title: Leadership and transformational change in healthcare organisations: a qualitative analysis of the North East Transformation System.
abstract: The research project 'An Evaluation of Transformational Change in NHS North East' examines the progress and success of National Health Service (NHS) organisations in north east England in implementing and embedding the North East Transformation System (NETS), a region-wide programme to improve healthcare quality and safety, and to reduce waste, using a combination of Vision, Compact, and Lean-based Method. This paper concentrates on findings concerning the role of leadership in enabling tranformational change, based on semi-structured interviews with a mix of senior NHS managers and quality improvement staff in 14 study sites. Most interviewees felt that implementing the NETS requires committed, stable leadership, attention to team-building across disciplines and leadership development at many levels. We conclude that without senior leader commitment to continuous improvement over a long time scale and serious efforts to distribute leadership tasks to all levels, healthcare organisations are less likely to achieve positive changes in managerial-clinical relations, sustainable improvements to organisational culture and, ultimately, the region-wide step change in quality, safety and efficiency that the NETS was designed to deliver.
authors.affiliation: Centre for Public Policy and Health, Wolfson Research Institute, Durham University, Stockton-on-Tees, UK jonathan.erskine@durham.ac.uk.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Erskine
authors.affiliation: Centre for Public Policy and Health, Wolfson Research Institute, Durham University, Stockton-on-Tees, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hunter
authors.affiliation: Newcastle University Business School, Newcastle upon Tyne, UK.
authors.forename: Adrian
authors.initials: A
authors.lastname: Small
authors.affiliation: Newcastle University Business School, Newcastle upon Tyne, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Hicks
authors.affiliation: Newcastle University Business School, Newcastle upon Tyne, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: McGovern
authors.affiliation: Newcastle University Business School, Newcastle upon Tyne, UK.
authors.forename: Ed
authors.initials: E
authors.lastname: Lugsden
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Paula
authors.initials: P
authors.lastname: Whitty
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Steen
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Martin Paul
authors.initials: MP
authors.lastname: Eccles
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D005069:Evaluation Studies as Topic; D006801:Humans; D007407:Interviews as Topic; D007857:Leadership; D009936:Organizational Innovation; D061214:Patient Safety; D058996:Quality Improvement / Q000458:organization & administration; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom
keywords: NHS reorganisation; leadership; lean thinking; quality improvement; transformational change