Leading and managing experts

Source: NHE Jan/Feb 2019

A coaching conversation is likely to yield the best results. Managing experts in the health industry can be a challenging and varying responsibility. Dr Darren Leech, director and coach at NHS Elect, tells more on how to unlock your team’s potential.

In healthcare management, we are surrounded by experts. Lots of highly-qualified, experienced, and self-confident clinical and scientific minds. These people can present quite a challenge to those tasked with leading and managing them – especially as this type of employee is unlikely to consider themselves to be subordinate to managers or leaders in that sense.

The classic ‘situational leadership’ model taught on most leadership development programmes tells us that the most effective leaders adapt their style of operating, depending on the task and the person or people they are dealing with. These differing styles are made up of four primary tools used by leaders and managers in practice—to direct, mentor, coach, or delegate:

  • Direct – telling or instructing. Usually deployed with those who know little about the task or environment, or used in emergency or time-critical situations;
  • Mentor – provides advice and guidance. Often relates to technical areas in which the mentor is seen as an expert and problem solver;
  • Coach – questioning that prompts reflection and action. The coach unlocks and enables the resourcefulness and motivation of the coachee to solve issues or problems for themselves;
  • Delegate – the assignment of responsibility to complete tasks or objectives to those with experience and expertise, without need for further instruction, advice, or support.

It is easy to imagine situations and people for whom each of these styles might work well. For example, we’ve all welcomed clear instructions and advice on our first day in a new job or turned to a more experienced colleague for advice or help with a task.

On the other hand, it is not difficult to remember a boss who tried to delegate to an inexperienced or junior employee, or indeed the manager who tried to direct an expert. When the wrong style is deployed, the results often feature mutual frustration, conflict, and a lack of progress. Consideration and clarity of roles can be an important factor for groups of people required by structure and process to work together. It is important to recognise and appreciate the knowledge of experts as part of that clarity.

Also, an important but often misunderstood area is the difference between the roles of leader and manager. Management roles more often involve direction and advice, whereas leadership requires more of a coaching and delegative approach. Clarity on the functional aspects of these distinct roles within a team that includes technical experts can be a useful exercise and a good first step to avoiding or reducing conflict within teams.

Successful leaders use good, open coaching questions as part of well-structured coaching conversations. The ‘GROW’ model is one of the most well-known frameworks for coaching conversations. This structure enables a coach (and coachee) to properly work through four clear stages of conversation:

  • Goal – Setting a clear goal;
  • Reality – Being clear about the current context and reality for the coachee;
  • Option – Going through the options available, which is important to properly consider best possible steps forward;
  • What/when – Being clear on the actions the coachee will undertake.

In terms of getting the best from staff with expert knowledge and a desire to improve outcomes for patients, a coaching approach not only avoids the prospect of ‘management dependency’ which arises when direction and advice are over-used, it increases motivation and independent problem solving. A coaching style often results in expert employees seeing their manager or leader as an approachable peer, from whom they gain useful insights through reflection. They also become more motivated, by working toward decisions and actions that, ultimately, they generate for themselves.


Enjoying NHE? Subscribe here to receive our weekly news updates or click here to receive a copy of the magazine!


There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

latest healthcare news

UH Bristol NHS Foundation Trust retains ‘Outstanding’ rating from CQC

16/08/2019UH Bristol NHS Foundation Trust retains ‘Outstanding’ rating from CQC

University Hospitals Bristol NHS Foundation Trust has once again been rated as ‘Outstanding’ by inspectors from the Care Quality Comm... more >
Government announces £25m Brexit medicines ‘express freight service’

15/08/2019Government announces £25m Brexit medicines ‘express freight service’

In the event of a No Deal Brexit, the Government has announced the setting up of a high-speed train service to ferry medicine to the UK from Fran... more >
CQC rates Gateshead Health NHS Foundation Trust ‘Good’

14/08/2019CQC rates Gateshead Health NHS Foundation Trust ‘Good’

Gateshead Health NHS Foundation Trust has achieved a score of ‘Good’ following an inspection by the Care Quality Commission (CQC). ... more >

681 149x260 NHE Subscribe button

the scalpel's daily blog

Urology nurses are leading the way in adoption of prostate cancer biopsy technique

11/07/2019Urology nurses are leading the way in adoption of prostate cancer biopsy technique

Jonah Rusere, Advanced Nurse Practitioner for South East London Accountable Cancer Network, outlines an opportunity for urology nurses to make a difference to prostate cancer pathways. What is TRexit and why is it great news for prostate cancer patients all over the country? Let me explain. TRexit is the name given to a national initiative for hospitals to phase out TRUS biopsies and replace them with transperineal biopsies un... more >
read more blog posts from 'the scalpel' >


How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

health service focus

Improving commercial contract research  in the NHS

15/08/2019Improving commercial contract research in the NHS

Clare Morgan, research delivery director at t... more >
Digitising the acute sector: the barriers to ambition

14/08/2019Digitising the acute sector: the barriers to ambition

Rachel Hutchings, a researcher in policy at t... more >