The Changing Role of Leadership


Dympna Cunnane, Organisation Development Consultant and Programme Director at London Business School, discusses her views on how healthcare leaders respond to the pressures of the job and their role in ensuring high quality, compassionate care for patients.

She talks about using power in the right way, for the best interest of oneself and others. How you can improvement process and policies but you might lose the sole of health care.

Dympna talks about the difficulties and challenges when dealing with people and the anxiety which can be cause by uncertainly and complexity.

The importance of role modelling is key and can be contagious, so needs to be positive, rathe than bullying or mistrust. Leaders on their own can’t do anything, but they are very influential in creating a culture and climate in which people work.

Whilst you are watching this video, think about the leadership climate that you help to set in your organisation and whether you balance the medical education needs as well as what she refers to as the humanities, or softer skills.


Segment 1 (00:14):
“You know every Greek play is a play about power, practically all of Shakespeare’s plays are about the use and misuse of power. And if there’s one thing central to leadership, it’s the test, “How do I use my power? For my own self interest or for the good of others?” And so I think that this is a huge challenge and therefore having a mechanism and a mirror in wonderful literature enables people to think about the fact that all power involves a kind of Faustian plot where you get the power but you might lose your soul. And I think that’s particular for healthcare, is you might be able to improve the systems and procedures and processes, but you might lose the whole purpose of healthcare.”

Segment 2 (01:06):
“Leaders need to think about the impact of the psychological challenge of dealing with healthcare. It’s not like running a business, it’s not like making helicopters or dealing with Tescos, it’s about human beings and it’s about the difficulties and the challenges that we as clinicians are faced with when we deal with people. How do we manage that in ourselves and how do we manage that with the patients? So I think we haven’t really paid enough attention to the anxiety produced by the kind of work that we do, the uncertainty, the ambiguity, the complexity. It is really not similar to managing an organisation which produces things.”

Speaker 1 (01:52):
“I think a leader has a very important role in terms of a role model and the values and their ways of interacting are contagious. I know that when I go into a senior manager’s office, into a senior team, I know that the behaviors in that team will be replicated everywhere in the organisation. So if that’s an atmosphere of distrust, if that’s an atmosphere of bullying, that will be replicated throughout the organisation. So leaders on their own can’t do anything, but they are very influential in creating a culture and a climate in which people work.”

Speaker 1 (02:30):
“I think we need to have rebalance, the system, particularly from medical education, needs to balance the humanities as well as the technical and medical area because I think that increased specialisation means that there is increased fragmentation of service and it’s the patient that loses out in the gaps between specialisation. And I think all of healthcare needs to think about the social and psychological aspects of organisations. Organisations are social systems. Change won’t happen unless people feel free and feel psychologically safe to raise concerns and to do things differently and to use their imagination on an everyday basis to solve problems. This requires leaders to create an environment in which people do feel safe and in which people can be supported when they need help, can ask for help when they need help. And I think a lot of the pressure of targets and the financial pressures has driven out psychological safety and created cultures of fear. Somebody said this morning that command and control worked, I’m not sure I believe command and control worked, I think the we’re suffering the consequences now, which is what happened in Mid Staffs and which can happen anywhere.”




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