DEFINING POLICY AND STRATEGY IN THE CONTEXT OF CCGS: A THEORY OF TRANSFORMATIONAL LEADERSHIP, STRATEGIC LEADERSHIP, AND TOP MANAGEMENT TEAMS

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1 DEFINING POLICY AND STRATEGY IN THE CONTEXT OF CCGS: A THEORY OF TRANSFORMATIONAL LEADERSHIP, STRATEGIC LEADERSHIP, AND TOP MANAGEMENT TEAMS Thomas West

2 Overview Context and Policy NHS Reforms Project Description Objectives Contributions Project Methodology Framework Mixed methods

3 Context & Policy NHS reforms New structures: PCT/SHA abolitions, forming of CCGs CCGs will be given 65bn to use for commissioning Equity and excellence: NHS White Paper Leadership essential to success Clinical Leadership New work domains with little to no knowledge of how leadership will affect functionality

4 Project Description Why look at strategy? Task of CCGs is essentially a strategic one Decisions on where to spend the 60bn How to make savings while providing effective healthcare How to do this? Challenging, achievable goals reflecting local and national priorities Long term view of 3 5 years with regular revisits Effective translation into front line activity Maintenance and development of interactions between member organisations

5 Project Description CCG composition overview: 211 in total by 1 st April 2013 Clinical leadership central either as Chief Clinical Officer (Accountable Officer) or as Chair Plus other GP practice members as clinical leads Consider other clinical professionals Minimum of 4 independent members: 2 lay one of whom to be either chair or deputy chair One with lead role in governance One with lead role in championing patient and public empowerment One secondary care doctor One registered nurse Chief officer (AO) - if not clinician Chief financial officer Source: Foresight Partnership 2012

6 Project Description Objectives To establish a useful description of strategy and leadership amongst CCGs To add to the academic literature by incorporating existing models of Transformational Leadership, and Strategic Leadership

7 Project Description Transformational Leadership and Strategy It may be a complex relationship with certain aspects of strategic leadership relating to certain aspects of transformational leadership Unlikely to be one style suits all The way the leader (AO) is may affect the TMT(CCG)

8 Proposed Hypotheses Ireland & Hitt model (1999) Determining firm s vision or purpose What the organisation exists to achieve How to direct learning efforts Transformational leaders should encourage openness in feedback and discussion H1a The more transformational the AO, the greater the climate for openness within the TMT H1b TMT openness climate will have a positive relationship with organisational climate

9 Proposed Hypotheses Ireland & Hitt model (1999) Exploiting and maintaining core competencies Understanding resources and capabilities Knowledge sharing Draw from wider knowledge base to benefit from wider objectivity Encouraging openness should facilitate knowledge sharing and subsequent decision making H2a: The greater the level of openness within the TMT, the greater the climate for innovative strategic decision making

10 Proposed Hypotheses Ireland & Hitt model (1999) Establishing balanced organisational controls Process controls (action focus) vs financial controls (outcome focused) Transactional leaders vs transformational Short term financial controls lead to risk averse decisions H3a: Transactional leaders are more likely to lead a TMT that generates risk averse strategic decisions

11 Proposed Hypotheses TMT processes The influence the leader has on TMT processes is likely to affect TMT outcomes Innovative strategy generation By encouraging openness in discussion and subsequent decision making: H4a: TMT climate will mediate the relationship CEO aspects and Organisational Climate H5a: Organisational Climate will have a positive relationship with Organisational outcomes

12 Project Methodology Framework Input Process Output Pilot study To identify the mechanisms members see as relevant for performance, which will influence main study variables To identify how CCGs will operationalise performance outcomes To identify any control variables relevant

13 Project Methodology Main study Quantitative questionnaires measuring variables highlighted as important in pilot study Transformational leadership MLQ Leader openness adaptation from the NEO personality inventory Innovative strategic decision making adapted from Jansen et al. (2009) Strategic decision making risk propensity adapted from Ling et al. (2008) Organisational performance Quality outcomes framework & commissioning outcomes framework Multiple regression analysis likely

14 Conclusion Access through PWC contacts who have direct links to CCGs and bodies responsible for CCG implementation

15 Questions and Discussion