John Edmonstone

Appraising the state of performance appraisal

Relates performance appraisal in the National Health Service to performance management and emphasizes the need for integration of diverse management initiatives. Identifies the multiple purposes of appraisal and a number of perennial issues. Outlines rules of thumb for enabling appraisal systems and states that these form the basis for specifying success (and failure) criteria for the design of appraisal systems. Stresses the importance of the context within which appraisal exists.

Managing change: an emerging new consensus.

The management of change has been a continuing concern for NHS managers. Suggests that many of the change processes over the last 25 years have been subject to fundamental flaws, preventing the successful management of change. Outlines a new approach for the management of change and examines the implications for management practice, the role of top management, and of external and internal consultancy/advisory resources.

Evaluating clinical leadership: a case study

– The paper aims to describe an evaluation study of advanced leadership programmes run for clinical leaders in the National Health Service (NHS) in England., – This was a limited, post‐hoc study, strongly influenced by a “moving target” problem, which collected and analysed reaction and learning‐level data through e‐mail questionnaires, document analysis and semi‐structured interviews., – Significant underlying unchecked assumptions in relation to the programmes were made and were never realised in practice. There were split funding arrangements and lack of clarity over the purpose of the programmes. While there were organisational and individual benefits achieved the programmes only partly met their original objectives., – The post‐hoc nature of the research study was a major limitation, together with the “bespoke” nature of programme delivery, This meant that the findings of the study were broad and general, rather than specific to each individual programme. Future evaluation studies would need to be planned with the programme design, rather than as an afterthought., – Robust project management arrangements are necessary for steering purposes in such complex leadership development programmes. A continuing diagnostic orientation is needed on the part of the programme provider. Programme titles matter – and create expectations. The contractual model potentially creates tensions between client(s) and provider., – Few evaluation studies of clinical leadership programmes have been conducted and reported. The case study offers a rich source of shared learning with regard to the complexity and challenges in this sphere.

The development of strategic clinical leaders in the National Health Service in Scotland

Purpose – The paper seeks to describe a national strategic and multi‐professional clinical leadership programme designed and developed for the National Health Service in Scotland. It addresses the policy imperatives behind the programme, the local and national processes for identifying future clinical leaders and their preparation through the programme.Design/methodology/approach – The background context and case for the programme are considered against international and local contexts. The programmes roots are explored, drawing upon the extensive consultation process used. The programme design is explained and the evaluation methodology and results are described.Findings – Key learning related to programme design and delivery issues is highlighted, as is that relating to leadership itself.Research limitations/implications – This is a one‐country case study but draws upon recent international good practice.Originality/value – The case study identifies how a small (five million population) country can dev...

Whither the elephant?: the continuing development of clinical leadership in the UK National Health Services

The paper revisits the theme of clinical leadership in UK countries, following an earlier (2009) review. It examines the competency-based approach; considers the emerging voices of clinical leaders; explores the results of evaluation research studies; identifies learning from intra-UK and international comparisons and considers the issue of leader development versus leadership development. It concludes that there is little conceptual clarity; that there continues to be a major disconnect between clinicians and managers; that different approaches to developing clinical leaders are emerging in different parts of the UK and that the major challenge remains to develop leadership, rather than leaders.

When action learning doesn't ‘take’: reflections on the DALEK programme

This article describes the use of ‘business-driven’ action learning in a healthcare setting. It reviews and reflects on an example where action learning does not ‘take’, identifying the likely causes of this. It also poses four questions – whether action learning is counter-cultural in some organisations; whether the Organisation Development function is really developmental; whether the nature of the contracting process for external help adversely influences action learning; and whether the external consultant should challenge the brief.

Action learning and organisation development: overlapping fields of practice

This paper explores the relationship between action learning and Organisation Development (OD). It proposes that they are overlapping fields of practice, with interesting similarities and differences. Both fields of practice are experienced as challenging to conventional ways of viewing organisations and people but are also subject to increasing challenge themselves and both aspects are examined. Two accounts of practice are included, which cast light on action learning and OD and some preconditions for a more fruitful future relationship between the two fields are proposed.

The Challenge of Evaluating Action Learning

The paper examines the benefits claimed for action learning at individual, organisational and inter-organisational levels. It goes on to identify both generic difficulties in evaluating development programmes and action learning specifically. The distinction between formative and summative evaluation is considered and a summative evaluation framework is outlined, based on recent reviews of evaluations of development programmes, while recognising that establishing clear causal links remains problematic.

A step into the unknown? The new education and training contracting arrangements.

The next few years are likely to see the introduction of an educational contracting regime for professional education in the UK between the NHS and the higher and further education sectors. It will involve all employers of health care staff-the NHS, private and voluntary sectors, GP fundholders and local authorities. Outlines these changes and identifies some of the likely problem areas with the new arrangements. Seven key areas are explored--workforce planning, membership of the new consortia, the NHS Executive/regional office role, timescales, finance, the scope for innovation and the operation of the new system.

Healthcare leadership: learning from evaluation

Purpose – The purpose of this paper is to review eight major evaluations of leadership and management development programmes in parts of the UK National Health Service and also to identify learning from these as a basis for an evaluation framework which focuses on impact within healthcare organisations.Design/methodology/approach – Eight evaluations conducted over a 13‐year period are reviewed in terms of the staff groups covered, numbers involved, duration, programme elements, evaluation approach adopted and key learning points. General conclusions are derived from this review.Findings – Although each evaluation relates to a unique context or setting, there are clear common messages running across all those studied which are of wider interest and concern.Practical implications – The framework developed from the review may be useful to those commissioning, designing, delivering and evaluating leadership programmes.Originality/value – The paper seeks to identify common learning across programmes involving ...