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Transformational Leadership – It’s not management – James Adams

Transformational Leadership – It’s not management

by James Adams

As a young fresher, I had decided to set up a new student society. I had big plans for what we could achieve, recruiting a committee and excitedly bringing them all together to share what we were going to do and how exactly we were going to achieve it. Quickly I became frustrated at others who weren’t pulling their weight or doing jobs to a high standard. I tried supporting them, showing them ‘the best’ (i.e. my) way of doing things and motivating them with my grand vision, but nothing seemed to work. In other areas of their life many individuals in the team were thriving – why weren’t they doing it for me?

As I met up with team members individually, I began to grasp that the main barrier to performance wasn’t ability but motivation. It seemed our team didn’t thrive off being told what to do and how to do it; this authoritarian ‘dictatorial’ style was just leaving them demoralised and apathetic.

At our next meeting, rather than dictating my vision, we discussed it together. Rather than delegating tasks, I let them set goals and decide how they would be achieved. The team thrived on being given ownership and autonomy to decide their own approach and, all of a sudden, we were finding creative solutions to problems we’d been struggling with and the quality we delivered was vastly improved. The society became a huge success and eventually a national charity.

My experience of leadership in the NHS is that it seems to be a slightly misunderstood term. Often, when we talk about leadership, what we’re actually referring to is management; making sure everything is happening just the way it should, that the rota is made, and the service is delivered according to plan.

Of course, there are many different levels and types of leadership, but within the NHS, many of these ‘leader’ roles in reality are ‘management’ positions. This creates a culture where, on our wards, we perceive good leaders to be the ones who ‘manage’ well. I’m an obsessive organiser. Everything must be laid out in spreadsheets and lists, and my emailing filling system has to be immaculate. But even the anankastic micromanager within me has to accept that whilst good organisational and management skills are a part of effective leadership, they are certainly not paramount.

The most important aspect of good leadership is the ability to drive a vision forward. Good leaders don’t just manage, they inspire. Leaders aren’t there to maintain, they should be the torch bearers, the road makers and the transformation. The ones constantly looking to move forward, deliver better and to climb higher. The ones who aren’t there to do a job, but who are there to see the realisation of a vision, and those who will not rest until the world has been changed – these are the sort of leaders who inspire.

In the NHS, the work we undertake is some of the most inspiring you can think of. As cheesy as it sounds, we’re here to save and improve lives. Yet staff morale is at an all time low, with huge numbers of staff fleeing away to pastures greener – why is this? Yes, we are facing unprecedented pressures with an aging population, but I don’t believe this is the whole story. I think a big part of the answer is how we model leadership.

Writing a nicely laid out department plan isn’t good leadership, it’s good management. Good leadership is taking that document and giving it life, bringing others on board, continually developing and investing in them, and finally sending them out to carry the vision and drive it forward. Good leadership isn’t about just having a vision, it’s about allowing and equipping others to own it too.

One of the best ways to do this is to empower people. We live in a very different world to that of 50 years ago, where the norm was to turn up to work and ‘do your job’. We now live in culture where individuals are increasingly placing much more emphasis on job satisfaction, and fulfilment than on wage packets. In short, we don’t want to be cogs, we desire to be part of the bigger picture.

In the NHS of today, with all the challenges that today brings, we are in desperate need of these trail blazing leaders. Individuals who don’t just manage, but instead empower and inspire, allowing others to own the vision. Turning staff on the shop floor from followers to problem-solvers, allowed to utilise their insights and creativity rather than just being made to follow orders. With ever increasing pressures, making tomorrow look forever more challenging, we need more of these transformational leaders. To be ready for tomorrow, we need them today.


James Adams is final year medical student based in Manchester. He’s the founder of three charities, including his current project Number 11 – a centre based in Stoke-on-Trent which offers sustainable, holistic and relationship based support to those struggling with debt, addiction, unemployment, isolation and homelessness.



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