There are a number of free tools, which are designed to support your own self-understanding. Click on the title to access the test or use the menu bar above.

We have been working on free online leadership tools for the last year and we believe that these are among the best online tools anywhere. They have been designed to support your personal and leadership development and some of them can be incorporated into personal and team development programmes. They all take between 10 and 15 minutes to complete.

Test 1 - What is your leadership style?

This test is designed to help you identify your preferred leadership style.

Test 2 - What is your team role?

This test is designed to help you understand your team role and can form the basis of personal development as well as tea development roles.

Test 3 - What is your next career move?

This test is designed to help you identify the stage you are at in your career and provide some guidance as to your next steps

Test 4 - What are your career strengths?

This test is designed to help you identify your key career strengths.

Test 5 - Are you suffering from burnout

This test is designed to help you assess whether you may be suffering from burnout

Who Cares Wins - the business aspects of patients care

Who Cares, Wins is a study commissioned by The Burdett Trust for Nursing about the business aspects of patient care and the implications for nurse leaders and their boards. Designed to trigger the actions that will take patient care ‘from bedside to the boardroom’, the report argues that if a more market driven health system is going to deliver ‘a new NHS’, then patient satisfaction and customer care need equal ranking with finance, targets and outputs on board agendas.

The business of caring is a whole board issue. Nurse leaders, because they have or can develop many of the qualities that will be required to deliver on this agenda, and as a result of the increasing breadth of their responsibilities, are well placed to lead the business of caring on their board’s behalf. There are examples of exceptional clinical leaders who have succeeded in making patient care a driving force in their organisation’s strategy and operational processes, but they are in short supply. Two characteristics of these individuals stand out. The first is their skills, confidence and tenacity to ‘bring the bedside to the boardroom’ and keep this on the agenda against other competing interests. The second characteristic is a sophisticated grasp of their organisational and political context and ability to tailor their leadership style to it. Exceptional clinical leaders are important in delivering improved patient care. But Who Cares, Wins makes it clear that there are also critical organisational factors that need to be in place: clear structures and accountability; valuing, seeking and acting on patient opinion and measuring its impact; and influential champions for patients at board level1. Who Cares, Wins makes recommendations on what clinical leaders, their organisations and those in the business of leadership development can do to create the exceptional leaders and boards that will place patient experience at the heart of health care commissioning and provision.

The study can be downloaded here (pdf format - 136Kb)

An exploratory study of the clinical content of NHS trust board meeting in an attempt to identify good practice

This exploratory study, commissioned by The Burdett Trust for Nursing and conducted by the University of Plymouth, studied the clinical content of NHS Trust meetings in an attempt to identify good practice. We examined publicly available board meeting minutes for a random sample of 60 Trusts. We identifi ed trusts with higher and lower levels of clinical content and examined the minutes of a sub-sample over one year to check consistency. Minutes for two trusts with high clinical content were reviewed in more detail to identify possible factors leading to greater focus on clinical matters. Based on these reviews a checklist approach was used to review factors in low scoring trusts.

The study looked at practice in a random sample of 60 trusts and found that:

• Overall just 14% of items in trust board meetings were rated as clinical but varied between 7% and 22% over the year for different Trusts.
• Trusts with higher levels of reporting of clinical issues seemed to have a chief executive who ensured that clinical issues were closely linked to all Trust developments including finance and information technology.
• In trusts with higher levels of clinical content, non-executive directors seemed to question and interrogate trust board executives in an open and transparent manner.

The study can be downloaded here (pdf format - 136Kb)

Review of the literature on team leadership published

We have published our Review of the Literature on Team Leadership which was commissioned by the Health Foundation. The review can be downloaded here (pdf format 632Kb) and contains an analysis of the key literature on teams, team development and team leadership. It also provides an evidence base to a variety of team interventions and should be of particular use to those who are trying to develop team leadership prorgammes.

The Performance and Innovation Unit Review on Leadership Literature

The Performance and Innovation Unit (part of the Cabinet Office) produced this literature review which is an excellent analysis of changes and trends in leadership thinking and the implications for public sector leadership. The review is Annex D of "Strengthening Leadership in the Public Sector" by the PIU (March 2001) - Performance and Innovation Unit. To read this review, click here (pdf format - 582 Kb).

Warwick University's Systematic Review of the Leadership Development literature

The field of leadership development has generated a growing body of literature. This study, which looked at about 3,500 items, mainly from the USA, Canada, Australasia and the UK, aimed to find and assess the most valuable contributions. Most of them date from the past eight to ten years, though the focus of the study was on 1997-2003. The research, commissioned from Warwick Institute of Governance and Public Management at Warwick Business School, University of Warwick, was conducted by Jean Hartley and Barrie Hinksman.

The main purpose was to produce a summary of the research on leadership development from across the NHS and public and private sector organisations, identifying key themes, findings and areas of debate.

The research includes:

• A summary of the research produced from across the NHS, public and private sectors identifying key themes, findings and areas of debate
• A summary of the key learning methodologies associated with leadership development and the research to support their use
• A summary of the key leadership models underpinning leadership development activities and the research to support their use
• An outline of different approaches to leadership development across public and private sectors
• A summary of different methodologies and models
• Outlines of the key literature associated with each topic area

To read this review, click here (pdf format - 1.01 Mb)

Henley Management College's literature review

"A Literature Review: Evidence of the contribution leadership development for professional groups makes in driving their organisations forward" by Sadie Williams of Henley Management College, Greenlands, Henley-on-Thames.
The aim of the review was to answer the question, what evidence is there of the contribution leadership development of professional groups makes in driving their organisations forward? Key issues addressed by the review include:

• What is known about the ways in which leadership development for professional groups has an effect on change in organisations?
• Are there ways in which such development can move organisations forward?

To read this review, click here (pdf format - 497 Kb)

Sir William Wells' Review of the NHSU

This report was commissioned in 2004 into the NHSU and has never been released to the public. Following a landmark victory with the Information Tribunal by Rod Ward, this report has now been made available. We are indebted to Rod Ward for making this report available and his summary of the report is as follows:

"The NHS university was proposed in the labour manifesto of 2001 and established as a special health authority in 2003. It's demise was announced on November 30th 2004 by the then Health Secretary John Reid, following a report into it's progress and performance by Sir William Wells. The report itself is in two parts, the first detailing progress and performance and the second forward to the creation of the "NHS Institute of Healthcae Innovation and Education". It starts by setting out the original concept behind the NHSu, but even on page one criticises the lack of clarity about where the NHSu fitted into the "already crowded healthcare education and training sector" and what its role should be. It goes on to describe tensions between strategic objectives and potential roles as a provider or broker of training. The lack of understanding of the wishes of customers (eg Strategic health Authorities) , is highlighted as a reason for the lack of support and integration with the wider NHS. The quest for University title is highlighted as a major problem which was not understood by senior staff in the NHSu or ministers and added to confusion over the NHSu's role.

A major part of the report is devoted to delivery and value for money, which deals with a range of issues including; the staff complement of 412, learning services, and academic partners. It gives some numbers of the limited take up of NHSu courses ad predicts that these would not meet the projections, particularly once the courses had to be paid for. Comments from a variety of stakeholders about the lack of a clear business plan caused Sir William concern as did the processes for governance. The 30% of staff involved in corporate services "seems disproportionately large" especially when viewed in the light of comments about the "culture and style of a start-up enterprise" and the lack of focus on structure and systems. Frequent changes of structure and individual roles were seen as another barrier to the establishment of effective working.

The report concludes with some answers to crucial questions about whether the investment was appropriate and over what timescale it is likely to bear fruit. The answers are damming and relate to lack of clarity of purpose, the absence of market surveys or prices, governance, pursuit of the University title, and engagement with stakeholders. It suggests that in the light of the £72 million investment up to March 2005 "the Department of Health is exposed to significant embarrassment if the value for money delivered by the NHSU were to be probed"."

The report can be downloaded here in pdf format (3.6 Mb)

Improving Leaders Guides published by the NHS Leadership Centre
For everyone involved in improving patient care and experience, these are a summary of current thinking, advice and tips for improvement. These guides provide practical help for anyone involved in a leadership role who is trying to improve service delivery.

Process mapping, analysis and redesign
Process mapping is a simple exercise. It helps a team to know where to start making improvements that will have the biggest impact for patients and staff. The 'Model for Improvement' helps a team to set aims, targets and measures, and introduces a way of testing ideas before implementing them. (download this guide - Adobe pdf format - 233k)

Matching capacity and demand
Improvement of a patient's healthcare journey will not necessarily improve with just more staff, more equipment and more facilities. It has been proved in various projects that our valuable resources are not always best used and if there is a need for investment, the location of that investment should be carefully considered. (download this guide - Adobe pdf format 240k)

Measurement for improvement
"The first step is to measure whatever can be measured easily. This is OK as far as it goes. The second step is to disregard that which can't easily be measured or to give it an arbitrary quantitative value. This is artificial and misleading. The third step is to presume that what can't be measured easily really isn't important. This is blindness. The fourth step is to say that what can't easily be measured really doesn't exist. This is suicide." Charles Handy

You are about to set off on your journey of improvement. You have agreed your overall aims and objectives and an outline project plan. You have contacted key stakeholders and got their support. You may have produced your first process map and are beginning to really understand the whole patient's journey. If you did not collect the right information to measure progress, you will not have the evidence to back up your gut feeling that things have got better. So how do you go about collecting the evidence to demonstrate the impact you've had? How can you impress colleagues with graphical representations of improvement? (download this guide - Adobe pdf 203k)

Sustainability and spread
Recent years have seen tremendous growth and change within healthcare, supported by the use of improvement methods such as those described in this series of guides. Staff in health and social service organisations have demonstrated better ways to provide clinical care, manage patient flow, reduce waste and so on. Whilst most organisations can list many change efforts that have led to successful improvement, health and social care staff are increasingly experiencing two major frustrations:

• The "improvement evaporation effect" (lack of sustainability). Staff have made major efforts to achieve improvement - only to discover later perhaps for a variety of reasons, that there has been slippage or decay in maintaining the approved process or the outcomes achieved. For example, we work to improve flow and patient experience in A&E, only to find that a year later the improvements have not been maintained and that improvements in flow and patient experience have slipped back.
• The "islands of improvement" effect (lack of spread). Great improvements occur in parts of the organisation, but the learning does not spread naturally. For example, nurses on one ward develop a better way to monitor pain, but that better way does not become the hospital's standard. Or, networks for better care of the elderly emerge from great work in one part of the country across primary care, acute care and social services, but the new knowledge about these better ways of doing things does not naturally spread to others.

In this guide, we will describe actions, that you as an Improvement Leader can take to sustain the gains from past improvement efforts and improve the way ideas for better practice can be spread across the NHS. (download this guide - Adobe pdf format 217k)

Involving patients and carers
Patient and public involvement is a large and complex subject. Before breaking it down into more manageable chunks, a look at the big picture can help us to understand where we are focusing our improvement and who we should be involving. Broadly speaking, the guide suggests that involvement may occur at a number of different levels of contact, ranging from patients' treatment to strategic policy making, with essentially three broad modes of participation: informing, consulting and partnership.

An increasing number of initiatives in health and social care explore how to actively engage members of the public in determining local priorities. Such approaches demand active involvement of local community members in dialogue about local provision. Guidelines for undertaking activity at these levels are being developed collaboratively by the Department of Health, the Modernisation Agency and other organisations such as the Commission for Health Improvement. They are not included in this guide. Our focus is more around the shaded elements in the table below: on service delivery and treatment, with the emphasis on active partnership leading to jointly designed and implemented improvements in these two areas. (download this guide - Adobe pdf 220k)

Managing the human dimensions of change
Many change projects fail, and the most commonly cited reason is neglect of the human dimensions of change. This neglect often centres around a lack of insight into why people resist organisational change, a poor appreciation of the process of changing people and a limited knowledge of the tools and techniques that are available to help Improvement Leaders overcome resistance to change. This guide will help you to understand and to better manage these fundamental aspects of the change management process, and help you to empower, enable and engage those you work with. The psychology behind the human dimensions of change is an ever-growing area and there has been much research and theorising on the subject. This guide has been written by experienced Improvement Leaders who are involved in healthcare improvement initiatives. We have put together the models and frameworks that have helped us while working with the wide variety of people in healthcare. It is a starting point for you as an Improvement Leader. (download this guide - Adobe pdf 197k)

Impact of the Manager’s Span of Control on Leadership and Performance by Doran et al

This study examined the relationships between types of leadership, the number of staff that managers are responsible for, and patient and nurse outcomes.

• Nurse managers with positive leadership styles, who develop, stimulate, and inspire followers to exceed their own self-interests for a higher purpose and are based on a series of exchanges or interactions between leader and followers, had more-satisfied staff.
• Nurse managers with negative leadership styles, who take action only when required or when issues become serious or who avoid leadership responsibilities, had less-satisfied staff.
• Patient satisfaction was higher on units where managers used a positive leadership style.
• Patient satisfaction was lower on units where managers had a large number of staff reporting to them.
• Units with managers who had a large number of staff reporting to them had higher levels of staff turnover.
• Units with managers who used a positive leadership style had lower levels of staff turnover.
• Having a large number of staff reporting to the managers reduced the positive effect of the positive leadership styles on staff satisfaction and increased the negative effect of the negative leadership styles on staff satisfaction.
• Having a large number of staff reporting to the managers also reduced the positive effect of the positive leadership styles on patient satisfaction.
• No leadership style will overcome having a large number of staff reporting to the managers.
• Organizations should implement management training programs to develop positive leadership styles.
• Guidelines need to be developed regarding the optimum number of staff that should report to nurse managers.

The full report can be downloaded here (pdf format - 453 Kb)

Budgeting for change(pdf format) - developed by the NHS National Nursing Leadership Project

This is a workbook designed to help nurses understand and manage budgets. The guide is divided into nine sections

• Budgets.
• Managing & Controlling spend.
• How is the Health Service financed?
• Benchmarking & sharing best practice.
• Preparing a Business Case & Managing Change.
• Managing the Nursing resource.
• Leadership Skills.
• Numerical Exercises.
• Practical Case Study.

Each section includes case studies to help practically illustrate each subject area.

Leadership Style Survey - Questionnaire
This questionnaire was developed by Don Clark and is a 30-question self-assessment to assess your leadership style. You will be measured on how much your leadership style is autocratic, democratic or participative.

Click here to take the Questionnaire

Team Development Tools
Developed by Department of Indian Affairs and Northern Development, Canada

Tools for building & developing a team
There are two critical elements to effective team building: a connection between all members of the team and a shared understanding between the leadership and each team member. These four tools can help you create a group identity and a sense of shared purpose:

• The Stand-up
• The 12-minute Interview
• 360-degree Feedback
• The Daily News

How do we involve all the team members
If everyone is involved at the beginning, everyone will understand what the group is doing, why it is doing so and how they can contribute. Here's how to give your group a mission statement and work plans that mean business:

• The Team Charter
• The Team's 30-minute mission statement

Problem solving
It could happen this Tuesday, sometime in March, an hour from now, or every day next week. At some time you and your colleagues will face a problem. These tools will help you understand what is really going wrong and why. They will also help you find solutions:

• The Process Map
• The Workout
• The Win-Win tool

How to develop a learning culture in your team
Effective learning is not just about signing up for another course. It is about sharing knowledge with your colleagues, respecting the wisdom of long-time employees, and encouraging creativity. These tools will help you make learning an everyday event:

• The Learning Team
• The Learning Centre
• The Brainsqueezer
• The Open Space Conference

Tools for improving team performance
If your team is already the best in its line of work, these tools will guide you in sharing your secrets with others. If you are like most of us, however, you probably would like to do some things better. These tools can help you save time and money and improve your effectiveness:

• The 12-minute Briefing
• Benchmarking
• The Service Standard

Working with the people we serve
The most effective groups change constantly. Why? Because they are responding to the needs of the people they serve. These tools will help you ask the right questions and use the answers to make your work relevant and effective.

• Strategic Partner Consultation
• The Survey
• The Focus Group
• The Future Search

Leadership and Learning Guide: Teams Handbook
Developed by Department of Indian Affairs and Northern Development, Canada

Section 1 - The basics

-What is a team?
-What does teamwork mean?
-What are the benefits of teams?
-Are teams needed all the time?
-Types of teams
-Characteristics of an effective team
-Summary

Section 2 - Understanding team dynamics/process

-Stages of team development
-Guidelines for team discussion
-Problem-solving model
-Learning from conflict
-Effective team meetings
-Summary

Section 3 - Checklists

-Setting up an effective team
-Leading a team meeting
-Sample Agenda
-Adjourning a team

To view "Sections 1,2,3" click here (PDF 1,215Kb)

Section 4 - Tools

-Brainstorming
-Nominal group technique
-Mind map
-Force Field Analysis
-Consensus
-Team performance index
-Summary

Section 5 - Resources

-Internet sites
-Books
-Handbooks
-Workshop
-Other

To view "Sections 4,5" click here (PDF 848Kb)

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Blake and Mouton Managerial Grid - Questionnaire 5

Blake and Mouton Managerial Grid was developed by Don Clark .
Objective: To determine the degree that a person likes working with tasks and other people.
Time: 45 Minutes
The Grid provides a basis for comparison of styles in terms of two principle dimensions:

• concern for production
• concern for people

Instead of presenting a manager with a dilemma of choosing one or the other alternative, it shows how a leader can simultaneously maximize both production oriented methods and those that are people orientated.

Click here to take the fifth Questionnaire

 Centre for Coaching and Mentoring - Leadership Quizzes

This area conatains a number of self-development quizzes covering:

• What Are Your Influencing Tactics?
• Coaching Up - Test Your Readiness
• How's Your Team Spirit
• Test Your Coaching Skills
• The Empowering Work Environment
• Teams: What's Your Coaching Climate
• Finding a Coach
• Are You Ready To Manage In The 21st. Century?
• How In Step Are You With Generation X?
• What's Your Commitment to Yourself?
• Leadership Trustworthiness: How Far Can They Throw You?

 Centre for Coaching and Mentoring - click here to take the Leadership Quizzes

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