Leadership within the ambulance service: rhetoric or reality?

BackgroundEffective leadership is central to the success of providing a modern and responsive NHS (Institute for Innovation and Improvement, 2006) but one of the difficulties of looking at leadership for healthcare professionals is that most leadership theories have not been developed within a healthcare context. Typically, leadership theory has been developed within a business arena and then applied to healthcare (Vance and Larson, 2002). For a paramedic profession which is in the process of forming a new identity (Woollard, 2006) and continues to define its unique body of knowledge and practice (Gregory, 2011), this represents a significant challenge.Leadership within the health professions has been borne out of the ‘professionalisation’ process, with the emergence of regulatory bodies such as the Health Professions Council (HPC) (Saks, 2009), yet the role of leaders within the health professions is just as crucial as the various regulatory bodies. Initial research into leadership, however, pre-dates the HPC by several decades. As early as the 1920s, trait theory emerged in an attempt to identify common characteristics of an effective leader and early theorists could be categorised as either descriptive theorists (Wald and Doty, 1954; Ghiselli, 1963) or prescriptive theorists (Barnard, 1938). Into the 1940s, and style theory emerged (McGregor, 1960; Likert, 1961; Blake and Mouton, 1964) as an alternative to the management principles espoused by Frederick Winslow Taylor (Taylor, 1911). Although a greater emphasis was placed on ‘human’ factors, it was not a theory which effectively evaluated leadership in itself.‘Although a greater emphasis was placed on ‘human’ factors, it was not a theory which effectively evaluated leadership in itself?’

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