Leadership development in the English National Health Service: A counter narrative to inform policy

Abstract

ObjectivesTo examine the current approach to leadership development in the English National Health Service (NHS) and consider its implications for nursing.To stimulate debate about the nature of leadership development in a range of health care settings. BackgroundGood leadership is central to the provision of high quality nursing care. This has focussed attention on the leadership development of nurses and other health care staff. It has been a key policy concern in the English NHS of late and fostered the growth of leadership development programmes founded on competency based approaches. DesignThis is a policy review informed by the concept of episteme. Data sourcesRelevant policy documents and related literature. Review methodsUsing Foucault's concept of episteme, leadership development policy is examined in context and a ‘counter narrative’ developed to demonstrate that current approaches are rooted in competency based accounts which constitute a limited, yet dominant narrative. ConclusionLeadership takes many forms and varies hugely according to task and context. Acknowledging this in the form of a counter narrative offers a contribution to more constructive policy development in the English NHS and more widely. A more nuanced debate about leadership development and greater diversity in the provision of development programmes and activities is required. Leadership development has been advocated as being crucial to the advancement of nursing. Detailed analysis of its nature and function is essential if it is to meet the needs of nurse leaders.