NHS Senior Leadership Onboarding and Support

Making an impact

Whether it’s your first board level role, you’re working with new board colleagues or leading for the first time across a system to make an impact on population health – you’ll want to feel that your input and expertise land well and drive the organisation and system forward to delivering goals and commitments.

These resources are aimed at supporting you in thinking about how you can work most effectively with colleagues at board, governing body and across systems, signposting you to resources and networks which will help you think through how you maximise your impact and input in your role.

These maybe a refresher for you or some interesting new angles. As systems develop around us the ways we make an impact will develop too. You may wish to also take a look at the Collaborating and Systems Leadership theme.

This theme supports development in the Strategy and Transformation domain of the leadership framework.

These resources are designed to support the individual. There is a much wider set of resources and support for board development.

Article: Successfully transitioning to new leadership roles – Forbes, May 2018. This article suggests how leaders can focus on five key areas to set a firm foundation for success in a new leadership role.

Video: NHS NWLA Masterclass with Matthew Syed (masterclass recording) how to develop a ‘system mind-set’ to enable a culture of innovation and continuous improvement, within the context of flow across systems.

Tool: Maximising Potential Conversation Tool: NHS Leadership Academy. This resource is a visual way of helping you with exploring the journey in your current role and maximising your potential within it, and your potential beyond your current role.

Model: API (Authority, Presence, Impact) Model by Peter Hawkins: Improving your chances of bringing people with you in your thinking and decision making.

Working with senior colleagues and board dynamics

Article: Health Services Management Research – Roles and behaviours of diligent and dynamic healthcare boards – Naomi Chambers & Judith Smith. This article gives insights into how boards behave and interact as individuals and so may be useful in thinking about one’s own approach.

Framework and Tool: NHS NWLA Systems Leadership Behaviour Framework (website page) and Conversation Cards (video) A significant system-wide piece of research was undertaken in the North West to understand the kinds of behaviours needed to enable effective system leadership across the public sector. The results were tested and developed into a practical development tool, with a pack of 13 cards available to request online. The cards can be used in a variety of way including board and governing body development.

Best Practice Guide: NHS Leadership Academy NHS Healthy Board Principles for Good Governance. The strong relationship between leadership capability and performance is well demonstrated in the evidence. Good leadership leads to a good organisational climate. Good organisational climates leads, via improved staff satisfaction and loyalty, to sustainable, high performing organisations.

Article: The Five Ss in Governance Julia Unwin – What sort of board are we? What mode are we operating in? Are we behaving in the right way at the right time?

Report: The Board Perspective: A collection of McKinsey insights focusing on boards of directors

  • The role of the board – which activities should the board engage in, and how?
  • Board structure and foundations – what foundation do you need to deliver on increasing expectations?
  • Board effectiveness – how can you increase the overall effectiveness and impact of your board?

Article: A More Effective Board of Directors – Forbes

Article: Understanding “New Power” – Harvard Business Review

Building Networks

You may also want to have a look at the digital and social media pages of this site

Article: How Leaders Create and Use Networks – Harvard Business Review. Two year follow-up on a cohort of 30 managers making their way through a leadership transition, an inflection point in their careers that challenges them to rethink both themselves and their roles. 

Article: How To Network The Right Way: Eight Tips Forbes

Article: An introvert’s advice for networking

Report: Ashridge Executive Education – The Changing Nature of Leadership: An exploratory investigation into how the evolution of social media is changing what it means to be an effective leader.  The challenge for leadership is not simply a practical one of using social media but one of adapting to changing leader/follower relationships. This research, in partnership with UNICON, questioned whether the use of social media is changing our concept of leadership, how those relationships are managed and what may be the implications for leadership development.

Article:  Three Ways Social Media Make You A Better Leader – Forbes Jan 2019

Suggested subscriptions and briefings

The suggested resources below are to support your ability to work with diverse thinking and frame things in a way which will maximise the chances of bringing people with you. You are probably already using some of the suggestions below. Think about changing some of them… follow someone from outside your own sector or profession; if you’re a commissioner read the NHS Provider brief and vice versa. Those insights may help your understanding of why people have the perspectives they do.

Health Service Journal subscription – for Healthcare Leaders, an HSJ subscription provides you with a clear and unbiased view of what’s happening now and what’s coming up, locally and nationally.

NHS Providers Briefings – as part of their offer for members, NHS Providers produce a number of briefings to help boards understand policy developments and provide an effective commentary.

Podcasts and social media – Links to a variety of health and social care podcasts and tips on social media reach.

Suggested books

Book: ‘Quiet’ by Susan Cain

Book:  Serve to Lead by Winston Churchill

Book: ‘Alive at Work’ by Dan Cable

Book: Feet in the Clouds by Richard Askwith (helps manage the balance of work vs life and bringing a passion and purpose to the latter that could enable you to be more effective in the former)

Book: Your First 100 Days: How to make maximum impact in your new leadership role (Financial Times Series) Paperback – 11 Oct 2011 – concise and easy to read, with helpful examples and an ongoing case study

Book: ‘New Power – How it’s changing the 21st century and why you need to know’ by Henry Timms and Jeremy Helmans


  • Be personally visible – work shifts, share lunch and breaks in the same place as everyone else does, even with a busy schedule, use these insights to inform and triangulate the views you are receiving in data and board papers.

  • Create Joy in Work – encourage fun, laughter and innovation. Encourage ‘radiators’ (people who radiate positivity, enthusiasm, good stories and laugher)

  • Listen carefully to negative views – work to understand the perspectives of those people who aren’t feeling positive about their roles. What part can the organisation play in improving that? These diverse views are important – ignoring them makes change and your leadership feel less credible to those people.

  • Don’t compromise on hiring great people – with the right values.

  • Ask yourself and others consistently – what is it like to be on the receiving end of me? Particularly if things are not going as well as you would wish. Use a 360 tool after six to nine months in role (see homepage link).

  • Get onto social media – it might not be your natural setting but just watch and listen to start with until you are ready start to contribute. It can be an extension of your leadership presence. Of course, as it is an immediate interface with the public, people will comment for good or ill, but it is a way to share what you are passionate about and your organisation’s profile.

  • Two-way communication – communicate extensively to your teams, remembering that communication must be a two-way process. Tell stories and try everything – newsletters, podcasts, social media, large and small meetings. Always ask staff what they think should be done. “You said, we did” is as powerful for staff as it is for patients.

  • Practice self-compassion – prioritise your wellbeing, personal development, ensure you have a coach and a mentor; two very different things and both essential support when transitioning into an executive role.

  • Foster the learning opportunity when things go wrong – the key is to learn, respond and adapt. Calmness is hugely underrated but it’s a key quality in leadership.

  • Network and be curious – learn from others, find /give support, build relationships, inside and outside your own organisation.

  • Remember what your role is here to do – a non-executive holds the executives to account but is also a member of the unitary board. An executive leads their function but is also a member of the unitary board.

  • Don’t ever be afraid to ask the obvious questions. They may seem obvious, but they can be the most revealing.

  • NHS Constitution, Trust Strategic Objectives and Values – anchoring decisions and discussions with these foundations can cut through some of the turbulence of operational challenges.