title: Leadership development in the English National Health Service: A counter narrative to inform policy.
abstract: OBJECTIVE
  To examine the current approach to leadership development in the English National Health Service (NHS) and consider its implications for nursing. To stimulate debate about the nature of leadership development in a range of health care settings.
  
  
  BACKGROUND
  Good leadership is central to the provision of high quality nursing care. This has focussed attention on the leadership development of nurses and other health care staff. It has been a key policy concern in the English NHS of late and fostered the growth of leadership development programmes founded on competency based approaches.
  
  
  METHODS
  This is a policy review informed by the concept of episteme.
  
  
  METHODS
  Relevant policy documents and related literature.
  
  
  METHODS
  Using Foucault's concept of episteme, leadership development policy is examined in context and a 'counter narrative' developed to demonstrate that current approaches are rooted in competency based accounts which constitute a limited, yet dominant narrative.
  
  
  CONCLUSIONS
  Leadership takes many forms and varies hugely according to task and context. Acknowledging this in the form of a counter narrative offers a contribution to more constructive policy development in the English NHS and more widely. A more nuanced debate about leadership development and greater diversity in the provision of development programmes and activities is required. Leadership development has been advocated as being crucial to the advancement of nursing. Detailed analysis of its nature and function is essential if it is to meet the needs of nurse leaders.
authors.affiliation: School of Health & Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom. Electronic address: a.hewison@bham.ac.uk.
authors.forename: Alistair
authors.initials: A
authors.lastname: Hewison
authors.affiliation: Warwick Business School, University of Warwick, Coventry CV4 7AL, United Kingdom. Electronic address: Kevin.Morrell@wbs.ac.uk.
authors.forename: Kevin
authors.initials: K
authors.lastname: Morrell
mesh_terms: D004739:England; D006291:Health Policy; D007857:Leadership; D013222:State Medicine / Q000458:organization & administration*
keywords: Episteme; Leadership development; Nursing leadership; Policy