For many years the literature has predicted a shift from line managerial role power and a bureaucratic style of management to a broader emphasis on leadership and flexible cross boundary working as a correlate of the move to network forms (Ferlie 2010). Many commentators have argued that this shift probably lies at the heart of successful organising practice in the globalised era (Pettigrew and Fenton 2000, Hosking 2002, Giddens 2010, Anderson-Wallace, Blantern and Lejk 2000).
Many argue that heroic and hierarchical forms of leadership that focus on a leader’s individual and personal competencies and behaviours are increasingly unsuitable in the current networked environment (Blantern 2010, Steyaert & Van Looy 2010). Where leadership is largely context dependent and a situated set of skills, it simply cannot be condensed or defined into various constituent elements (Bolden & Gosling 2006). And so, if we make sense of leadership by seeing it as both an individual and a collective activity, it can never be adequately expressed if viewed simply as the sum total of the personal attributes or characteristics of an individual or group of individuals. This tends to obscures the tacit knowledge, know how and relationships which are embedded in the way the organisation does things and the way that meaning is made.
As healthcare continues to struggle with rising demand, increased complexity and fragmentation, effective collaboration across the boundaries of hitherto deliberately separated functions, professions and traditions have never been more necessary. But at the same time the policy and regulatory demands can often feel – at least to clinicians and managers closest to the delivery of care - evermore centralised and prescribed.
For me, the leadership style required to tackle these apparent tension is intensely relational and demands an associated set of leadership practices - also referred to as relational sensibilities (Oliver 2005) - to help guide and facilitate effective collective action. But these are not competencies or skills that can be easily defined or measured. They are the human qualities that enable leaders to appreciate, analyse and respond in humane, ethical and pragmatic ways in highly complex, uncertain and emergent conditions.
In my mind, it is possible to loosely categorise these qualities into five key areas of practice.
- Systemic - Here we emphasise the importance of recognising patterns of interaction. This includes the ability to name, map and explore repeating patterns and to understand the contexts, stories and behaviours between people that hold them in place, and the effects. This includes a deep understanding complex systems, how different sized work groups behave and the ability to take a meta-position to see one’s own contribution to the patterns of a system.
- Constructionist - Here we are most interested in formative or constitutive quality of communication processes. This involves recognising the power and importance of language as more than simply representational of the world. In this view, semantics matter and words get their meaning from the way that they are used.
- Critical - This involves acknowledging the political nature of communication and the need to develop authentic and humane approaches to feedback, evaluation and measurement. Here we recognise how power relations are co-constructed, how voice is used and the effects of power in mediating relationships.
- Appreciative - Here we encourage a real openness to realities beyond our own egocentricity. This includes a genuine willingness to be influenced by others in dialogue, and to trade personal territory – intellectually and practically - for the wider benefit.
- Complexity - Recognising the complex nature of organisational life and inviting consideration of strategies other than polarisation, fragmentation or reductionism to manage complexity. This means becoming comfortable with “mess” and learning to support others to feel less fearful of ambiguity and contradiction.
As the limited utility and impact of the “command and control” approaches of the 19th and 20th century become more apparent, and the emerging conditions of the 21st Century become increasingly challenging, there is little doubt in my mind that the time for more relational approach has come. The big question is whether we have the collective courage to embrace them.
Much of this text is drawn from Chapter 7 in Malby B, & Anderson Wallace M. (2016) Networks in Healthcare. Managing complex relationships. Emerald.
Anderson-Wallace, M., Blantern, C. and Lejk, A., 2000. Advances in cross-boundary practice. Collaborative Strategies and Multiorganizational Partnership. Leuven-Apeldoorn: Garant.
Bolden, R. and Gosling, J., 2006. Leadership competencies: time to change the tune?. Leadership, 2(2), pp.147-163.
Ferlie, E., 2010. Networks in health care: a comparative study of their management, impact and performance (Doctoral dissertation, School of Management, Royal Holloway University of London).
Giddens, A., 2011. Runaway world. Profile books.
Hosking, D.M., 2002. Constructing changes: A social constructionist approach to change work (and beetles and witches). Katholieke Universiteit Brabant, Faculteit Sociale Wetenschappen.
Oliver, C., 2005. Reflexive inquiry: A framework for consultancy practice. Karnac Books.
Steyaert, C. and Van Looy, B., 2010. Participative organizing as relational practice. Relational practices, participative organizing, pp.1-17.