Florence Nightingale School of Nursing & Midwifery

A brief review of leadership

theory
Sign posts to guide your
exploration of leadership theory
 What is leadership?
The question continues to allude answers over
time.
Definitions often reflect the ethos of the time
What is clear however is that leadership occurs
contextually within particular situations and
within specific organisations
Leadership and its impact in the health service
continues to attract particular attention in order
to determine high quality and successful
performance
 Defining Leadership theory
A multi dimensional concept including
intrapersonal, interpersonal, intergroup
and situational variables
Social nature of leadership considers the
interpersonal skills necessary to be
effective in a range of contexts
The ethical component refers to the issue
of power and influence over others
Current thinking in healthcare
now
The focus of leadership in healthcare
organisations is based upon the premise
of collective team work being a priority for
patient care
Shared or distributed leadership is
propositioned as the way forward
Identifies principal values
 Historical steps
There is a value in reviewing where our
current understanding of leadership has
emerged from.
It is interesting to note the influences of
social history, environmental context and
organisational development in the
development of leadership theories
 1930s to 1950s
The predominant view is that leaders are born,
not made. These theories refer to Great man
theories and are characteristic of classical
leadership
Ascendancy to particular positions through
lineage were considered to demonstrate that
leaders are born and not made.
This theory is identified as Classical leadership
theory
 Behavioural school of
leadership
1930s brought a focus upon the
behaviours of leaders, in particular their
decision making style:
Autocratic (leader centred or dictatorial),
democratic (participative) and laissez-faire
(group centred or autonomous decision
making) This original work was explored
by Lewin, Lippitt and White (1939)
 1950s to 1960s
The primary focus of interest was upon the
behavioural elements of leadership practice. The
view being that if the traits of effective
leadership could be identified then leadership
could be utilised to influence others.
There continues to be interest in this the view,
and more recent research continues to
demonstrate particular characteristics
corresponding to effective leadership and impact
on followers
 1960s to 1970s
Situational leadership came to the
foreground as there was a growing
awareness of the importance of the:
1. Relationship between the leader and
those that were being led (followers)
2. Task structures
3. The power held by the leader in terms of
their position in the system
 Situational Leadership
The following variables were identified by
Fiedler (1967)
The extent to which the task was
structured
The way the leader interacted with others
The position and power conferred upon
the leader
The preferred style that the leader adopted
 Additional variables were
identified
Hershey and Blanchard (1978/1993)
identified a further contribution to the list of
variables considered to be of significance
for situational leadership. These were
Maturity of the follower
Competence of the leader
Experience of the leader
Self-confidence of the leader
 Life cycle theory
Herseys theoretical perspective took the
readiness of the follower as the
determining feature to guide the leaders
behaviour
Readiness refers to the followers level of
motivation and competence for the task
The leader assesses the followers
capacity in the given situation.
 Situational leadership
behaviours
Telling
Selling
Participating
Delegating
Determining features are the necessary
support (relationship behaviours) and
guidance to the task (readiness to
complete the tasks
 1980s onwards
A collection of leadership theories
proposed , most of which pay particular
attention to the quality of the relationship
between the leader and followers

Bennis and Nanus (1985) identify four

types of human handling skills
 Human handling skills
Strategy 1: attention through vision
Strategy 2: meaning through
communication
Strategy 3: trust through positioning
Strategy 4: use of positive self regard
 Transactional leadership
Focus on the tasks to be achieved
Leader is clear in identifying the
rewards/outcomes expected and the
followers view the rewards as of benefit to
them
The leader shapes the follower behaviour
in order to achieve excellent outcomes
 Transformational Leadership
Transformational leaders focus upon
each individual and seek to inspire
motivation and provide the necessary
intellectual stimulation that influences the
follower behaviour
This style of leadership often enables
achievements beyond expectations
5 actions for transformational
leaders
Model the way
Inspire the shared vision
Challenge the process
Enable others to act
Encourage the heart

Bass (1985) and Kouzes and Posner (1987)

 2000 onwards
Visionary leadership is considered to be
present with the current fast paced, turbulence
of organisational development or demise.
Followers must be active and participative in
order for the vision to be achieved
Authentic leadership considers the value base
of the individual
Ethical Leadership recognition of the
implications of influence over others
 Authentic Leadership (2015)
Developing interest in authentic practice
Considers the importance of self
awareness of the leader particularly in
terms of engagement with others
Interplay between the leader and follower
particularly in relation to follower
satisfaction needs being met
 Medical leadership (2010)
Identified shared leadership from
recognition of the importance of
participatory decision making within the
multi-disciplinary team
Priority is to view leadership held by the
team not just a single individual
Each persons experience, knowledge and
capacity is valued by the team
Current features for leaders in
healthcare
Personal mastery, self confidence and a positive
self esteem
Evidence of an in depth understanding of the
whole organization and the context within which
it operates
Dynamics of leadership and the followership
group
Effective and positive relationships
Attention to the ethics of leadership
 Review your experiences
Critically review your personal thoughts and
experiences of leadership in terms of:

1. Your style of leadership

2. Your experience of working with leaders

3. Your experience of leadership in the context of

the organization you work within
 Key resources for your
exploration of leadership
Avery G.C. (2004) Understanding
Leadership London Sage Publications
Gill R (2006) Theory and practice of
Leadership London Sage Publications
Northouse PG (2010) 5th Ed Leadership:
Theory and Practice London. Sage
Publications
www.leadershipacademy.nhs.uk