Leading questions

Two managers of mental health teams were talking to each other
as they waited to go into another series of meetings with their
health colleagues, pending the integration of their services. One
was heard to say to the other, “yes, we need leadership, and we
need someone to tell us what to do”.

This comment highlights one of the tensions that key players are
experiencing in the unfolding drama of change in social care –
often no one knows quite what to do and no one really seems to be
in charge. It also illustrates one of the firmly held beliefs about
leaders – that they are people who can tell you what to do. Rather,
leadership often involves encouraging the leadership of

Anyone who has read transcripts from the various recent inquiries
into social and health care tragedies must surely have been struck
by the need to pose one question in particular – who was in charge?
It is not a question about blame. Nor is it a question about who
gives instructions and tells others what to do. It is a question
about clarity of role and function.

A leader is someone who sets a good example by showing that they
have fully understood the agency’s direction of travel and who
takes responsibility to ensure that others follow the same
direction. This will mean that leadership is most frequently
demonstrated by successful outcomes and much more rarely by the
need to stand up and be counted when things have gone wrong.

There are two forms of leadership: changing how we do things, or
changing what we do. In both cases, there is a drive towards a
given or new objective. While management can control the
organisation and deployment of resources towards a given outcome,
in the case of leadership there is a creative or visionary aspect.
Hence, some managers are leaders and some are not.

So how is this leadership role to be exercised? While conventional
wisdom would indicate a blueprint is designed at the “top” of an
organisation and then handed down for implementation, in fact the
true process of leadership is almost the reverse of this.

On becoming manager of a community health mental health team, where
the care co-ordination process and integrated working was being
initiated, Anita said: “My new manager will be expecting from me
this sense of vision, this integrated way of working which is new
to the area I’m going to, and one of the things I sold myself on at
my interview.”

Even before she started Anita could see that people were expecting
her to wave a magic wand. She was determined to stick to modest
aims: her first three months in the job would be spent getting to
know the key players and what made her team tick.

Three months into the job she was pleased that she had managed to
do this, and that she did not underestimate how difficult it was
going to be.

She found that the team was “rigid with fear about changes” and
that achieving integration was difficult. But Anita said: “I do
believe that as a team we will get there. It’s pointless me getting
there on my own. You can’t have a manager just storming ahead.
Somehow either I have to get in front of them and pull or get
behind and push.”

A leader is someone who puts their head and shoulders above the
parapet – not by waving a blueprint, but by acting as the symbolic
focus for the energy and collective direction which can be
generated by the resources and people under their control and

When I was…..

“…recently at King’s Cross station I saw hundreds of cub scouts
and young guides. They had been batched into smaller groups. Some
adults dressed in khaki or royal blue were discernibly in charge.
Others were wearing everyday clothes. Some of the leaders ‘herded’
their young charges with trepidation, yelling repeatedly. Others
communicated very little but walked sometimes ahead, sometimes
behind, desperately counting heads, visibly sweating with anxiety.
One youngster thought that he might have lost his batch. ‘It’s OK,’
said his friend, ‘I can see our leader Jeannie. See, she’s up there
by the stairs. I can see her uniform. She said when she reached the
stairs she would be there to count us all through’. Good leadership
will always mean that the led recognise their need to follow, know
why they are following and where to look for guidance.” (Daphne


Get to know people’s skills and encourage them to play to their

Encourage others to develop leadership.

Recognise when to lead from the front and when to stand back and
let go.

Leadership is an art not a science; don’t let science drive out the


Work it all out in advance and impose your plan on others.

Try to solve all the problems at once.

A leader has all the answers.

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