The Unique Challenges Of Leading In The NHS


Leaders face the same challenges whatever sector they work in.  On one level this might well be true but having work in both the NHS and outside of the NHS I believe that leaders face some unique challenges.


Public Expectations


The public have a real interest in the NHS which overall is a real positive.  On the other hand they look at progress that is being made in other areas of life and perhaps, not unreasonably expect the same level of progress within the NHS.  What I noticed from my time in senior roles in the NHS is that one fundamental difference between the NHS and a commercial business is that they have far less freedom to set their own strategy.  To some extent they are required to take and implement government policy which may or may not be in touch with what the public wants.


Unlimited Demand But Not Unlimited Resources


In the commercial world doing more business or providing more services is a good thing.  After all more profitable sales leads to more profit.  In the case of the NHS demand continually rises and there is never going to be enough resources to pay for that demand.


Significant Changes Take A Long Time To Achieve


While very local small scale changes can be made pretty quickly, significant changes are going to require change within different organisations, all facing their own challenges and having to meet their own targets.


Teams Work In Silos


Within specific parts of organisations teams might work well but what I noticed that this was far less common across the organisation.  Yet we all know that to treat or deal with just one patient requires people to collaborate.


The Ever Moving Goal Posts


It’s hard to believe that it took until around the year 2000 to set out a 10 year plan for the NHS.  Often what happens is that policy and ideas chop and change without an apparent reason making planning tough.


People Know Healthcare


This in my view is both an asset and liability.  The positives are that people really understand the sector.  The downside is that people sometimes have no other frame of reference gained through different experiences.


The Bottom Line:  Being in a leadership role in the NHS is in my e is a strange mixture of real fulfilment and frustration but always challenging.


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