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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 others.

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 influence.

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 Obang)


TOP TIPS

Get to know people's skills and encourage them to play to their strengths.

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 vision.


RUBBISH TIPS

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.