Posted by: ayrshirehealth | November 25, 2015

Leadership tips by @DavidfosterDH

A government advisor

leadership wordleAt a recent leadership event I was asked to give some tips on leadership. I am no guru, but these are some thoughts that come directly from my experience, experience of being a nurse and midwife for over thirty years. Throughout those years I have worked in intensive care, management and leaderships roles, ended my NHS career as a director of nursing and am now a government advisor.

I have reflected on those roles and given some thought to what’s been helpful. So, here are some tips I think have made a difference.

Choose a mentor or two

I usually have more than one mentor. The best mentor I have had wouldn’t have used that term. She was a hugely experienced nurse and general manager, an SRN (State Registered Nurse) and had no other paper qualifications. She was of the generation who wouldn’t have used management jargon like “Mentor”. MentorYet she was the person who taught me most, offered me some great opportunities and is The person I think about when I’m perplexed and ask myself “what would she have done?”

She was interested in me, she reckoned she spotted some potential and gave me chances to develop. My horizons were lifted and, because of her ambition for me, I think I achieved more than I might have done left to my own devices.

This means that the mentoring relationship is not always cosy. You need challenge and difference. It would be narcissistic and unproductive. To be mentored by a clone of yourself, so seek out those who think differently (and differently from you) who are going to stretch and cajole in a safe yet stimulating way. You don’t have to agree with them all the time or follow all their thinking but you will need to ensure that it is a meaningful two way relationship­ there has to be something in it for the mentor otherwise why should they give you their time?

Role models

Role model 2My role models differ from my mentors because I usually observe them from a distance and don’t always have a personal relationship with them. There are those I wish to emulate, but perhaps more importantly there are the ones I don’t want to be like.

They have traits I hope I don’t exhibit.

I hate being late and being inconsistent. I hate transferring stress onto others and I want to support people, not criticise them when they have done their best. And I don’t, by any stretch, always get it right.

I know of some leaders who readily keep people waiting to emphasise their seniority rather than respecting people by being on time. Leaders who are stressed by their role and create a frenzy of chaos around them are generally going to be ineffective and not necessarily create a successful team. And there are also those who are stunning role models who should be emulated. It’s always fascinating to me how they conduct themselves, dress, and speak. The best have such linguistic dexterity they can communicate sophisticated messages simply for different audiences (and do it equally well verbally and in writing). If only!


Get connected!

Being part of a network or more than one network or constructing your own is essential for getting support and being influential.

NetworksSo much effective change depends on relationships and nurturing those through networks is a great way of getting to know a number of people and working out how they can support you and open doors for you. Networks are not just

one-way traffic though.  It’s important you give as much as you take: your contacts and sphere of influence might be of importance to someone else and it’s always good to help others out.  You could become part of a local, national, regional or international network of people working in the same speciality or of peers crossing boundaries and working across broader issues.  I often hear about the need to integrate care, but don’t often see networks that really cross health and social care.

There is a lot to learn in both directions and I think we, me included, need to do more to recognise that nursing leadership is as important in a care home with nursing as it is in an acute hospital, commissioning or community team or GP surgery: nursing is bigger than the NHS!

NetworkThe size and shape of your networks don’t really matter as long as they serve a purpose and continue to be useful.  But also consider having a small personal network of people with whom you can have confidential chats, run ideas passed and contact on an ad hoc basis – and don’t forget to reciprocate, if you are asking others for their time and advice make sure you are available for them as well.

Develop your social skills and social intelligence


The academics and opinion formers in the field of leadership will come up with lists of words that characterise leadership attributes and skills.  Visible, visionary, trusting, good at communicating, etc., but overarching this are the niceties that the socially skilled observe; the politeness that makes the world go round.

A lot of management texts will also talk about emotional intelligence.  Leadership-changeBut whatever the latest management jargon is you will need some self-awareness, to be resilient and keep control of your emotions, be self-motivated and know how to motivate others and exhibit empathy.

Your social skills will oil the wheels in difficult situations and also help manage conflict when it arises. And going back to mentoring skills, show you are interested in people and they will feel more valued.  So, these skills are also important in encouraging others.

It is said that it takes courage to speak out and raise concerns particularly about poor practice, but there is also the other side of the coin.  That is the courtesy to say thank you and well done – and perhaps more often than we do.


“Where’s the nursing voice?” is a common question.  This is usually proxy for suggesting there is a lack of leadership in certain situations.  One of the difficulties with this is that lots of voices can create noise and contradiction rather than convey effective messages.  David Foster - Leaders-2015And lots of people, including politicians, have, and express, opinions on nursing.  But it is important for nurses to exhibit leadership at all levels and get nursing messages across effectively.   The so called “elevator pitch” is one technique for practising this.

So, if you were in a lift for 30 seconds with your influential audience what would you actually say?  You have time for about 100 words – just under the length of this paragraph so far.  So your message needs to be constructed of carefully selected words to be concise, pithy, memorable and polite.  This technique can be used in many situations: corridor conversations, committees, interviews, presentations.  It is always good to base the content on evidence.

There doesn’t need to be a randomised controlled trial behind it but some weight of evidence adds authority so that the message cannot be disregarded as only your opinion (important though that might be in some situations).  And it is also powerful to talk about the impact and outcomes for patients, the quality of care or the effectiveness of services rather than a wholly nursing focussed perspective.  At a meeting I was once in, a Minister said to a lobbyist that evidence about declining outcomes for patients would be much more persuasive than just a passionate plea to increase the numbers of nurses- a salutary message.

Getting your voice heard means grasping and sometimes creating opportunities to contribute to a discussion.

Opportunity knocks

When the opportunity comes don’t waste it. I recently listened to a prominent nurse leader at an international conference who was given a great slot on the programme to make a significant impact. My notes captured some key points she made about the importance of nurses in public health and preventing poor health. TimeBut I had to turn to my notes to recall that.

Although she made a good impact in her first five minutes on the stage her presentation overran by 15 minutes.

Not only is that discourteous to the conference organisers, the presenters following her and the audience it also eroded her message. She didn’t even stop when people started to walk out! So, my lasting memory is that she went on too long.

At which point I had better stop and wish you well in developing your leadership style and hope, for what they are worth, my experiences go some way to helping you!

This week’s blog was by @davidfosterDH (David Foster), Head of the Nursing, Midwifery and Allied Health Professions Policy Unit, Department of Health, England.

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