Effe
ctiv
e le
ader
ship
req
uire
s in
divi
dual
s to
wor
k w
ith o
ther
s in
tea
ms
and
netw
orks
to
deliv
er a
nd im
prov
e se
rvic
es. T
his
requ
ires
them
to
dem
onst
rate
eff
ectiv
enes
s in
deve
lopi
ng n
etw
orks
, bui
ldin
g an
d m
aint
aini
ng r
elat
ions
hips
, enc
oura
ging
con
trib
utio
n, a
nd w
orki
ng w
ithin
tea
ms.
Elem
ent
1O
wn
Prac
tice/
Imm
edia
te T
eam
2W
hole
Ser
vice
/Acr
oss
Team
s3
Acr
oss
Serv
ices
/Wid
er O
rgan
isatio
n4
Who
le O
rgan
isatio
n/W
ider
H
ealth
care
Sys
tem
2.1
Dev
elo
pin
g N
etw
ork
sId
entif
ies
whe
re w
orki
ng a
nd c
oope
ratin
gw
ith o
ther
s ca
n re
sult
in b
ette
r ser
vice
s.En
deav
ours
to w
ork
colla
bora
tivel
y.
Use
s ne
twor
ks t
o br
ing
indi
vidu
als
and
grou
ps t
oget
her
to s
hare
info
rmat
ion
and
reso
urce
s an
d to
ach
ieve
goa
ls.
Iden
tifie
s an
d bu
ilds
effe
ctiv
e ne
twor
ksw
ith a
ran
ge o
f in
fluen
tial s
take
hold
ers
inte
rnal
and
ext
erna
l to
the
orga
nisa
tion.
Wor
ks a
cros
s bo
unda
ries
crea
ting
netw
orks
whi
ch fa
cilit
ate
high
leve
ls of
colla
bora
tion
with
in a
nd a
cros
sor
gani
satio
ns a
nd s
ecto
rs.
2.2
Bu
ildin
g a
nd
Mai
nta
inin
gR
elat
ion
ship
sC
omm
unic
ates
with
and
list
ens
to o
ther
s,re
cogn
ising
diff
eren
t per
spec
tives
.Em
path
ises
and
take
s in
to a
ccou
nt th
ene
eds
and
feel
ings
of o
ther
s. G
ains
and
mai
ntai
ns tr
ust a
nd s
uppo
rt.
Build
s an
d m
aint
ains
rel
atio
nshi
ps w
ith a
rang
e of
indi
vidu
als
invo
lved
inde
liver
ing
the
serv
ice.
Man
ages
sens
itivi
ties
betw
een
indi
vidu
als
and
grou
ps.
Build
s an
d nu
rtur
es t
rust
ing
rela
tions
hips
at a
ll le
vels
with
in a
nd a
cros
s se
rvic
esan
d or
gani
satio
nal b
ound
arie
s.
Build
s an
d m
aint
ains
sus
tain
able
str
ateg
ical
lianc
es a
cros
s th
e sy
stem
and
oth
erse
ctor
s. H
as h
igh
impa
ct w
hen
inte
ract
ing
with
oth
ers
at a
ll le
vels.
2.3
Enco
ura
gin
gC
on
trib
uti
on
Seek
s an
d ac
know
ledg
es th
e vi
ews
and
inpu
t of o
ther
s. S
how
s re
spec
t for
the
cont
ribut
ions
and
cha
lleng
es o
f oth
ers.
Cre
ates
a s
uppo
rtiv
e en
viro
nmen
t w
hich
enco
urag
es o
ther
s to
exp
ress
div
erse
opin
ions
and
eng
age
in d
ecis
ion-
mak
ing.
Con
stru
ctiv
ely
chal
leng
essu
gges
tions
and
rec
onci
les
conf
lictin
gvi
ews.
Inte
grat
es t
he c
ontr
ibut
ions
of
a di
vers
era
nge
of s
take
hold
ers,
bei
ng o
pen
and
hone
st a
bout
the
ext
ent
to w
hich
cont
ribut
ions
can
be
acte
d up
on.
Cre
ates
sys
tem
s w
hich
enc
oura
geco
ntrib
utio
n th
roug
hout
the
orga
nisa
tion.
Invi
tes
cont
ribut
ion
from
diff
eren
t sec
tors
to b
ring
abou
t im
prov
emen
ts.
2.4
Wo
rkin
g w
ith
in T
eam
sU
nder
stan
ds ro
les,
resp
onsib
ilitie
s an
dpu
rpos
e w
ithin
the
team
. A
dopt
s a
colla
bora
tive
appr
oach
and
resp
ects
team
deci
sions
.
Hel
ps le
ad o
ther
s to
war
ds c
omm
ongo
als,
pro
vidi
ng c
lear
obj
ectiv
es a
ndof
ferin
g ap
prop
riate
sup
port
. Sh
ows
awar
enes
s of
tea
m d
ynam
ics
and
acts
to
prom
ote
effe
ctiv
e te
am w
orki
ng.
App
reci
ates
the
eff
orts
of
othe
rs.
Take
s on
rec
ogni
sed
posi
tiona
l lea
ders
hip
role
s w
ithin
the
org
anis
atio
n. B
uild
shi
gh p
erfo
rmin
g in
clus
ive
team
s th
atco
ntrib
ute
to p
rodu
ctiv
e an
d ef
ficie
nthe
alth
and
car
e se
rvic
es.
Prom
otes
auto
nom
y an
d em
pow
erm
ent
and
mai
ntai
ns a
sen
se o
f op
timis
m a
ndco
nfid
ence
.
Con
trib
utes
to a
nd le
ads
seni
or te
ams.
Enab
les
othe
rs to
take
on
lead
ersh
ipre
spon
sibili
ties,
bui
ldin
g hi
gh le
vel
lead
ersh
ip c
apab
ility
and
cap
acity
from
adi
vers
e ra
nge
of b
ackg
roun
ds.
Gen
eric
beh
avio
urs
ob
serv
ed if
ind
ivid
ual
is n
ot
yet
dem
on
stra
tin
g t
his
do
mai
n:
• F
ails
to
netw
ork
with
oth
ers
and/
or a
llow
s re
latio
nshi
ps t
o de
terio
rate
• Fa
ils t
o w
in t
he s
uppo
rt a
nd r
espe
ct o
f ot
hers
• D
oes
not
enco
urag
e ot
hers
to
cont
ribut
e id
eas
• D
oes
not
adop
t a
colla
bora
tive
appr
oach
Leadership Framework: A Summary 15
3. M
AN
AG
ING
SER
VIC
ESEf
fect
ive
lead
ersh
ip r
equi
res
indi
vidu
als
to f
ocus
on
the
succ
ess
of t
he o
rgan
isat
ion(
s) in
whi
ch t
hey
wor
k. T
his
requ
ires
them
to
be e
ffec
tive
in p
lann
ing,
man
agin
g re
sour
ces,
man
agin
g pe
ople
and
man
agin
g pe
rfor
man
ce.
Elem
ent
1O
wn
Prac
tice/
Imm
edia
te T
eam
2W
hole
Ser
vice
/Acr
oss
Team
s3
Acr
oss
Serv
ices
/Wid
er O
rgan
isatio
n4
Who
le O
rgan
isatio
n/W
ider
H
ealth
care
Sys
tem
3.1
Plan
nin
gC
ontr
ibut
es id
eas
to s
ervi
ce p
lans
,in
corp
orat
ing
feed
back
from
oth
ers
-in
clud
ing
a di
vers
e ra
nge
of p
atie
nts,
serv
ice
user
s an
d co
lleag
ues.
Wor
ks c
olla
bora
tivel
y to
dev
elop
busi
ness
cas
es a
nd s
ervi
ce p
lans
tha
tsu
ppor
t or
gani
satio
nal o
bjec
tives
,ap
prai
sing
the
m in
ter
ms
of b
enef
its a
ndris
ks.
Lead
s se
rvic
e de
sign
and
pla
nnin
gpr
oces
ses.
Com
mun
icat
es a
nd k
eeps
othe
rs in
form
ed o
f st
rate
gic
and
oper
atio
nal p
lans
, pro
gres
s an
dou
tcom
es.
Ant
icip
ates
the
impa
ct o
f hea
lth tr
ends
and
deve
lops
str
ateg
ic p
lans
that
will
hav
ea
signi
fican
t im
pact
on
the
orga
nisa
tion
and
wid
er h
ealth
care
sys
tem
. En
sure
sst
rate
gic
obje
ctiv
es a
re tr
ansla
ted
into
oper
atio
nal p
lans
.
3.2
Man
agin
g R
eso
urc
esU
nder
stan
ds w
hat r
esou
rces
are
ava
ilabl
ean
d or
gani
ses
the
appr
opria
te ty
pe a
ndle
vel o
f res
ourc
es re
quire
d to
del
iver
saf
ean
d ef
ficie
nt s
ervi
ces.
Iden
tifie
s re
sour
ce r
equi
rem
ents
asso
ciat
ed w
ith d
eliv
erin
g se
rvic
es.
Man
ages
res
ourc
es a
nd t
akes
act
ion
toen
sure
the
ir ef
fect
ive
and
effic
ient
use
.
Fore
cast
s re
sour
ce r
equi
rem
ents
asso
ciat
ed w
ith d
eliv
erin
g co
mpl
exse
rvic
es e
ffic
ient
ly a
nd e
ffec
tivel
y.M
anag
es r
esou
rces
tak
ing
into
acc
ount
the
impa
ct o
f na
tiona
l and
loca
l pol
icie
san
d co
nstr
aint
s.
Stra
tegi
cally
man
ages
reso
urce
s ac
ross
the
orga
nisa
tion
and
wid
er h
ealth
care
sys
tem
.
3.3
Man
agin
g P
eop
leSu
ppor
ts o
ther
s in
del
iver
ing
high
qua
lity
serv
ices
and
exc
elle
nce
in h
ealth
and
car
e.Pr
ovid
es o
ther
s w
ith c
lear
pur
pose
and
dire
ctio
n. H
elps
oth
ers
in d
evel
opin
gth
eir
role
s an
d re
spon
sibi
litie
s.
Mot
ivat
es a
nd c
oach
es in
divi
dual
s an
dte
ams
to s
tren
gthe
n th
eir
perf
orm
ance
and
assi
st t
hem
with
dev
elop
ing
thei
row
n ca
pabi
litie
s an
d sk
ills.
Alig
nsin
divi
dual
dev
elop
men
t ne
eds
with
serv
ice
goal
s.
Insp
ires
and
supp
orts
lead
ers
to m
obili
sedi
vers
e te
ams
that
are
com
mitt
ed to
and
alig
ned
with
org
anisa
tiona
l val
ues
and
goal
s. E
ngag
es w
ith a
nd in
fluen
ces
seni
orle
ader
s an
d ke
y st
akeh
olde
rs to
del
iver
join
ed u
p se
rvic
es.
3.4
Man
agin
gPe
rfo
rman
ceU
ses
info
rmat
ion
and
data
abo
utpe
rfor
man
ce to
iden
tify
impr
ovem
ents
whi
ch w
ill s
tren
gthe
n se
rvic
es.
Wor
ks w
ith o
ther
s to
set
and
mon
itor
perf
orm
ance
sta
ndar
ds, a
ddre
ssin
g ar
eas
whe
re p
erfo
rman
ce o
bjec
tives
are
not
achi
eved
.
Esta
blis
hes
rigor
ous
perf
orm
ance
mea
sure
s. H
olds
sel
f, in
divi
dual
s an
dte
ams
to a
ccou
nt f
or a
chie
ving
perf
orm
ance
sta
ndar
ds. C
halle
nges
whe
n se
rvic
e ex
pect
atio
ns a
re n
ot b
eing
met
and
tak
es c
orre
ctiv
e ac
tion.
Prom
otes
an
incl
usiv
e cu
lture
that
ena
bles
peop
le to
per
form
to th
eir b
est,
ensu
ring
that
app
ropr
iate
per
form
ance
man
agem
ent s
yste
ms
are
in p
lace
and
that
perf
orm
ance
dat
a is
syst
emat
ical
lyev
alua
ted
and
fed
into
futu
re p
lans
.
Gen
eric
beh
avio
urs
ob
serv
ed if
ind
ivid
ual
is n
ot
yet
dem
on
stra
tin
g t
his
do
mai
n:
• D
isor
gani
sed
or u
nstr
uctu
red
appr
oach
to
plan
ning
• W
aste
s re
sour
ces
or f
ails
to
mon
itor
them
eff
ectiv
ely
• D
oes
not
effe
ctiv
ely
man
age
and
deve
lop
peop
le•
Fai
ls t
o id
entif
y an
d ad
dres
s pe
rfor
man
ce is
sues
Leadership Framework: A Summary16
4. IM
PRO
VIN
G S
ERV
ICES
Effe
ctiv
e le
ader
ship
req
uire
s in
divi
dual
s to
mak
e a
real
diff
eren
ce t
o pe
ople
’s h
ealth
by
deliv
erin
g hi
gh q
ualit
y se
rvic
es a
nd b
y de
velo
ping
impr
ovem
ents
to
serv
ices
. Thi
s re
quire
sth
em t
o de
mon
stra
te e
ffec
tiven
ess
in e
nsur
ing
patie
nt s
afet
y, c
ritic
ally
eva
luat
ing,
enc
oura
ging
impr
ovem
ent
and
inno
vatio
n an
d fa
cilit
atin
g tr
ansf
orm
atio
n.
Elem
ent
1O
wn
Prac
tice/
Imm
edia
te T
eam
2W
hole
Ser
vice
/Acr
oss
Team
s3
Acr
oss
Serv
ices
/Wid
er O
rgan
isatio
n4
Who
le O
rgan
isatio
n/W
ider
H
ealth
care
Sys
tem
4.1
Ensu
rin
g P
atie
nt
Safe
tyPu
ts th
e sa
fety
of p
atie
nts
and
serv
ice
user
s at
the
hear
t of t
heir
thin
king
inde
liver
ing
and
impr
ovin
g se
rvic
es.
Take
sac
tion
to re
port
or r
ectif
y sh
ortf
alls
inpa
tient
saf
ety.
Revi
ews
prac
tice
to im
prov
e st
anda
rds
ofpa
tient
saf
ety
and
min
imis
e ris
k.M
onito
rs t
he im
pact
of
serv
ice
chan
geon
pat
ient
saf
ety.
Dev
elop
s an
d m
aint
ains
aud
it an
d ris
km
anag
emen
t sy
stem
s w
hich
will
driv
ese
rvic
e im
prov
emen
t an
d pa
tient
saf
ety.
Cre
ates
a c
ultu
re th
at p
riorit
ises
the
heal
th, s
afet
y an
d se
curit
y of
pat
ient
s an
dse
rvic
e us
ers.
Del
iver
s as
sura
nce
that
patie
nt s
afet
y un
derp
ins
polic
ies,
proc
esse
s an
d sy
stem
s.
4.2
Cri
tica
lly E
valu
atin
gU
ses
feed
back
from
pat
ient
s, c
arer
s an
dse
rvic
e us
ers
to c
ontr
ibut
e to
hea
lthca
reim
prov
emen
ts.
Enga
ges
with
oth
ers
to c
ritic
ally
eva
luat
ese
rvic
es a
nd c
reat
e id
eas
for
impr
ovem
ents
.
Synt
hesi
ses
com
plex
info
rmat
ion
toid
entif
y po
tent
ial i
mpr
ovem
ents
to
serv
ices
. Id
entif
ies
pote
ntia
l bar
riers
to
serv
ice
impr
ovem
ent.
Benc
hmar
ks th
e w
ider
org
anisa
tion
agai
nst e
xam
ples
of b
est p
ract
ice
inhe
alth
care
and
oth
er s
ecto
rs.
Eval
uate
sop
tions
for i
mpr
ovin
g se
rvic
es in
line
with
futu
re a
dvan
ces.
4.3
Enco
ura
gin
gIm
pro
vem
ent
and
Inn
ova
tio
n
Que
stio
ns e
stab
lishe
d pr
actic
es w
hich
do
not a
dd v
alue
. Put
s fo
rwar
d cr
eativ
esu
gges
tions
to im
prov
e th
e qu
ality
of
serv
ice
prov
ided
.
Act
s as
a p
ositi
ve r
ole
mod
el f
orin
nova
tion.
Enc
oura
ges
dial
ogue
and
deba
te in
the
dev
elop
men
t of
new
idea
sw
ith a
wid
e ra
nge
of p
eopl
e.
Cha
lleng
es c
olle
ague
s’ t
hink
ing
to f
ind
bett
er a
nd m
ore
effe
ctiv
e w
ays
ofde
liver
ing
serv
ices
and
qua
lity.
Acc
esse
scr
eativ
ity a
nd in
nova
tion
from
rel
evan
tin
divi
dual
s an
d gr
oups
.
Driv
es a
cul
ture
of i
nnov
atio
n an
dim
prov
emen
t. In
tegr
ates
radi
cal a
ndin
nova
tive
appr
oach
es in
to s
trat
egic
pla
nsto
mak
e th
e N
HS
wor
ld c
lass
in th
epr
ovisi
on o
f hea
lthca
re s
ervi
ces.
4.4
Faci
litat
ing
Tran
sfo
rmat
ion
Art
icul
ates
the
need
for c
hang
es to
proc
esse
s an
d sy
stem
s, a
ckno
wle
dgin
g th
eim
pact
on
peop
le a
nd s
ervi
ces.
Focu
ses
self
and
othe
rs o
n ac
hiev
ing
chan
ges
to s
yste
ms
and
proc
esse
s w
hich
will
lead
to
impr
oved
ser
vice
s.
Ener
gise
s ot
hers
to
driv
e ch
ange
tha
t w
illim
prov
e he
alth
and
car
e se
rvic
es.
Act
ivel
y m
anag
es t
he c
hang
e pr
oces
s,dr
awin
g on
mod
els
of e
ffec
tive
chan
gem
anag
emen
t. R
ecog
nise
s an
d ad
dres
ses
the
impa
ct o
f ch
ange
on
peop
le a
ndse
rvic
es.
Insp
ires
othe
rs to
take
bol
d ac
tion
and
mak
e im
port
ant a
dvan
ces
in h
ow s
ervi
ces
are
deliv
ered
. Re
mov
es o
rgan
isatio
nal
obst
acle
s to
cha
nge
and
crea
tes
new
stru
ctur
es a
nd p
roce
sses
to fa
cilit
ate
tran
sfor
mat
ion.
Gen
eric
beh
avio
urs
ob
serv
ed if
ind
ivid
ual
is n
ot
yet
dem
on
stra
tin
g t
his
do
mai
n:
• O
verlo
oks
the
need
to
put
patie
nts
at t
he f
oref
ront
of
thei
r th
inki
ng•
Doe
s no
t qu
estio
n/ev
alua
te c
urre
nt p
roce
sses
and
pra
ctic
es•
Mai
ntai
ns t
he s
tatu
s qu
o an
d st
icks
with
tra
ditio
nal o
utda
ted
way
s of
doi
ng t
hing
s•
Fai
ls t
o im
plem
ent
chan
ge o
r im
plem
ents
cha
nge
for
chan
ge’s
sak
e
Leadership Framework: A Summary 17
5. S
ETTI
NG
DIR
ECTI
ON
Effe
ctiv
e le
ader
ship
req
uire
s in
divi
dual
s to
con
trib
ute
to t
he s
trat
egy
and
aspi
ratio
ns o
f th
e or
gani
satio
n an
d ac
t in
a m
anne
r co
nsis
tent
with
its
valu
es. T
his
requ
ires
them
to
dem
onst
rate
eff
ectiv
enes
s in
iden
tifyi
ng t
he c
onte
xts
for
chan
ge, a
pply
ing
know
ledg
e an
d ev
iden
ce, m
akin
g de
cisi
ons,
and
eva
luat
ing
impa
ct.
Elem
ent
1O
wn
Prac
tice/
Imm
edia
te T
eam
2W
hole
Ser
vice
/Acr
oss
Team
s3
Acr
oss
Serv
ices
/Wid
er O
rgan
isatio
n4
Who
le O
rgan
isatio
n/W
ider
H
ealth
care
Sys
tem
5.1
Iden
tify
ing
th
eC
on
text
s fo
r C
han
ge
Und
erst
ands
the
rang
e of
fact
ors
whi
chde
term
ine
why
cha
nges
are
mad
e.Id
entif
ies
the
exte
rnal
and
inte
rnal
driv
ers
of c
hang
e an
d co
mm
unic
ates
the
ratio
nale
for
cha
nge
to o
ther
s.
Act
ivel
y se
eks
to le
arn
abou
t ex
tern
alfa
ctor
s w
hich
will
impa
ct o
n se
rvic
es.
Inte
rpre
ts t
he m
eani
ng o
f th
ese
for
serv
ices
and
inco
rpor
ates
the
m in
tose
rvic
e pl
ans
and
actio
ns.
Synt
hesis
es k
now
ledg
e fr
om a
bro
adra
nge
of s
ourc
es.
Iden
tifie
s fu
ture
chal
leng
es a
nd im
pera
tives
that
will
cre
ate
the
need
for c
hang
e an
d m
ove
the
orga
nisa
tion
and
the
wid
er h
ealth
care
syst
em in
new
dire
ctio
ns. I
nflu
ence
s th
eco
ntex
t for
cha
nge
in th
e be
st in
tere
sts
ofse
rvic
es a
nd s
ervi
ce u
sers
.
5.2
Ap
ply
ing
Kn
ow
led
ge
and
Evid
ence
Gat
hers
dat
a an
d in
form
atio
n ab
out
aspe
cts
of th
e se
rvic
e, a
naly
ses
evid
ence
and
uses
this
know
ledg
e to
sug
gest
chan
ges
that
will
impr
ove
serv
ices
in th
efu
ture
.
Obt
ains
and
ana
lyse
s in
form
atio
n ab
out
serv
ices
and
pat
hway
s to
info
rm f
utur
edi
rect
ion.
Sup
port
s an
d en
cour
ages
othe
rs t
o us
e kn
owle
dge
and
evid
ence
to in
form
dec
isio
ns a
bout
the
fut
ure
ofse
rvic
es.
Und
erst
ands
the
com
plex
inte
rdep
ende
ncie
s ac
ross
a r
ange
of
serv
ices
. A
pplie
s kn
owle
dge
to s
etfu
ture
dire
ctio
n.
Use
s kn
owle
dge,
evi
denc
e an
dex
perie
nce
of n
atio
nal a
nd in
tern
atio
nal
deve
lopm
ents
in h
ealth
and
soc
ial c
are
toin
fluen
ce th
e fu
ture
dev
elop
men
t of
heal
th a
nd c
are
serv
ices
.
5.3
Mak
ing
Dec
isio
ns
Con
sults
with
oth
ers
and
cont
ribut
es to
deci
sions
abo
ut th
e fu
ture
dire
ctio
n/vi
sion
of th
eir s
ervi
ce.
Invo
lves
key
peo
ple
and
grou
ps in
mak
ing
deci
sion
s. A
ctiv
ely
enga
ges
info
rmal
and
info
rmal
dec
isio
n-m
akin
gpr
oces
ses
abou
t th
e fu
ture
of
serv
ices
.
Rem
ains
acc
ount
able
for
mak
ing
timel
yde
cisi
ons
in c
ompl
ex s
ituat
ions
. M
odifi
esde
cisi
ons
and
flexe
s di
rect
ion
whe
nfa
ced
with
new
info
rmat
ion
or c
hang
ing
circ
umst
ance
s.
Ensu
res
that
cor
pora
te d
ecisi
on-m
akin
g is
rigor
ous
and
take
s ac
coun
t of t
he fu
llra
nge
of fa
ctor
s im
ping
ing
on th
e fu
ture
dire
ctio
n of
the
orga
nisa
tion
and
the
wid
er h
ealth
care
sys
tem
. Can
ope
rate
with
out a
ll th
e fa
cts.
Tak
es u
npop
ular
deci
sions
whe
n in
the
best
inte
rest
s of
heal
th a
nd c
are
in th
e lo
ng te
rm.
5.4
Eval
uat
ing
Imp
act
Ass
esse
s th
e ef
fect
s of
cha
nge
on s
ervi
cede
liver
y an
d pa
tient
out
com
es.
Mak
esre
com
men
datio
ns fo
r fut
ure
impr
ovem
ents
.
Eval
uate
s an
d em
beds
app
roac
hes
and
wor
king
met
hods
whi
ch h
ave
prov
ed t
obe
eff
ectiv
e in
to t
he w
orki
ng p
ract
ices
of t
eam
s an
d in
divi
dual
s.
Iden
tifie
s ga
ins
whi
ch c
an b
e ap
plie
del
sew
here
in t
he o
rgan
isat
ion
and
inco
rpor
ates
the
se in
to o
pera
tiona
l/bu
sine
ss p
lans
. Dis
sem
inat
es le
arni
ngfr
om c
hang
es w
hich
hav
e be
enin
trod
uced
.
Synt
hesis
es le
arni
ng a
risin
g fr
om c
hang
esw
hich
hav
e be
en in
trod
uced
and
inco
rpor
ates
thes
e in
to s
trat
egic
pla
ns.
Shar
es le
arni
ng w
ith th
e w
ider
hea
lth a
ndca
re c
omm
unity
.
Gen
eric
beh
avio
urs
ob
serv
ed if
ind
ivid
ual
is n
ot
yet
dem
on
stra
tin
g t
his
do
mai
n:
• U
naw
are
of p
oliti
cal,
soci
al, t
echn
ical
, eco
nom
ic, o
rgan
isat
iona
l fac
tors
tha
t im
pact
on
the
futu
re o
fth
e se
rvic
e/or
gani
satio
n•
Doe
s no
t us
e an
evi
denc
e-ba
se f
or d
ecis
ion-
mak
ing
• M
akes
poo
r de
cisi
ons
abou
t th
e fu
ture
• F
ails
to
eval
uate
the
impa
ct o
f pr
evio
us d
ecis
ions
and
act
ions
Leadership Framework: A Summary18
6. C
REA
TIN
G T
HE
VIS
ION
Thos
e in
sen
ior
posi
tiona
l lea
ders
hip
role
s cr
eate
a c
ompe
lling
vis
ion
for
the
futu
re, a
nd c
omm
unic
ate
this
with
in a
nd a
cros
s or
gani
satio
ns. T
his
requ
ires
them
to
dem
onst
rate
effe
ctiv
enes
s in
dev
elop
ing
the
visi
on f
or t
he o
rgan
isat
ion,
influ
enci
ng t
he v
isio
n of
the
wid
er h
ealth
care
sys
tem
, com
mun
icat
ing
the
visi
on a
nd e
mbo
dyin
g th
e vi
sion
.
Elem
ent
ELEM
ENT
DES
CR
IPTO
RS
(see
als
o p
age
11)
4W
hole
Org
anis
atio
n/W
ider
Hea
lthca
re S
yste
m
6.1
Dev
elo
pin
g t
he
Vis
ion
for
the
Org
anis
atio
n•
Act
ivel
y en
gage
with
col
leag
ues
and
key
influ
ence
rs, i
nclu
ding
pat
ient
s an
d pu
blic
,ab
out t
he fu
ture
of t
he o
rgan
isatio
n
•Br
oadl
y sc
an a
nd a
naly
se th
e fu
ll ra
nge
of fa
ctor
s th
at w
ill im
pact
upo
n th
eor
gani
satio
n, to
cre
ate
likel
y sc
enar
ios
for i
ts fu
ture
•C
reat
e a
visio
n w
hich
is b
old,
inno
vativ
e a
nd re
flect
s th
e co
re v
alue
s of
the
NH
S
•C
ontin
uous
ly e
nsur
es th
at th
e or
gani
satio
n’s
visio
n is
com
patib
le w
ith fu
ture
deve
lopm
ents
with
in th
e w
ider
hea
lthca
re s
yste
m
Act
ivel
y en
gage
s ke
y st
akeh
olde
rs in
cre
atin
g a
bold
, inn
ovat
ive,
sha
red
visio
n w
hich
refle
cts
the
futu
re n
eeds
and
asp
iratio
ns o
f the
pop
ulat
ion
and
the
futu
re d
irect
ion
ofhe
alth
care
. Th
inks
bro
adly
and
alig
ns th
e vi
sion
to th
e N
HS
core
val
ues
and
the
valu
es o
fth
e w
ider
hea
lthca
re s
yste
m.
6.2
Infl
uen
cin
g V
isio
n in
th
eW
ider
Hea
lth
care
Sys
tem
•Se
ek o
ppor
tuni
ties
to e
ngag
e in
deb
ate
abou
t the
futu
re o
f hea
lth a
nd c
are
rela
ted
serv
ices
•W
ork
in p
artn
ersh
ip w
ith o
ther
s in
the
heal
thca
re s
yste
m to
dev
elop
a s
hare
d vi
sion
•N
egot
iate
com
prom
ises
in th
e in
tere
sts
of b
ette
r pat
ient
ser
vice
s
•In
fluen
ce k
ey d
ecisi
on-m
aker
s w
ho d
eter
min
e fu
ture
gov
ernm
ent p
olic
y th
at im
pact
son
the
NH
S an
d its
ser
vice
s
Act
ivel
y pa
rtic
ipat
es in
and
lead
s on
deb
ates
abo
ut th
e fu
ture
of h
ealth
, wel
lbei
ng a
ndre
late
d se
rvic
es.
Man
ages
pol
itica
l int
eres
ts, b
alan
cing
tens
ions
bet
wee
n or
gani
satio
nal
aspi
ratio
ns a
nd th
e w
ider
env
ironm
ent.
Sha
pes
and
influ
ence
s lo
cal,
regi
onal
and
natio
nal h
ealth
prio
ritie
s an
d ag
enda
s.
6.3
Co
mm
un
icat
ing
th
eV
isio
n•
Com
mun
icat
e th
eir i
deas
and
ent
husia
sm a
bout
the
futu
re o
f the
org
anisa
tion
and
itsse
rvic
es c
onfid
ently
and
in a
way
whi
ch e
ngag
es a
nd in
spire
s ot
hers
•Ex
pres
s th
e vi
sion
clea
rly, u
nam
bigu
ously
and
vig
orou
sly
•En
sure
that
sta
keho
lder
s w
ithin
and
bey
ond
the
imm
edia
te o
rgan
isatio
n ar
e aw
are
ofth
e vi
sion
and
any
likel
y im
pact
it m
ay h
ave
on th
em
•Ta
ke ti
me
to b
uild
crit
ical
sup
port
for t
he v
ision
and
ens
ure
it is
shar
ed a
nd o
wne
d by
thos
e w
ho w
ill b
e co
mm
unic
atin
g it
Cle
arly
com
mun
icat
es th
e vi
sion
in a
way
that
eng
ages
and
em
pow
ers
othe
rs.
Use
sen
thus
iasm
and
ene
rgy
to in
spire
oth
ers
and
enco
urag
e jo
int o
wne
rshi
p of
the
visio
n.A
ntic
ipat
es a
nd c
onst
ruct
ivel
y ad
dres
ses
chal
leng
e.
6.4
Emb
od
yin
g t
he
Vis
ion
•A
ct a
s a
role
mod
el, b
ehav
ing
in a
man
ner w
hich
refle
cts
the
valu
es a
nd p
rinci
ples
inhe
rent
in th
e vi
sion
•D
emon
stra
te c
onfid
ence
, sel
f bel
ief,
tena
city
and
inte
grity
in p
ursu
ing
the
visio
n
•C
halle
nge
beha
viou
rs w
hich
are
not
con
siste
nt w
ith th
e vi
sion
•Id
entif
y sy
mbo
ls, ri
tual
s an
d ro
utin
es w
ithin
the
orga
nisa
tion
whi
ch a
re n
ot c
onsis
tent
with
the
visio
n, a
nd re
plac
e th
em w
ith o
nes
that
are
Con
siste
ntly
disp
lays
pas
sion
for t
he v
ision
and
dem
onst
rate
s pe
rson
al c
omm
itmen
t to
itth
roug
h th
eir d
ay-t
o-da
y ac
tions
. Use
s pe
rson
al c
redi
bilit
y to
act
as
a co
nvin
cing
advo
cate
for t
he v
ision
.
Gen
eric
beh
avio
urs
ob
serv
ed if
ind
ivid
ual
is n
ot
yet
dem
on
stra
tin
g t
his
do
mai
n:
• D
oes
not
invo
lve
othe
rs in
cre
atin
g an
d de
finin
g th
e vi
sion
• D
oes
not
alig
n th
eir
visi
on w
ith t
he w
ider
hea
lth a
nd c
are
agen
da•
Mis
ses
oppo
rtun
ities
to
com
mun
icat
e an
d sh
are
unde
rsta
ndin
g of
the
vis
ion
with
oth
ers
• L
acks
ent
husi
asm
and
com
mitm
ent
for
driv
ing
the
visi
on
Leadership Framework: A Summary 19
7. D
ELIV
ERIN
G T
HE
STRA
TEG
YTh
ose
in s
enio
r pos
ition
al le
ader
ship
role
s de
liver
the
stra
tegi
c vi
sion
by d
evel
opin
g an
d ag
reei
ng s
trat
egic
pla
ns th
at p
lace
pat
ient
car
e at
the
hear
t of t
he s
ervi
ce, a
nd e
nsur
ing
that
thes
e ar
e tr
ansla
ted
into
ach
ieva
ble
oper
atio
nal p
lans
. Thi
s re
quire
s th
em to
dem
onst
rate
eff
ectiv
enes
s in
fram
ing
the
stra
tegy
, dev
elop
ing
the
stra
tegy
, im
plem
entin
g th
e st
rate
gy, a
nd e
mbe
ddin
g th
e st
rate
gy.
Elem
ent
ELEM
ENT
DES
CR
IPTO
RS
(see
als
o p
age
12)
4W
hole
Org
anis
atio
n/W
ider
Hea
lthca
re S
yste
m
7.1
Fram
ing
th
e St
rate
gy
•Ta
ke a
ccou
nt o
f the
cul
ture
, hist
ory
and
long
term
und
erly
ing
issue
s fo
r the
org
anisa
tion
•U
se s
ound
org
anisa
tiona
l the
ory
to in
form
the
deve
lopm
ent o
f str
ateg
y
•Id
entif
y be
st p
ract
ice
whi
ch c
an b
e ap
plie
d to
the
orga
nisa
tion
•Id
entif
y st
rate
gic
optio
ns w
hich
will
del
iver
the
orga
nisa
tion’
s vi
sion
Crit
ical
ly re
view
s re
leva
nt th
inki
ng, i
deas
and
bes
t pra
ctic
e an
d ap
plie
s w
hole
sys
tem
sth
inki
ng in
ord
er to
con
cept
ualis
e a
stra
tegy
in li
ne w
ith th
e vi
sion.
7.2
Dev
elo
pin
g t
he
Stra
teg
y•
Enga
ge w
ith k
ey in
divi
dual
s an
d gr
oups
to fo
rmul
ate
stra
tegi
c pl
ans
to m
eet t
he v
ision
•St
rive
to u
nder
stan
d ot
hers
’ ag
enda
s, m
otiv
atio
ns a
nd d
river
s in
ord
er to
dev
elop
stra
tegy
whi
ch is
sus
tain
able
•C
reat
e st
rate
gic
plan
s w
hich
are
cha
lleng
ing
yet r
ealis
tic a
nd a
chie
vabl
e
•Id
entif
y an
d m
itiga
te u
ncer
tain
ties
and
risks
ass
ocia
ted
with
str
ateg
ic c
hoic
es
Inte
grat
es th
e vi
ews
of a
bro
ad ra
nge
of s
take
hold
ers
to d
evel
op a
coh
eren
t, jo
ined
up
and
sust
aina
ble
stra
tegy
. A
sses
ses
orga
nisa
tiona
l rea
dine
ss fo
r cha
nge.
Man
ages
the
risks
, pol
itica
l sen
sitiv
ities
and
env
ironm
enta
l unc
erta
intie
s in
volv
ed.
7.3
Imp
lem
enti
ng
th
eSt
rate
gy
•En
sure
that
str
ateg
ic p
lans
are
tran
slate
d in
to w
orka
ble
oper
atio
nal p
lans
, ide
ntify
ing
risks
, crit
ical
suc
cess
fact
ors
and
eval
uatio
n m
easu
res
•Id
entif
y an
d st
reng
then
org
anisa
tiona
l cap
abili
ties
requ
ired
to d
eliv
er th
e st
rate
gy
•Es
tabl
ish c
lear
acc
ount
abili
ty fo
r the
del
iver
y of
all
elem
ents
of t
he s
trat
egy,
hol
d pe
ople
to a
ccou
nt a
nd e
xpec
t to
be h
eld
to a
ccou
nt th
emse
lves
•Re
spon
d qu
ickl
y an
d de
cisiv
ely
to d
evel
opm
ents
whi
ch re
quire
a c
hang
e in
str
ateg
y
Resp
onds
con
stru
ctiv
ely
to c
halle
nge.
Put
s sy
stem
s, s
truc
ture
s, p
roce
sses
, res
ourc
es a
ndpl
ans
in p
lace
to d
eliv
er th
e st
rate
gy.
Esta
blish
es a
ccou
ntab
ilitie
s an
d ho
lds
peop
le in
loca
l, re
gion
al, a
nd n
atio
nal s
truc
ture
s to
acc
ount
for j
oint
ly d
eliv
erin
g st
rate
gic
and
oper
atio
nal p
lans
. D
emon
stra
tes
flexi
bilit
y w
hen
chan
ges
requ
ired.
7.4
Emb
edd
ing
th
e St
rate
gy
•Su
ppor
t and
insp
ire o
ther
s re
spon
sible
for d
eliv
erin
g st
rate
gic
and
oper
atio
nal p
lans
,he
lpin
g th
em to
ove
rcom
e ob
stac
les
and
chal
leng
es, a
nd to
rem
ain
focu
sed
•C
reat
e a
cons
ulta
tive
orga
nisa
tiona
l cul
ture
to s
uppo
rt d
eliv
ery
of th
e st
rate
gy a
nd to
driv
e st
rate
gic
chan
ge w
ithin
the
wid
er h
ealth
care
sys
tem
•Es
tabl
ish a
clim
ate
of tr
ansp
aren
cy a
nd tr
ust w
here
resu
lts a
re d
iscus
sed
open
ly
•M
onito
r and
eva
luat
e st
rate
gic
outc
omes
, mak
ing
adju
stm
ents
to e
nsur
e su
stai
nabi
lity
of th
e st
rate
gy
Enab
les
and
supp
orts
the
cond
ition
s an
d cu
lture
nee
ded
to s
usta
in c
hang
es in
tegr
al to
the
succ
essf
ul d
eliv
ery
of th
e st
rate
gy.
Kee
ps m
omen
tum
aliv
e by
rein
forc
ing
key
mes
sage
s, m
onito
ring
prog
ress
and
reco
gnisi
ng w
here
the
stra
tegy
has
bee
n em
brac
edby
oth
ers.
Eva
luat
es o
utco
mes
and
use
s le
arni
ngs
to a
dapt
str
ateg
ic a
nd o
pera
tiona
lpl
ans.
Gen
eric
beh
avio
urs
ob
serv
ed if
ind
ivid
ual
is n
ot
yet
dem
on
stra
tin
g t
his
do
mai
n:
• D
oes
not
alig
n th
e st
rate
gy w
ith lo
cal,
natio
nal a
nd/o
r w
ider
hea
lth c
are
syst
em r
equi
rem
ents
• W
orks
to
deve
lop
the
stra
tegy
in is
olat
ion
with
out
inpu
t or
fee
dbac
k fr
om o
ther
s•
Abs
olve
s on
esel
f of
res
pons
ibili
ty f
or h
oldi
ng o
ther
s to
acc
ount
• F
ails
to
enab
le a
n or
gani
satio
nal c
ultu
re t
hat
embr
aces
the
str
ateg
y