Research Proposal: Leadership

National Health Service Leadership

Question1 - Evaluate a Range of Leadership Theories and Models that Reflect Current Thinking

United Kingdom's National Health Service (NHS) one of the first comprehensive healthcare systems created worldwide; advocates believed that not only would this help solve the healthcare problem, but that it was also an important step in rebuilding Britain after World War II. From its inception, the NHS was to be—and has been—funded almost entirely from a taxation system, wherein the rate paid was based upon a person's income. Moreover, anyone living in England, even if temporarily, was able to receive its benefits, even if the person had not paid into the healthcare system; visitors would also be eligible. (Zaccaro, 2001)

Leadership in NHS presents opportunity for unique challenge and self-fulfillment. It also calls on deep personal strength, values, and vision. In addressing health care leaders, we are reminded of the clear differences among them: Some lead academic medical centers, others are responsible for health systems comprising multiple hospitals, and still others work in long-term care services, rehabilitation and specialty hospitals, hospice care, outpatient and ambulatory care, teaching and research institutions, managed care organizations, and other divergent organizations—all of them participants within a continuum of care. In some cases, hospitals stand alone as the sole provider in their communities, smaller in size, more narrow in scope of services, and limited to the primary and secondary care services that are within their range of technology and practitioner skill. Still others are of moderate size and scope. In each case, leadership is faced with similar challenges related to changing reimbursement systems, clinician workforce shortages, new technologies, and waves of patients unable to pay for their services. (Reilly, 2005)

Hospitals daily face competitive environments in which not only other hospitals but also their own medical staff providers often pursue competitive interests (e.g., inbuilding their own surgery centers and thereby pulling market share from the hospital). As professionals, health care leaders are going to find themselves faced with even more competition in the years ahead. (Van Velsor, 2003)

NHS work in a UK in which the tax exemption that favors them brings with it the cost of providing community benefits to the poor and needy in the community—and increasing pressure from community leaders to do so. They face increasing shortages of key personnel and growing demands among a public that is reaching deeper into its pocket to pay for medical care and correspondingly bringing higher expectations to the care setting.

The NHS is generally viewed as having the best health care in the world—when best is defined as having the most advanced technology and highly skilled specialists. However, when the UK is compared on basic health status factors against other countries in the world, it comes up deficient. Infant mortality status is a measure of how many children die before their first birthday. (Harris, 2006)

This presents a problem for health care leadership—one in which improving the health of the community comes into conflict with the existing structure of the delivery ...