Equality Act
2010: to help
protect those with
mental health
disability not be
discriminated
against within the
work place and
when applying for
jobs1.
Future In Mind
Department of Health
want to aim to improve
mental health across
young people via
promotion, prevention by
2020. One of the main
focus of the document is
to tackle stigma and
improve attitudes
around mental
illness2.What has time for change done?
They have used several
strategies:
- Local hubs with professionals to
give advise and promote anti
stigma and discrimination, inter-
professional trust& respect.
- Social Marketing campaigns to
engage people who haven’t
experienced mental health illness
relevant to them and changing
attitudes and behaviours about
mental health.
- Working alongside schools and
organisations to improve
knowledge, educating young
people about mental health. Also
carrying out workshops with
teachers to help create time for
change workshops within the
schools.
- Provide resources for
professionals in the work
place4.
What is time for change?
A partnership lead by Mind and
Rethink Mental Health funded
by the Department of Health
and Social Care, Comic Relief
and National Lottery. It’s a
growing social movement
with the aim to change the
way that people think and act
about mental health problems
by working within communities,
work places and with young
people with the aim of trying to
change attitudes. The
partnership therefore showing
cultural continuity3 .
Outcomes
Critical Evaluation
Unequal power relationships between
service users and staff, reducing role
clarity.
Staff burnout and structural
discrimination affecting resources, no
shared commitment.
Participation rate to gain figures not
reliable
Study found an increase in discrimination
towards those on welfare benefits
Have met the aims the partnership has
set out to do so far, displaying
successful independence of outcomes6
Conclusion
Overall time for change has been
slowly making a difference in
educating about mental health.
However, as a partnership it’s not
working so well. It could be improve
the negatives found in the study
across staff and discrimination
towards welfare benefits.
5
References
1.Illness, R. and Illness, R. (2019). The Equality Act 2010. [online] Rethink.org. Available at:
https://www.rethink.org/living-with-mental-illness/mental-health-laws/discrimination [Accessed
12 May 2019].
2.Future In Mind. (2013). England: gov.uk.
3.Time To Change. (2019). Time To Change: About Us. [online] Available at: https://www.time-to-
change.org.uk/about-us [Accessed 12 May 2019].
4.Time To Change. (2019). Time To Change: What we do. [online] Available at: https://www.time-to-
change.org.uk/about-us/what-we-do [Accessed 12 May 2019].
5.Time To Change. (2019). Our impact. [online] Available at: https://www.time-to-
change.org.uk/home/about-us/our-impact [Acce ...
Model Call Girl in Bikash Puri Delhi reach out to us at 🔝9953056974🔝
Equality Act 2010 to help protect those with ment
1. Equality Act
2010: to help
protect those with
mental health
disability not be
discriminated
against within the
work place and
when applying for
jobs1.
Future In Mind
Department of Health
want to aim to improve
mental health across
young people via
promotion, prevention by
2. 2020. One of the main
focus of the document is
to tackle stigma and
improve attitudes
around mental
illness2.What has time for change done?
They have used several
strategies:
- Local hubs with professionals to
give advise and promote anti
stigma and discrimination, inter-
professional trust& respect.
- Social Marketing campaigns to
engage people who haven’t
experienced mental health illness
relevant to them and changing
attitudes and behaviours about
mental health.
- Working alongside schools and
organisations to improve
3. knowledge, educating young
people about mental health. Also
carrying out workshops with
teachers to help create time for
change workshops within the
schools.
- Provide resources for
professionals in the work
place4.
What is time for change?
A partnership lead by Mind and
Rethink Mental Health funded
by the Department of Health
and Social Care, Comic Relief
and National Lottery. It’s a
growing social movement
with the aim to change the
way that people think and act
about mental health problems
4. by working within communities,
work places and with young
people with the aim of trying to
change attitudes. The
partnership therefore showing
cultural continuity3 .
Outcomes
Critical Evaluation
Unequal power relationships between
service users and staff, reducing role
clarity.
Staff burnout and structural
discrimination affecting resources, no
shared commitment.
Participation rate to gain figures not
reliable
Study found an increase in discrimination
towards those on welfare benefits
Have met the aims the partnership has
set out to do so far, displaying
successful independence of outcomes6
Conclusion
Overall time for change has been
slowly making a difference in
5. educating about mental health.
However, as a partnership it’s not
working so well. It could be improve
the negatives found in the study
across staff and discrimination
towards welfare benefits.
5
References
1.Illness, R. and Illness, R. (2019). The Equality Act 2010.
[online] Rethink.org. Available at:
https://www.rethink.org/living-with-mental-illness/mental-
health-laws/discrimination [Accessed
12 May 2019].
2.Future In Mind. (2013). England: gov.uk.
3.Time To Change. (2019). Time To Change: About Us. [online]
Available at: https://www.time-to-
change.org.uk/about-us [Accessed 12 May 2019].
4.Time To Change. (2019). Time To Change: What we do.
[online] Available at: https://www.time-to-
change.org.uk/about-us/what-we-do [Accessed 12 May 2019].
5.Time To Change. (2019). Our impact. [online] Available at:
https://www.time-to-
change.org.uk/home/about-us/our-impact [Accessed 12 May
2019].
6.Corker, E., Henderson, C. and Thornicroft, G. (2011). The
Viewpoint discrimination survey - the
extent of discrimination faced by mental health service users in
6. England. Psychiatrische Praxis, 38(S
01).
Explain how consensus building complements the course
material you’ve learned to date. Why is consensus building a
natural extension of principled negotiation? What gets in the
way of effective consensus building?
In 10 Sentences, No need for a title page.
Explain how consensus building complements the course
material you’ve learned to date. Why
is consensus building a natural extension of principled
negotiation? What gets in the way of
effective consensus building
?
In 1
0
Sentences
, No nee
d for a t
itle page.
Explain how consensus building complements the course
material you’ve learned to date. Why
is consensus building a natural extension of principled
negotiation? What gets in the way of
effective consensus building?
In 10 Sentences, No need for a title page.
7. The Prison Health Partnership
Improving the Health & Wellbeing of the Prison Population in
England through Multi-Agency Cohesiveness & Shared
Responsibility (1)
and HM Prison & Probation Service established in
2012, joined by Ministry of Justice & Department of Health &
Social Care in 2018 (1).
and Social Care Act (2012) which increased focus on
partnership working and integrated care (2) despite claims that
the UK Government’s reliance on partnerships
are ineffective at reducing health inequalities (3).
amongst prisoners and recently released offenders,
many of which were preventable & often the result of suicide,
substance use, or poor prison conditions which
lead to those at risk of premature death remaining unidentified
by both prison staff and health professionals (4).
Public Health England: Surveillance & Quality Assurance
HM Prison & Probation Service: Prison Service Provision
NHS England: Commissioning of Prison Health Services
Ministry of Justice: Justice & Prison Reform Policy
8. Department of Health & Social Care: Health Policy
Conclusion: Since the Prison Health Partnership was
established, prison mortality rates have decreased. This suggests
that the partnership has worked effectively towards achieving
its
aims, however mortality rates are still considered to be at an
unacceptable level (4). Therefore, there is room for
improvement, which could include expansion to include relevant
private &
voluntary sector agencies fundamental to the provision of
various prison services to eliminate missed opportunities for
improvement and enhance quality of care.
1) To reduce health inequalities
and improve the health &
wellbeing of prisoners
2) To identify and address health-
related factors which contribute to
offending and re-offending
3) To improve access to health care
services for prisoners both during
and after incarceration
Clear & Robust Partnership Arrangements: linked
governance structures enable the partnership to work
towards 10 agreed priorities set out in the National Prison
Healthcare Board’s Partnership Agreement 2018/2021 (1)
9. Clarity & Realism of Purpose: a shared vision
of reducing health inequalities with realistic
expectations & acknowledgment of the complexity
of factors affecting the health of prisoners and the
difficulties of overcoming identified issues
Developing & Maintaining Trust: Recognition
of organisational independence with individual
resources, strategies and specific roles (above,
right) within the partnership valued and respected.
Recognizing the Need for Partnership: the complexity of
health needs amongst prisoners is acknowledged as a
rationale for the partnership. However, government policy at
the time influenced the alliance of various government
agencies, suggesting partnership involvement is involuntary
Monitoring, Measuring & Learning: Internal &
independent monitoring boards continually
evaluating the effectiveness of service delivery to
improve staff training and enhance quality of care (4)
Commitment & Ownership: Expansion of the partnership
in 2018 to further strengthen the collaboration and increase
efficiency, however a lack of involvement from private and
10. voluntary sector agencies limits possibilities for improvement
Enabling Factors:
Disabling Factors:
X
X
All 5 partners are government agencies working towards similar
political agendas and influenced by the same political
ideologies
Issues regarding prison health is widely publicised leading to
the partnership being scrutinised and under increased pressure
(6
)
Effectiveness of The Prison Health Partnership: Evaluated using
the Partnership Assessment Tool
(5)
Underfunding and overcrowding in prisons limits what the can
be
achieved, reducing the impact on prisoner health outcomes
(1)
11. A whole system approach- from sentencing to release- provides
opportunity for improvement across the whole prison population
References
(1) HM Government. (2018) National Partnership Agreement for
Prison Healthcare in England 2018-2021. (Online). Available at:
https://assets.publishing.service.gov.uk/government/uploads/sys
tem/uploads/attachment_data/file/767832/6.4289_MoJ_National
_hea
lth_partnership_A4-L_v10_web.pdf. (Accessed: 20 February
2019).
(2) HM Government. (2012) Health and Social Care Act 2012-
Part 5: Chapter 2. (Online). Available at:
http://www.legislation.gov.uk/ukpga/2012/7/part/5/chapter/2/cr
ossheading/health-and-wellbeing-boards-functions/enacted.
(Accessed: 20 February 2019).
(3) Perkins, N., Smith, K., Hunter, D.J., Bambra, C., and Joyce,
K. (2010) ‘What Counts is What Works? New Labour and
Partnerships in Public
Health’, Policy and Politics, 38 (1), pp. 101-117.
(4) House of Commons Health and Social Care Committee.
(2019) Prison Health: Twelfth Report of Session 2017–19.
(Online). Available at:
https://publications.parliament.uk/pa/cm201719/cmselect/cmhea
lth/963/963.pdf. (Accessed: 24 February 2019).
(5) Hardy, B., Hudson, B., and Waddington, E. (2003)
Assessing Strategic Partnership: The Partnership Assessment
12. Tool. Leeds: Nuffield
Institute for Health.
(6) HM Government. (2019) Government Response to the
Health and Social Care Committee's Inquiry into Prison Health.
(Online). Available
at: https://www.parliament.uk/documents/commons-
committees/Health/Correspondence/2017-19/Government-
Response-to-twelfth-
report-into-prison-health-cp4.pdf. (Accessed: 21 February
2019).
https://assets.publishing.service.gov.uk/government/uploads/sys
tem/uploads/attachment_data/file/767832/6.4289_MoJ_National
_health_partnership_A4-L_v10_web.pdf
http://www.legislation.gov.uk/ukpga/2012/7/part/5/chapter/2/cr
ossheading/health-and-wellbeing-boards-functions/enacted
https://publications.parliament.uk/pa/cm201719/cmselect/cmhea
lth/963/963.pdf
https://www.parliament.uk/documents/commons-
committees/Health/Correspondence/2017-19/Government-
Response-to-twelfth-report-into-prison-health-cp4.pdf
Leadership and
collaborative working in
Public Health and
Healthcare
13. Analysis of
Leadership
and
Management
applied to
Healthcare
By: [Name]
Analysis of Leadership and Management applied to Healthcare
1
Introduction
Healthcare organisations are developed in a complex system
that is hard to predict
due to their changing nature (Weberg, 2012). Understanding the
complexity of the context
has been important to raising awareness on how Healthcare
organisations must be
understood in order to improve their performance (Ghiasipour et
al., 2017; Belrhiti, Nebot
Giralt, and Marchal, 2018). For instance, these arguments have
been used in the literature
to justify that the success of the performance of Healthcare
settings is subject to different
14. interconnected and complex components, like an adequate level
of skills, knowledge,
competencies, and a high level of motivation among the
workforce (Mosadeghrad, 2014).
Interestingly, the components mentioned before have a common
element, the members
of the staff, who show all those characteristics through their
performance. According to
this, Plsek and Wilson (2001) understood that the focus on
delivering good practice
should be shifted to developing appropriate knowledge about
the individuals who are in
charge of leading those members of the staff, and as a
consequence exploring how
leadership and management play an important role in the
interactions that are produced
within the complexity of Healthcare organisations. In the United
Kingdom, the relevance
of strong leadership and management has also been stated as a
core element for the
success of the Healthcare system, the NHS England (2014) has
settled a 5 years forward
view scenario where leadership and management, in conjunction
with the promotion of a
15. positive culture, are key elements for achieving a high-quality
care, and it is not surprising
that they are investing in training people with strong leadership
skills to ensure that they
will deliver a good service (NHS England, 2018). Therefore,
this essay has the aim to
critically discuss what are leadership and management and how
the different models can
play a fundamental role in the success of Healthcare
organisations.
Discussing leadership and management, are they the same
thing?
Leadership and management started to be conceptualised as two
different things more
than 40 years ago, thanks to the work of Abraham Zaleznik
(1977), who considered that
these two concepts had different roles in the organisation. In the
following years, a very
broad range of authors developed an extensive literature of
knowledge regarding these
two concepts (Bennis and Nanus, 1985; Gardner, 1990; Kotter,
1990), and interestingly
today it is still easy to find a debate on how the differences
among management and
16. leadership can be used to achieve the success of the
organisation (Toor and Ofori, 2008;
Bass, 2010; Algahtani, 2014) . In this aspect, Kotter´s (1991)
conclusions about
Analysis of Leadership and Management applied to Healthcare
2
leadership and management are very remarkable for analysing
how these two elements
can be linked to deliver high-quality standards in a complex
Healthcare system, saying
that ´Managing is about coping with complexity, leadership is
about coping with change´
(Kotter, 1991, p.32). Then, it is possible to affirm that, even
though they are two different
things, both, managers and leaders are needed for any effective
organisation (Kotter,
1991). An interesting interpretation to Kotter´s (1991) statement
can also lead to thinking
that managers are people in charge of confronting the chaos of
the organisations with the
aim of bringing consistency to them (Kotterman, 2006).
However, if manager is about
17. efficiency and leadership is about bringing change, and
successful change is about
motivating people to work towards the same vision in an active
way while creating a
positive culture (Hechanova, Caringal-Go and Magsaysay,
2018), then using Gill (2011)
definition of leadership can be useful to understand how
effective leadership can be linked
to success.
Leadership is showing the way and helping others to pursue it.
This entails
envisioning a desirable future, promoting a clear purpose or
mission, supportive
values and intelligent strategies, and empowering and engaging
all those concerned.
(Gill, 2011,p.9).
When analysing and comparing these two concepts it seems that
there is a general trend
to assume that managers apply solutions to problems following
the procedures of the
organisations, while leadership plays a fundamental role in
bringing innovative solutions
when the situation is unpredictable (Weberg, 2012). Therefore,
18. leadership is associated
with words like visionary or with strong statements like doing
the right thing, while
managers are more focused on the task and doing the things
right (Azad et al., 2017),
Kotterman (2006) uses the terminology unimaginative cold to
illustrate the general
perception of managers work in the organisations. However, a
perfect example of how
this conceptualisation might affect the effectiveness of a
Healthcare organisation can be
found in the United Kingdom with the case of Mid Staffordshire
Hospital, where the basic
principles of care were ignored, resulting in catastrophic results
for both, the organisation
and the patients, due to the lack of effective leadership and
management (Francis, 2013),
this means that both roles share a responsibility on the results
of the organisation (Azad
et al., 2017). Then, affirming that management and leadership
focus on different things
might be right depending on the context, but it is also important
to understand that in
Healthcare, managers and leaders have the same moral duties
19. and obligations towards the
Analysis of Leadership and Management applied to Healthcare
3
costumers to deliver a high quality of care (Parand et al., 2014).
For this reason, the
differences between those two components might not be as clear
as Zaleznik (1977) or
Kotter (1990) identified in their work. In conclusion, not just
leadership and management
is needed for the success of the organisations, it is also
important to understand that both
can share similar skills and they are not two completely
different elements, in
contraposition, it is essential that they are both integrated, in
any successful Healthcare
organisation (Parand et al., 2014).
Theories of management and leadership, skills and application
to practice
There is a very broad literature in leadership and management
theories, however, since
Healthcare is a complex system which is constantly changing, it
20. seems that traditional
models about leadership are not appropriate for describing
which behaviors are the best
ones for the success of Healthcare organisations (Weberg,
2012). When analysing the
traditional leadership theories it is possible to understand that
leadership is mainly based
on the individual capacities of influencing the staff trough
elements like motivation, the
use of rewards and punishment or even manipulation (Bass,
2010), however the main
problem of this statement, when it is applied to Healthcare, is
how it draws an individual
who holds a role, rather than an individual who has a set of
behaviours to influence people
(Plowman & Duchon, 2008). Therefore, it is fundamental to use
a model of leadership
and management in Healthcare suitable for facing the challenges
of working in an
innovative system (Weberg, 2012).
In management, the system approach has been broadly applied
in Healthcare systems
(Waterson, 2009), this is not surprising considering that patient
safety has been one of the
21. focus of improvement in the last few years (Edworthy et al.,
2006; Benning et al., 2011;
Weaver et al., 2013). The most extensive model in patient
Safety was developed by
Reason´s (2000) and is called the Swiss Cheese Model of safety.
From the broad spectrum
of models that can be applied to management in Healthcare, the
Swiss Cheese Model
stands out from others because Reason (2000) understood that
due to the complexity of
care, human errors were going to be made, and those errors
won´t be avoided by using
punishment, instead there was a need to prevent the mistakes
and therefore avoid the
potential harm that they could produce. Collins (2014) uses the
example of avoiding
wrong-site surgeries during operations for understanding how
this model can suit the
demands of the Healthcare system. Every slice of the Swiss
cheese represents a way to
prevent errors, in the case of avoiding wrong-site surgery three
are the slices that can be
22. Analysis of Leadership and Management applied to Healthcare
4
used, key stakeholder support, surgical safety checklist, and the
communication among
the team and their collaborative work (Collins et al., 2014).
Each slice has holes, and
when they line up, they represent possible errors, which can be
latent errors or active
errors (Reason, 2000). From this particular situation, the latent
errors are product of the
organisation structure or design, then this could go from failure
in administering antibiotic
medication because of the lack of reviewing allergies before
administering, to aspects of
the Healthcare organisation that interfere with the members of
the staff producing them
distress or a lack of concentration (Collins et al., 2014). On the
other hand, active errors
are easy to spot because they are produced by the staff mistakes
usually at the time of
performing tasks in the system, for example, following the
previous example an active
errors would be giving the wrong medication, or conducting a
23. surgery in the wrong limb
(Collins, et al., 2014). The application of this model in
Healthcare not just avoids giving
the responsibility of outcomes to just one individual, it gives a
broader view that helps
analysing the situation from a nonlinear perspective, where
relationships among the
components are important, and therefore it allows a space of
analysis where errors can be
fixed (Collins, et al. 2014).
Another relevant approach of management is the contingency
approach, which states that
there is not a right path for managing, due to the diversity and
complexity of the
organisations, not all methods can work the same way for the
different organisations
(Engelseth and Kritchanchai, 2018). One of the characteristic
aspects of this theory is the
differentiation between internal factors, which includes the
climate and the culture of the
organisation, and external factors like healthcare policies when
analysing which strategy
should be adopted (Mintzberg,1979). Contrary to The Swiss
Model, the application of
24. this approach to the decision-making process hasn´t been
clearly defined (Lamminen et
al; 2015). However, it makes sense to affirm that having
awareness of both, internal, and
external factors, is fundamental in order to follow a strategy
that suits the demands of
competitive and complex Healthcare system, and therefore it
has a direct implication in
the decision-making process (Lamminen et al; 2015). In the
particular setting of
Healthcare, this approach can be useful when applied to
situations where change is needed
because there is a need to follow a strategy where changing the
culture and paying
attention to structural processes of the organisations is
fundamental for success (Mackian
and Simons, 2013). A personal example where this approach can
be useful is in the setting
of a care home for people with learning disabilities, where the
staff wasn´t engaging
Analysis of Leadership and Management applied to Healthcare
5
25. appropriately with basic tasks, like signing for medication or
following the support plans.
In this kind of situation, there is a need for a deep
restructuration of the workplace, then
for conducting successful change, it requires a manager that can
control the different
variables around them (Engelseth and Kritchanchai, 2018).
As it has been mentioned before, there is also a broad set of
leadership theories, in this
essay it is argued that two are the most suitable for facing the
demands of the complex
system. The first one is transformational leadership, which has
been linked with a positive
culture in Healthcare organisation and patient’s safety (Page,
2004). The strongest aspects
of this theory rely on the skills that a transformational leader
has, like charisma, effective
communication, creativity or innovation, which are linked to the
capacity of creating
followers who are motivated to work towards a vision (Burke
and Friedman, 2011; Al-
Sawai, 2013). In the context of the NHS applying
transformational leadership could be
26. useful for the improvement of the Children and Young People
Mental Health Services
(CAMHS), which are facing a process of change due to a need
for improving the services
delivered, in fact in Future in Mind (2015) it is specified the
need of leaders to supervise
that change is efficiently integrated across the Mental Health
Services. Transformational
leadership has been proved to be linked to positive attitudes
among teams and improving
the quality of service and care (Saravo, Netzel and Kiesewetter,
2017; Sfantou et al.,
2017). Therefore, it is argued that transformational leadership is
suitable for modern
healthcare environments because they facilitate change, trough
the transmission of the
vision to the staff while motivating them to pursue the goals
(Kumar and Khiljee, 2016).
Even though transformational leadership has been mentioned in
the literature as the ideal
model of leadership (Mackian and Simons, 2013) it can be
criticised by saying that it
glorifies the figure of the leader as an individual (Bolden,
2011). For this reason, it is
27. argued that distributed leadership is a good alternative to thi s
approach (Bolden, 2011).
Considering this approach over others might result surprisingly
at the beginning,
nonetheless, when paying attention to the massive number of
variables inside the settings
of Healthcare, it results interesting to adopt an approach where
leadership relies on many
members rather than one (Mackian and Simons, 2013). In the
past, Healthcare systems
like the NHS have prompted the application of leadership to
small groups of senior staff
(Miller and Sitton-Kent, 2016), however, improvements might
be needed at any level of
the organisation, for this reason in order to improve the quality
of care it makes sense to
use a theory where leadership can be used in specific settings
without needing a senior
Analysis of Leadership and Management applied to Healthcare
6
member of the staff (Boak et al., 2015). A perfect example on
28. how the lack of distributive
leadership can affect the quality of the service delivered by the
Healthcare system can be
seen in the example of Mid -Staffordshire mentioned before,
Francis (2013) stated that
part of the lack of a professional service was due the poor
management and leadership,
and due to this they ignored the needs of different levels of the
organisations. Therefore,
it can be concluded that distributed leadership could have been
useful for spotting these
issues at an early stage (Beirne, 2017). Moreover, there is
increasing investment in
innovating in specialised services such as cancer services that
will need the work of staff
with a background from different disciplines at a multi -level,
which at the same time will
require the use of multiple leaders to handle those situations
(Beirne, 2017).
Effective leadership and management are the key pieces for
successful Healthcare
organisations (Sfantou et al., 2017), for this reason it is not
surprising that the NHS offers
wide range of programs that aim to help staff to get trained in
29. leadership and management
skills, for example, the Mary Seacole Programme or the Edward
Jenner Programme (NHS
England, 2018). When looking at the content of this
programmes it is possible to observe
that they include skills that have been traditionally attributed to
management, like
technical skills to organise the tasks, do the planning and
budgeting and organise,
conceptual skills that help managers to understand what they
need to do and to make
decisions, and interpersonal skills useful for motivating and
manage people (Burke and
Friedman, 2011). One skill that is not frequently mentioned in
the programs but results
very useful in Healthcare is proactiveness, because the
hierarchical distribution of
management can limit those managers who are in the lower and
high positions of the
organization (Mackian and Simons, 2013), for this reason,
successful Healthcare
organizations need proactive managers with self-awareness who
understand themselves,
their values and their motivations, and managers able to use this
30. knowledge to influence
their performance at work in difficult situations (Mackian and
Simons, 2013). On the
other hand, when it comes to leadership, the Leadership
programs seems to agree that the
skills that need to be taught are identified in nine different
dimensions (NHS Leadership
Academy, 2013). Those dimensions are prioritising care and
being able to be aware of
the needs of others, understand the vision and communicate it to
the staff, being able to
create good relationships with the team, create followers
through the influence power,
being creative and critical when evaluating and considering the
information, being
influential with the results, being trustable, aware of the context
and finally being
Analysis of Leadership and Management applied to Healthcare
7
innovative (NHS Leadership Academy, 2013). These dimensions
are particularly
31. important in Healthcare because they have been designed to
avoid situations where
mistakes were made in the past, like Mid Staffordshire (NHS
England, 2018). Based on
this, it can be concluded that a fundamental skill for success in
Healthcare is empathy,
just as Francis (2013) highlighted in his report, having empathy
for others and listening
to people’s feelings is fundamental for guaranteeing patient´s
safety and therefore the
success of the organisation.
In conclusion, just by the cooperation of the staff, and the use
of their skills in the
performance, Healthcare organisation will be able to survive to
the big challenges that
will have to face due to the complex nature of the system (NHS
England 2014)
32. Analysis of Leadership and Management applied to Healthcare
8
References:
Algahtani, D. (2014). Are Leadership and Management
Different? A Review. Journal
of Management Policies and Practices, 2(3).
Al-Sawai, A. (2013). Leadership of Healthcare Professionals:
Where Do We
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41. THE ROLE OF MANAGEMENT &
LEADERSHIP IN PUBLIC HEALTH
AC7029:
LEADERSHIP AND COLLABORATIVE WORKING IN
PUBLIC HEALTH AND
HEALTHCARE
[name]
[student number]
May 2019
Word Count: 2336
Module: AC7029 Emma Shields
1
The Role of Management and Leadership in Public Health
The issues affecting population health are extremely complex
and require action
against a wide range of determinants to make lasting
42. improvements, therefore it is
fundamental that public health services are managed effectively
and efficiently. It is
therefore essential that those in charge of protecting population
health not only have
the knowledge and skills identified as essential for effective
management but are
able to lead others in their field. Theories of management and
leadership play a
pivotal role in determining how interventions and services
aimed at improving
population health should be implemented, both nationally and
locally. There are a
wide range of perspectives on the principles and practices of
management and
leadership, including the Contingency Approach to Management
and Participative
Leadership, which will be critically discussed in relation to
public health practice.
Public health agencies across the world play a key role in
protecting the health of the
population through disease control, health promotion and
overall reducing morbidity
and mortality rates to ensure people live long and healthy lives
43. (World Health
Organization, 2019a). This is achieved through research; the
development of public
health policy, law and regulations (Burke, 2011); collaboration
with a wide range of
public, private and voluntary organisations; service provision;
and, developing
effective management and leadership strategies (World Health
Organization, 2019b).
A wide range of determinants affecting population health exist,
such as social,
environmental, political, educational, cultural, economic and
genetic factors (Marmot
and Wilkinson, 2005). These include the prevalence and spread
of disease, access
to health services, living and working conditions, household
income and individual
behaviours, all which collectively determine a person’s health
outcomes (Baum,
2016). The complexity of public health and the issues affecting
it therefore requires
Module: AC7029 Emma Shields
44. 2
an understanding of management and leadership principles
which underpin the work
carried out in the field of public health (Brownson et al, 2018).
Managers are people appointed the role of overseeing the daily
functions of an
organisation and are given the authority to make important
decisions which can
affect the provision of whatever product or service is offered by
the company (Darr,
2011). Leaders are employees within the organisation, working
at any level or in any
role, who can influence and impact positive change to improve
organisational
outcomes (Rowitz, 2018). A clear distinction between managers
and leaders is that
whilst a leader may possess the ideas and strategies needed for
success, only those
in a managerial position have the power to implement and
enforce them (Barr and
Dowding, 2012). Johnson and Breckon (2007) suggest that the
level of authority a
manager is given should be synonymous to the level of
45. responsibility they have to
ensure successful outcomes. However, it is argued that the
relationship between the
management and leadership are interrelated and both equally as
important,
particularly in public health (Burke, 2011). It is also argued that
building a competent
public health workforce which demonstrates excellent
management and leadership
qualities is equally, if not more important, than simply being
experts in contemporary
health issues (Fraser et al, 2017). There are a range of
perspectives which
conceptualise the importance of both management and
leadership. Management
theories include the Scientific, Systems, Human Relations and
Contingency
approaches, whilst leadership theories include Authoritarian,
Transactional and
Transformational.
The Contingency approach to management combines aspects of
several other
theories: the Scientific approach, which is evidence-based and
systematic to ensure
46. maximum productivity; the Systems approach, which considers
how all parts of an
Module: AC7029 Emma Shields
3
organisation work together co-ordinately, each function equally
as important; and the
Humanistic approach, which focuses on the people within the
organisation and how
they interact with each other (Johnson and Breckon, 2007).
Developed by Lawrence
and Lorsch (1967) whose research into the organisational
structures of several
organisations concluded that no single method of management
was superior. The
theoretic emphasis of this approach is that management is
situational: it is essential
that managers adapt their management styles to both the needs
of the organisation
and the service or intervention they are overseeing, and if the
managerial structure
adopted fails to cohere with the goals of the organisation, it
47. must be changed to a
more appropriate style (Barrett, 2011). However, it is argued
that adapting
management style to suit the situation is futile; if managers
must change the way
they operate due to situations they cannot manage, they
consequently cannot
successfully manage the situation at all (Kreitner, 2008).
Despite this, the Contingency Approach is considered relevant
to public health
practice due to its strong focus on integration, which is a
fundamental principle
underpinning the work of various organisations in the delivery
of services,
collaborative research, and resource sharing, to achieve
common public health goals
(Redwood et al, 2016). The field of public health consists of
multiple stakeholders,
such as government agencies, educational institutions, private
and voluntary sector
organisations, and local communities (Freidman, 2011a).
Integration is particularly
important within private-public partnerships due to differences
in organisational
48. structures, collaborating workforces and strategy sharing, which
requires effective
management, delegation, negotiation and communication
(Waring et al, 2013). This
approach is particularly useful within the area of health
promotion, as understanding
the consequences of processes and behaviours is fundamental to
developing
Module: AC7029 Emma Shields
4
behaviour change-based policies and interventions (Elder,
2001). Therefore, how
public health challenges are approached is dependent on various
situational factors
such as the targeted population, the resources available, how
and where the
intervention will be implemented, and the overall aims of the
intervention (Sheeran et
al, 2016). The complexity of behaviour-change interventions
therefore requires a
contingent management strategy, which is essential to the
49. continually changing
organisational structures of public health agencies.
Managing organisational change can be challenging for those in
charge of protecting
and promoting the health of the population due to the political
ideologies which
impact the way health services are operated and delivered. In
2013, the
responsibility of public health in the United Kingdom (UK) w as
decentralised from the
Central Government to local authorities as a result of the
Localism Act (2011) giving
local authorities additional decision-making powers.
Additionally, many health
services were privatised to improve efficiency as part of the
Health and Social Care
Act (2012). These changes were enforced under the Coalition
Government, whose
political agenda was influenced by the New Localism ideology
which promotes local
service provision to meet the needs of local communities (Tait
and Inch, 2015).
However, the Central Government primarily retained financial
control, which
50. therefore limits what can be achieved by local authorities,
providing managers of
public health services at a local level with additional challenges
to contend with
(McKenna and Dunn, 2015). Bureaucratic management styles
which consist of multi-
level hierarchies are therefore unsuitable for fractured and
unstable environments
which require flexibility and fluidity to ensure organisational
change is as disruptive
as possible (Barrett, 2012). It is also argued that the outcomes
of an organisation
can vary depending on whether they are operated publicly or
privately, with public
Module: AC7029 Emma Shields
5
sector agencies under constant scrutiny from the general public
due to way they are
funded (Pollitt, 2003).This not only highlights the importance
of effective contingent
management strategies in public health, but also adds pressure
51. to public health
managers, enforcing the ideology that the employment of
competent leaders is
equally important for organisational success. Due to the
situational-based theory
which underpins the Contingency approach to management, the
need for effective
leadership is also a key aspect of this perspective, considering
the relationships
between those working at a managerial level and the rest of the
employees within
the organisation to achieve desired outcomes (Freidman,
2011b).
Leadership plays an integral role in the field of public health.
Whilst managers are
important in overseeing the functions of an organisation through
solving problems,
distributing finances and resources, and planning effective
strategies, leaders are
those who influence, motivate and empower others to ensure the
organisation
operates effectively and continually strives to improve and
progress (Stanfield,
2009). It is suggested that leaders have innate characteristics
52. which make them
effective at their job, but these skills and principles can also be
learnt by others
(Rowitz, 2018). Leadership is recognised as essential to the
provision of health care
services in the UK, as it is believed that mortality rates can be
reduced if all staff
actively participate in the improvement of the services they are
employed in (NHS
Leadership Academy, 2014). Theories conceptualising the
importance of leadership
include the Trait Approach, which suggests leaders are born
with the inherent
characteristic needed for effective leadership (Burke and
Freidman. 2011); The Style
approach, which favours emphasis on individual behaviours;
and, Transformational
Leadership, which builds on the concept of working together to
achieve common
goals (Healey and Lesneski, 2011).
Module: AC7029 Emma Shields
6
53. Transformational leadership is a theory which values mutual
respect, empowerment,
trustworthiness and motivation in which those in a managerial
position highly regard
the contributions of those at a lower level in the organisation
(Shelton, 2012).
Transformational leadership was conceptualised by Burns
(1978), who suggested
leaders where either Transactional, in which people lead others
in exchange for a
favourable reward, or Transformational, who inspire others for
the good of the
organisation. Transformational leadership is made up of four
components: Idealized
Influence, which is they behaviours which inspire others to
follow; Inspirational
Motivation, the optimistic and enthusiastic exchange between
leaders and others in
order to motivate and inspire ; Individualised Consideration, in
which leaders value
others’ aspirations and achievements; and, Intellectual
Stimulation, which involves
addressing and challenging issues to develop effective solutions
54. (Bass and Riggio,
2008). Forming good relationships is a key attribute needed to
fulfil these roles, as
influence and empowerment is only possible if others within the
organisation trust
and respect those they are following (Barling, 2014). Novick et
al (2008) suggests
that empowerment for all employees within a public health
organisation can be
chaotic, particularly if employees don’t agree with the political
agendas which
influence the aims of the organisation they are working for.
Healey and Lesneski
(2011) argue that the influential impact leaders can have on
others improves the
outcomes of services and interventions, resulting in
Transformational leadership
being well established in the public health field.
There are many different styles of leadership, such as
Transactional, Autocratic and
Participative, all which differ in terms of how leadership is
implemented within an
organisation. Participative leadership, also known as
Democratic leadership,
55. provides employees with the opportunity to make important
decisions regarding the
Module: AC7029 Emma Shields
7
service they provide (Ricketts and Ricketts, 2011). A systematic
review of leadership
styles during disease outbreaks by Arifah and colleagues (2018)
found that
participative leadership qualities such as encouragement,
effective communication
and partnership working, were considered essential components
in controlling and
managing outbreaks. Participative leadership styles coincide
with the perspectives of
Transformational Leadership theorists, and the World Health
Organization (2016)
regards Participative leadership styles as fundamental to
improving population
health, as all employees invested in working towards this aim
should be treated
equally and decisions made collaboratively. Research shows
56. that utilising this style
of leadership can improve job satisfaction which leads to an
improvement in
productivity, particularly in public sector organisations (Kim,
2002). However, this
approach to leadership relies on the assumption that al l
members of the
organisation, both managerial and frontline staff, have similar
interests and visions,
however this scenario is idealistic and may not always be the
case (Ricketts and
Ricketts, 2011).
Some of the challenges faced by public health managers and
leaders include
outbreaks of disease, new trends in unhealthy behaviours and
policy reform (Rhodes
et al, 2010). One of the key functions of a public health
manager is to make rational
and evidence-based decisions to overcome such challenges
(Brownson et al, 2018).
This requires technical skills such as planning and budgeting;
Interpersonal skills
such as effective listening and cooperating; and conceptual
skills such as analysing
57. complex situations, commitment and visualising success
(Healey and Lesneski,
2011). Public health managers are required to effectively plan
both short- and long-
term goals in addition to planning for unknown events which
can affect the outcomes
of those goals. Contingency planning allows for disasters to be
averted and is of
Module: AC7029 Emma Shields
8
particularly important in public health, for example during
disease outbreaks (Darr,
2011) Similar skills are identified as essential leadership
qualities, with the addition
of emotional intelligence, influence and self-awareness
(Moodie, 2016). It is argued
that attempting to teach leaders in the field of public health the
skills needed to excel
in the workplace is difficult due to those in managerial
positions lack leadership skills
themselves and therefore cannot inspire others (Yphantides et
58. al, 2016). However,
the similarity of skills needed for both management and
leadership provides an
insight into the resemblance of both concepts.
A systematic review by Neinbar (2010) provides an insight how
the concepts
management and leadership concepts are defined. The study
synthesises that the
terms are often used in existing literature synonymously, with
the responsibilities of
both managers and leaders often described the same. With the
tasks carried out by
both managers and leaders and skills required for effective
management and
leadership similarly described in both Moodie and Neinbars
studies, neither concepts
are distinctive, and both are required for the operati ons of an
organisation to be
successful. Freidman (2011b) also concludes that public health
requires both the
operational functions of managers and the influence of leaders
to overcome the
many challenges that arise due to changes in organisational
structures, cuts to
59. funding and resources, and ongoing threats to the health of the
population.
To conclude, the terms management and leadership are
interchangeable, and it is
often difficult to differentiate between the two. Despite this,
there are many different
theories of how management and leadership can be applied
within public health
organisations. The Contingency approach to management
displays relevance to
overcoming public health challenges such as organisational
change and the
implementation of new policies. This is due to its flexibility and
situational theoretic,
Module: AC7029 Emma Shields
9
whilst Transformational leadership is regarded as an important
concept in achieving
the overall aims of public health, such as prompting healthy
behaviours and effective
and efficient service provision, by developing a value and goal
60. orientated workforce.
The skills needed to effectively manage, and lead have been
revealed through
research to be similar, synthesising that both are of as equal
importance.
Word Count: 2336
Module: AC7029 Emma Shields
10
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Good Community and the Contradictions of Planning Reform in
England’, Planning
Practice and Research, 31 (2), pp. 174-194.
Waring, J., Currie, G., and Bishop, S. (2013) ‘A Contingent
Approach to the
Organization and Management of Public–Private Partnerships:
An Empirical Study of
English Health Care’, Public Administration Review, 73 (2), pp.
313-326.
World Health Organization. (2016) Participatory Leadership for
Health. (Online).
Available at:
https://apps.who.int/iris/bitstream/handle/10665/251458/978924
1511360-
eng.pdf;jsessionid=89DD84BD64C87470D686C387E9C4AB8F?
sequence=1.
(Accessed: 12 May 2019).
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(Online). Available at:
69. http://www.euro.who.int/en/health-topics/Health-
systems/public-health-services.
(Accessed: 11 May 2019).
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Public Health. (Online).
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May 2019).
Yphantides, N., Escoboza, S., and Macchione, N. (2016)
‘Leadership in Public
Health: New Competencies for the Future’, Front Public Health,
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https://apps.who.int/iris/bitstream/handle/10665/251458/978924
1511360-
eng.pdf;jsessionid=89DD84BD64C87470D686C387E9C4AB8F?
sequence=1
https://apps.who.int/iris/bitstream/handle/10665/251458/978924
1511360-
eng.pdf;jsessionid=89DD84BD64C87470D686C387E9C4AB8F?
sequence=1
http://www.euro.who.int/en/health-topics/Health-
systems/public-health-services
https://www.who.int/about/role/en/
https://elp.northumbria.ac.uk/bbcswebdav/pid-12858778-dt-
content-rid-
70. 26143346_2/xid-26143346_2
This module has a two-part summative assessment. The first
element is the
production of an electronic academic poster that will focus on
collaborative
and partnership working in public health / healthcare. The
second is a 2500
essay that critically discusses and evaluates the importance of
management
and leadership theory within a public health and /or healthcare
management
context. The two elements are not directly linked. The
weighting of each
component of the assessment is 50%.
Formative assessment
To support your summative assessments, we also provide
support via two
formative assessments.
1. You will produce an electronic academic poster on one
PowerPoint slide
which will critically analyse collaborative / partnership working
issues in an
existing collaborative / partnership public health and / or
healthcare
management project of your choice. In particular there should
be a critical
discussion of the effectiveness of the collaborative work/
partnership.
Examples of projects will be available on the e-learning portal
or you can
find your own. This will be presented to your peers and module
tutor(s) for
71. review and feedback. This peer and tutor feedback will help you
to develop
your final electronic academic poster which is one element of
the summative
assessment.
The electronic academic poster will provide the opportunity for
you to
present a visual representation of key issues relating to the
rationale and
effectiveness of an example of public health or healthcare
management
collaborative / partnership working. (MLO’s 1,2)
https://elp.northumbria.ac.uk/bbcswebdav/pid-12858778-dt-
content-rid-51725975_2/xid-
51725975_2?VxJw3wfC56=1645701996&Kq3cZcYS15=e3bc60
4d28ed49d9be4684edf1581543&3cCnGYSz89=HZWcH%2B%2
BKxNFzJ2Q02fQZx7%2BugBH7om%2FQ8P2%2FS0GVzpg%3
D
2. You will be asked to provide your allocated tutor with an
outline plan of
your essay via email. This should be no more than one page in
length. You
will also receive a small group tutorial with your module tutor,
which will
be an opportunity to ask specific questions about the
assignment.
Summative assessment
Part 1 (50%)
72. You will produce the final version of your academic poster,
which critically
analyses collaborative / partnership working issues within an
existing
collaborative / partnership public health and / or healthcare
management
project. (MLO’s 1, 2).
Part 2 (50%)
You will submit a 2,500 word essay which critically discusses
and evaluates
the importance of management and leadership theory and its
application
within a public health and/or healthcare context. You are
encouraged to
identify and write about a single public health or healthcare
topic.
https://elp.northumbria.ac.uk/bbcswebdav/pid-12858778-dt-
content-rid-
35448131_2/xid-35448131_2
https://elp.northumbria.ac.uk/bbcswebdav/pid-12858778-dt-
content-rid-51725977_2/xid-
51725977_2?VxJw3wfC56=1645701996&Kq3cZcYS15=e3bc60
4d28ed49d9be4684edf1581543&3cCnGYSz89=Ua5x60vwUqXe
QW3qVXhlkmLSRM22QZRdHccmizo0U8s%3D1