Reflections from a healthcare scientist in microbiology

Part of being an NHS Healthcare Scientist on the Higher Specialist Scientist Training (HSST) programme means exploring the vast world of social science and leadership models.

The NHS faces small, day to day challenges nestled amongst national crises. Upon reflection I have noted that different leadership models have a place in the NHS to help navigate and harness these waves.

Some musings from a healthcare scientist in microbiology on 2 leadership models in action.

Situational Leadership is a highly structured model nicknamed the ‘life cycle theory of leadership’ because the ‘follower’ moves through 4 stages as they gain knowledge and confidence, with mixed levels of motivation. The leader is guided by these stages, moving from a more directive and coaching leadership style to a supportive and delegating style.

NHS laboratories consist of large teams of scientists with a range of experience and confidence. There are many tests, which demand different scientific techniques, and a constant stream of innovative projects to modernise and stream line testing. While providing a stimulating and challenging place to work, it can be difficult to maintain a highly-trained, flexible team under the heavy workload. Therefore, staff need to be trained efficiently and innovative projects led effectively.

Projects that I have personally led in the lab that I found to be the least stressful, or those that I received positive feedback about, have been projects where I have altered my behaviour to better meet the individual team members’ needs. For instance, new staff members to the lab, eager but possibly lacking experience in bringing in new tests, often need a lot of hands-on help and direction. More experienced staff may be more self-directed and only need gentle pointers or motivation for the more technically difficult areas. This fits the Situational Leadership model and likely resonates with different workplaces.

Situational Leadership is highly structured compared to other models and can be taught and followed in a tangible way. Therefore, lab staff can get the same level of teaching and shouldn’t clash with the particular leadership style. This model may therefore have a place within the NHS, used at the local level by healthcare scientists and others.

However. There is always a however.

Situational Leadership is very reactive, can come across more like a management model and is individual-orientated: the follower is the one that dictates the leadership style. It is hard to see this model working on a large scale, across an organisation or further.

There are huge challenges facing the NHS: antimicrobial resistance leading to untreatable infections; constant threats to funding; improving equality; staying at the forefront of innovation to provide care that is up-to-date and fit for purpose; and global pandemics. COVID-19 demonstrated the need for collaboration between NHS trusts and organisations for fast and scaled mobilisation of resources, information and testing.

Public participation, led by and in collaboration with healthcare scientists, is also crucial: During the COVID-19 pandemic peak, the public needed to stay at home to prevent virus transmission. To prevent the spread of antibiotic-resistant super-bugs, the public are asked to not overuse antibiotics. To further our scientific knowledge the public are invited to participate in clinical trials and advocate innovation. These important movements need collaboration and co-operation. It is difficult to fit Situational Leadership into this construct: Shared or Collective Leadership may be required.

Collective Leadership is more about the shared visions and values of multiple leaders to shape a culture, collaboratively. It features flexibility and task-orientated leadership styles, similar to Situational Leadership. However, the leaders are assumed based on the required expertise for the task: a follower in one scenario could be a leader in another. For example, the knowledge base, established relationships and movement of resources needed to combat COVID-19 is very different to that needed for maintaining a long-term antimicrobial stewardship initiative.

This allows for a dynamic, resilient leadership model that can work on a large scale. As demands change, so can the leadership.

However, successful Collective Leadership assumes good communication and charismatic leaders. If a level of hierarchical responsibility is not maintained then the collective model can appear indecisive. Unlike Situational Leadership, if the wrong people assume the leader roles, not playing to peoples’ strengths, or if there are too many competing goals, then Collective Leadership can break down and become obstructive rather than collaborative.

Knowledge and reflection of leadership models can help us make sense of successes and failures.

Will preparing future generations to be more flexible and open-minded in their approach to leadership make them more likely to succeed?