Why existing and emerging local leaders need space and confidence to fail, grow and thrive

blog | 18 Mar 2021

Leaders vary in style, shape, size and position. What separates the good ones from the rest is the ability to set and share a clear vision for change. But even the best leaders aren’t always successful.

If I think about my 25 years in health and care, when I’ve been most successful at leading teams is when I’ve been a gardener. When my role has been to nurture the garden, not to control or change it. A good gardener knows that they don’t actually grow anything. Instead, they create the environment in which things can grow.

The same applies to effective leadership. What follows are lessons I have learnt about leadership from my work with organisations and systems over the last 10 years.

1. Understand the local conditions and see what grows naturally

As a good gardener you get to know the garden, the soil conditions, what’s already planted, the weather, the pests that the garden attracts. What you think is the biggest, prettiest or best plant may not be in this garden and you need to work with what you have.

Many of Innovation Unit’s projects are not dissimilar to this. We spend time with leaders helping them to understand their context; the people, organisations and cultures that exist; and the regulatory environment in which they operate. These leaders may look to other bigger and prettier organisations but we support them to grow something of beauty from within their own place.

Often our role at IU is of ‘honest broker’ – bringing people together to explore and recognise their conditions through open conversations. In Doncaster, we helped colleagues from the CCG, local authority, hospital and community trusts build new ways of working together. We spent time with them finding and growing new leaders from within existing organisations, we didn’t simply transplant people or ideas from elsewhere.

2. Start with an open mind

I really wanted to grow courgettes in my garden. Unfortunately, the slugs had a different idea. I had two choices: fight a losing battle to eliminate the slugs or rethink how and where I grew courgettes.

Keeping an open mind allows new opportunities, as I found when I led an NHS England programme to reduce hospital admissions for care home residents. I’d never worked in a care home, so I could’ve started with the assumption that the care sector was creating the problem by heading straight to hospital instead of other places for NHS support. Instead, I started by talking to the care sector about the problems they faced. By learning what they experienced, I could marry the two perspectives and find a solution. And, as a result of including different people in the dialogue, a series of leaders emerged with great insight, understanding and skills who became powerful convenors and shapers in their sector.

3. Help everything to come together

As a gardener, it’s great growing one plant really well – unless this plant crowds out all others. Creating an environment that allows all parts of the garden to thrive is critical.

As a leader, you need to do the same: bring people together; give them all a voice; translate and broker between the various players; and then give them time and space to develop. This convening role is critical to allow formal and informal relationships to develop and take the change forward.

Our learning work in Greater Manchester on innovations driven through Covid-response revealed a similar story across all 10 local authorities: community groups emerged to support their neighbourhoods, with informal leaders stepping forward to identify need, respond to it quickly and appropriately. Local authorities gave resources, advice and/or infrastructure – and then got out of the way.

4. It’s not all about the hard landscaping

There can be a tendency when gardening to build hard landscaping to contain and channel the growth. Whilst some structure can be helpful, it’s also valuable to see where the natural flow of the garden can take you. Similarly, informal networks of local leadership that emerge to mobilise a new vision are as important as formal structures to draw in system leaders.

In Southwark, the CCG, council, GPs and acute and hospital trusts came together to develop a common language around neighbourhood working. We co-designed a number of potential descriptions and definitions then, through “test and learn” sessions, we tried to practically experience what it means to work in a neighbourhood.

We made sure voluntary and community groups were seen as equal partners in the delivery of care and wellbeing alongside statutory services. We asked residents to make decisions on what language worked for them. Local leaders emerged along the way and, by the end, each provider’s vision could be described in simple and understandable terms and could be implemented in a way that made sense to each neighbourhood.

5. Not everything is going to work so create the conditions to learn, fail and thrive

In my garden I help my plants by providing protection from the elements and understanding which will thrive in which conditions. But I can’t guarantee success.

Similarly, the best leaders seek to create the conditions that allow learning to happen and appropriate risk to be taken. They value and accept failure as a building block of success and encourage honesty in their teams to ensure that learning happens.

In My Care, My Way in West London CCG, we used a series of live learning labs to explore what wasn’t working around care for over 65s. Our findings were rapidly shared across 42 GP practices who incorporated our learning into their work and tweaked their model as they went, seeing refinements as critical opportunities to improve the service. Now, five years on, they can demonstrate service quality improvements, reductions in hospital activity and financial savings.

6. A blooming success

Great place-based leadership means helping the garden to bloom, accepting that as a leader you nurture, support and protect local places to develop, fail, grow and thrive. We need to liberate existing leaders to think and then act in new ways, and to identify and encourage emerging leaders to make positive change happen.