https://elp.northumbria.ac.uk/bbcswebdav/pid-12858778-dt-content-rid- 26143346_2/xid-26143346_2

This module has a two-part summative assessment. The first element is the production of an electronic academic poster that will focus on collaborative and partnership working in public health / healthcare. The second is a 2500 essay that critically discusses and evaluates the importance of management and leadership theory within a public health and /or healthcare management context. The two elements are not directly linked. The weighting of each component of the assessment is 50%.

Formative assessment

To support your summative assessments, we also provide support via two formative assessments.

1. You will produce an electronic academic poster on one PowerPoint slide which will critically analyse collaborative / partnership working issues in an existing collaborative / partnership public health and / or healthcare management project of your choice. In particular there should be a critical discussion of the effectiveness of the collaborative work/ partnership. Examples of projects will be available on the e-learning portal or you can find your own. This will be presented to your peers and module tutor(s) for review and feedback. This peer and tutor feedback will help you to develop your final electronic academic poster which is one element of the summative assessment.

The electronic academic poster will provide the opportunity for you to present a visual representation of key issues relating to the rationale and effectiveness of an example of public health or healthcare management collaborative / partnership working. (MLO’s 1,2)

2. You will be asked to provide your allocated tutor with an outline plan of your essay via email. This should be no more than one page in length. You will also receive a small group tutorial with your module tutor, which will be an opportunity to ask specific questions about the assignment.

Summative assessment

Part 1 (50%)

You will produce the final version of your academic poster, which critically analyses collaborative / partnership working issues within an existing collaborative / partnership public health and / or healthcare management project. (MLO’s 1, 2).

Part 2 (50%)

You will submit a 2,500 word essay which critically discusses and evaluates the importance of management and leadership theory and its application within a public health and/or healthcare context. You are encouraged to identify and write about a single public health or healthcare topic.

https://elp.northumbria.ac.uk/bbcswebdav/pid-12858778-dt-content-rid- 35448131_2/xid-35448131_2

THE ROLE OF MANAGEMENT & LEADERSHIP IN PUBLIC HEALTH

AC7029:

LEADERSHIP AND COLLABORATIVE WORKING IN PUBLIC HEALTH AND HEALTHCARE

[name]

[student number]

May 2019

Word Count: 2336

Module: AC7029 Emma Shields

1

The Role of Management and Leadership in Public Health

The issues affecting population health are extremely complex and require action

against a wide range of determinants to make lasting improvements, therefore it is

fundamental that public health services are managed effectively and efficiently. It is

therefore essential that those in charge of protecting population health not only have

the knowledge and skills identified as essential for effective management but are

able to lead others in their field. Theories of management and leadership play a

pivotal role in determining how interventions and services aimed at improving

population health should be implemented, both nationally and locally. There are a

wide range of perspectives on the principles and practices of management and

leadership, including the Contingency Approach to Management and Participative

Leadership, which will be critically discussed in relation to public health practice.

Public health agencies across the world play a key role in protecting the health of the

population through disease control, health promotion and overall reducing morbidity

and mortality rates to ensure people live long and healthy lives (World Health

Organization, 2019a). This is achieved through research; the development of public

health policy, law and regulations (Burke, 2011); collaboration with a wide range of

public, private and voluntary organisations; service provision; and, developing

effective management and leadership strategies (World Health Organization, 2019b).

A wide range of determinants affecting population health exist, such as social,

environmental, political, educational, cultural, economic and genetic factors (Marmot

and Wilkinson, 2005). These include the prevalence and spread of disease, access

to health services, living and working conditions, household income and individual

behaviours, all which collectively determine a person’s health outcomes (Baum,

2016). The complexity of public health and the issues affecting it therefore requires

Module: AC7029 Emma Shields

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an understanding of management and leadership principles which underpin the work

carried out in the field of public health (Brownson et al, 2018).

Managers are people appointed the role of overseeing the daily functions of an

organisation and are given the authority to make important decisions which can

affect the provision of whatever product or service is offered by the company (Darr,

2011). Leaders are employees within the organisation, working at any level or in any

role, who can influence and impact positive change to improve organisational

outcomes (Rowitz, 2018). A clear distinction between managers and leaders is that

whilst a leader may possess the ideas and strategies needed for success, only those

in a managerial position have the power to implement and enforce them (Barr and

Dowding, 2012). Johnson and Breckon (2007) suggest that the level of authority a

manager is given should be synonymous to the level of responsibility they have to

ensure successful outcomes. However, it is argued that the relationship between the

management and leadership are interrelated and both equally as important,

particularly in public health (Burke, 2011). It is also argued that building a competent

public health workforce which demonstrates excellent management and leadership

qualities is equally, if not more important, than simply being experts in contemporary

health issues (Fraser et al, 2017). There are a range of perspectives which

conceptualise the importance of both management and leadership. Management

theories include the Scientific, Systems, Human Relations and Contingency

approaches, whilst leadership theories include Authoritarian, Transactional and

Transformational.

The Contingency approach to management combines aspects of several other

theories: the Scientific approach, which is evidence-based and systematic to ensure

maximum productivity; the Systems approach, which considers how all parts of an

Module: AC7029 Emma Shields

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organisation work together co-ordinately, each function equally as important; and the

Humanistic approach, which focuses on the people within the organisation and how

they interact with each other (Johnson and Breckon, 2007). Developed by Lawrence

and Lorsch (1967) whose research into the organisational structures of several

organisations concluded that no single method of management was superior. The

theoretic emphasis of this approach is that management is situational: it is essential

that managers adapt their management styles to both the needs of the organisation

and the service or intervention they are overseeing, and if the managerial structure

adopted fails to cohere with the goals of the organisation, it must be changed to a

more appropriate style (Barrett, 2011). However, it is argued that adapting

management style to suit the situation is futile; if managers must change the way

they operate due to situations they cannot manage, they consequently cannot

successfully manage the situation at all (Kreitner, 2008).

Despite this, the Contingency Approach is considered relevant to public health

practice due to its strong focus on integration, which is a fundamental principle

underpinning the work of various organisations in the delivery of services,

collaborative research, and resource sharing, to achieve common public health goals

(Redwood et al, 2016). The field of public health consists of multiple stakeholders,

such as government agencies, educational institutions, private and voluntary sector

organisations, and local communities (Freidman, 2011a). Integration is particularly

important within private-public partnerships due to differences in organisational

structures, collaborating workforces and strategy sharing, which requires effective

management, delegation, negotiation and communication (Waring et al, 2013). This

approach is particularly useful within the area of health promotion, as understanding

the consequences of processes and behaviours is fundamental to developing

Module: AC7029 Emma Shields

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behaviour change-based policies and interventions (Elder, 2001). Therefore, how

public health challenges are approached is dependent on various situational factors

such as the targeted population, the resources available, how and where the

intervention will be implemented, and the overall aims of the intervention (Sheeran et

al, 2016). The complexity of behaviour-change interventions therefore requires a

contingent management strategy, which is essential to the continually changing

organisational structures of public health agencies.

Managing organisational change can be challenging for those in charge of protecting

and promoting the health of the population due to the political ideologies which

impact the way health services are operated and delivered. In 2013, the

responsibility of public health in the United Kingdom (UK) was decentralised from the

Central Government to local authorities as a result of the Localism Act (2011) giving

local authorities additional decision-making powers. Additionally, many health

services were privatised to improve efficiency as part of the Health and Social Care

Act (2012). These changes were enforced under the Coalition Government, whose

political agenda was influenced by the New Localism ideology which promotes local

service provision to meet the needs of local communities (Tait and Inch, 2015).

However, the Central Government primarily retained financial control, which

therefore limits what can be achieved by local authorities, providing managers of

public health services at a local level with additional challenges to contend with

(McKenna and Dunn, 2015). Bureaucratic management styles which consist of multi-

level hierarchies are therefore unsuitable for fractured and unstable environments

which require flexibility and fluidity to ensure organisational change is as disruptive

as possible (Barrett, 2012). It is also argued that the outcomes of an organisation

can vary depending on whether they are operated publicly or privately, with public

Module: AC7029 Emma Shields

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sector agencies under constant scrutiny from the general public due to way they are

funded (Pollitt, 2003).This not only highlights the importance of effective contingent

management strategies in public health, but also adds pressure to public health

managers, enforcing the ideology that the employment of competent leaders is

equally important for organisational success. Due to the situational-based theory

which underpins the Contingency approach to management, the need for effective

leadership is also a key aspect of this perspective, considering the relationships

between those working at a managerial level and the rest of the employees within

the organisation to achieve desired outcomes (Freidman, 2011b).

Leadership plays an integral role in the field of public health. Whilst managers are

important in overseeing the functions of an organisation through solving problems,

distributing finances and resources, and planning effective strategies, leaders are

those who influence, motivate and empower others to ensure the organisation

operates effectively and continually strives to improve and progress (Stanfield,

2009). It is suggested that leaders have innate characteristics which make them

effective at their job, but these skills and principles can also be learnt by others

(Rowitz, 2018). Leadership is recognised as essential to the provision of health care

services in the UK, as it is believed that mortality rates can be reduced if all staff

actively participate in the improvement of the services they are employed in (NHS

Leadership Academy, 2014). Theories conceptualising the importance of leadership

include the Trait Approach, which suggests leaders are born with the inherent

characteristic needed for effective leadership (Burke and Freidman. 2011); The Style

approach, which favours emphasis on individual behaviours; and, Transformational

Leadership, which builds on the concept of working together to achieve common

goals (Healey and Lesneski, 2011).

Module: AC7029 Emma Shields

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Transformational leadership is a theory which values mutual respect, empowerment,

trustworthiness and motivation in which those in a managerial position highly regard

the contributions of those at a lower level in the organisation (Shelton, 2012).

Transformational leadership was conceptualised by Burns (1978), who suggested

leaders where either Transactional, in which people lead others in exchange for a

favourable reward, or Transformational, who inspire others for the good of the

organisation. Transformational leadership is made up of four components: Idealized

Influence, which is they behaviours which inspire others to follow; Inspirational

Motivation, the optimistic and enthusiastic exchange between leaders and others in

order to motivate and inspire ; Individualised Consideration, in which leaders value

others’ aspirations and achievements; and, Intellectual Stimulation, which involves

addressing and challenging issues to develop effective solutions (Bass and Riggio,

2008). Forming good relationships is a key attribute needed to fulfil these roles, as

influence and empowerment is only possible if others within the organisation trust

and respect those they are following (Barling, 2014). Novick et al (2008) suggests

that empowerment for all employees within a public health organisation can be

chaotic, particularly if employees don’t agree with the political agendas which

influence the aims of the organisation they are working for. Healey and Lesneski

(2011) argue that the influential impact leaders can have on others improves the

outcomes of services and interventions, resulting in Transformational leadership

being well established in the public health field.

There are many different styles of leadership, such as Transactional, Autocratic and

Participative, all which differ in terms of how leadership is implemented within an

organisation. Participative leadership, also known as Democratic leadership,

provides employees with the opportunity to make important decisions regarding the

Module: AC7029 Emma Shields

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service they provide (Ricketts and Ricketts, 2011). A systematic review of leadership

styles during disease outbreaks by Arifah and colleagues (2018) found that

participative leadership qualities such as encouragement, effective communication

and partnership working, were considered essential components in controlling and

managing outbreaks. Participative leadership styles coincide with the perspectives of

Transformational Leadership theorists, and the World Health Organization (2016)

regards Participative leadership styles as fundamental to improving population

health, as all employees invested in working towards this aim should be treated

equally and decisions made collaboratively. Research shows that utilising this style

of leadership can improve job satisfaction which leads to an improvement in

productivity, particularly in public sector organisations (Kim, 2002). However, this

approach to leadership relies on the assumption that all members of the

organisation, both managerial and frontline staff, have similar interests and visions,

however this scenario is idealistic and may not always be the case (Ricketts and

Ricketts, 2011).

Some of the challenges faced by public health managers and leaders include

outbreaks of disease, new trends in unhealthy behaviours and policy reform (Rhodes

et al, 2010). One of the key functions of a public health manager is to make rational

and evidence-based decisions to overcome such challenges (Brownson et al, 2018).

This requires technical skills such as planning and budgeting; Interpersonal skills

such as effective listening and cooperating; and conceptual skills such as analysing

complex situations, commitment and visualising success (Healey and Lesneski,

2011). Public health managers are required to effectively plan both short- and long-

term goals in addition to planning for unknown events which can affect the outcomes

of those goals. Contingency planning allows for disasters to be averted and is of

Module: AC7029 Emma Shields

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particularly important in public health, for example during disease outbreaks (Darr,

2011) Similar skills are identified as essential leadership qualities, with the addition

of emotional intelligence, influence and self-awareness (Moodie, 2016). It is argued

that attempting to teach leaders in the field of public health the skills needed to excel

in the workplace is difficult due to those in managerial positions lack leadership skills

themselves and therefore cannot inspire others (Yphantides et al, 2016). However,

the similarity of skills needed for both management and leadership provides an

insight into the resemblance of both concepts.

A systematic review by Neinbar (2010) provides an insight how the concepts

management and leadership concepts are defined. The study synthesises that the

terms are often used in existing literature synonymously, with the responsibilities of

both managers and leaders often described the same. With the tasks carried out by

both managers and leaders and skills required for effective management and

leadership similarly described in both Moodie and Neinbars studies, neither concepts

are distinctive, and both are required for the operations of an organisation to be

successful. Freidman (2011b) also concludes that public health requires both the

operational functions of managers and the influence of leaders to overcome the

many challenges that arise due to changes in organisational structures, cuts to

funding and resources, and ongoing threats to the health of the population.

To conclude, the terms management and leadership are interchangeable, and it is

often difficult to differentiate between the two. Despite this, there are many different

theories of how management and leadership can be applied within public health

organisations. The Contingency approach to management displays relevance to

overcoming public health challenges such as organisational change and the

implementation of new policies. This is due to its flexibility and situational theoretic,

Module: AC7029 Emma Shields

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whilst Transformational leadership is regarded as an important concept in achieving

the overall aims of public health, such as prompting healthy behaviours and effective

and efficient service provision, by developing a value and goal orientated workforce.

The skills needed to effectively manage, and lead have been revealed through

research to be similar, synthesising that both are of as equal importance.

Word Count: 2336

Module: AC7029 Emma Shields

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References

Arifah A.R., Mohd, T., Mohd F.R., Syahira, S., Rosliza. A.M., and Juni, M.A. (2018)

‘Leadership Theories in Disease Outbreak Management’, International Journal of

Public Health and Clinical Service, 5 (2), pp. 1-16.

Barling, J. (2014) The Science of Leadership: Lessons from Research for

Organizational Leaders. New York: Oxford University Press.

Barr, J. and Dowding, L. (2012) Leadership in Health Care. 2nd edition. London:

Sage Publications Ltd.

Barrett, I.R. (2012) Administration and Management Theory and Techniques: A

Guide for Practising Managers. Bloomington: Author House.

Bass, B.M. and Riggio, R.E. (2008) Transformational Leadership. 2nd edition. New

Jersey: Taylor and Francis Publishing.

Baum, F. (2016) The New Public Health. 4th edition. Oxford: Oxford University

Press.

Brownson, R., Baker, E.A., Deshpande, A.D., and Gillespie, K.N. (2018) Evidence-

Based Public Health. 3rd edition. New York: Oxford University Press.

Burke, R.E. (2011) ‘Introduction’, in Burke, R.E. and Friedman, L.J., (eds), Essentials

of Management and Leadership in Public Health, Burlington: Jones and Bartlett

Learning, pp. 1-5.

Darr, K. (2011) ‘Introduction to Management and Leadership Concepts, Principles

and Practices’, in Burke, R.E. and Friedman, L.J., (eds), Essentials of Management

and Leadership in Public Health, Burlington: Jones and Bartlett Learning, pp. 7-24.

Elder, J.P. (2001) Behavior Change and Public Health in the Developing World.

California: Sage Publications Ltd.

Fraser, M., Castrucci, B., and Harper, E. (2017) ‘Public Health Leadership and

Management in the Era of Public Health 3.0’, Journal of Public Health Management

and Practice, 23 (1), pp. 90-92.

Freidman, L.H. (2011a) ‘Strategic Planning and marketing for Public Health

Managers’, in Burke, R.E. and Friedman, L.J., (eds), Essentials of Management and

Leadership in Public Health, Burlington: Jones and Bartlett Learning, pp. 39-52.

Freidman, L.H. (2011b) ‘Changing Role of Public Health Managers and Leaders’, in

Burke, R.E. and Friedman, L.J., (eds), Essentials of Management and Leadership in

Public Health, Burlington: Jones and Bartlett Learning, pp. 149-158.

Health and Social Care Act. (2012). Arrangements for Provision of Health Services.

(Online). Available at:

http://www.legislation.gov.uk/ukpga/2012/7/part/1/crossheading/arrangements-for-

provision-of-health-services/enacted. (Accessed: 7 May 2019).

Module: AC7029 Emma Shields

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Johnson, J. and Breckon, D. (2007) Managing Health Education and Promotion

Programs: Leadership Skills for the 21st Century. 2nd edition. Sudbury: Jones and

Bartlett Publishers.

Kim, S. (2002) ‘Participative Management and Job Satisfaction: Lessons for

Management Leadership’, Public Administrative Review, 62 (2), pp. 231-241.

Kreitner, R. (2009) Principles of Management. 11th edition. Boston: Houghton Mifflin

Harcourt Publishing Company.

Lawrence, P.R. and Lorsch, J.W. (1967) ‘Differentiation and Integration in Complex

Organizations’, Administrative Science Quarterly, 12 (1), pp. 1-47.

Localism Act. (2011) Chapter 1: General Powers of Authorities. (Online). Available

at: http://www.legislation.gov.uk/ukpga/2011/20/part/1/chapter/1/enacted. (Accessed:

7 May 2019).

Marmot, M. and Wilkinson, R. (2005) Social Determinants of Health. 2nd edition.

Oxford: Oxford University Press.

Moodie, R. (2016) ‘Learning About Self: Leadership Skills for Public Health’, Journal

of Public Health Research, 5 (1), doi: 10.4081/jphr.2016.679.

Neinbar, H. (2010) ‘Conceptualisation of Management and Leadership’,

Management Decision, 48 (5), pp. 661-675.

NHS Leadership Academy. (2014) NHS Leadership Academy: An Overview.

(Online). Available at: https://www.leadershipacademy.nhs.uk/wp-

content/uploads/2014/11/NHS-Leadership-Academy-full-pack.pdf. (Accessed: 11

May 2019).

Novick, L.F., Morrow, C.B., and Mays, G.P. (2008) Public Health Administration:

Principles for Practice Based Management. 2nd edition. Massachusetts: Jones and

Bartlett Learning.

Pollitt, C. (2003) The Essential Public Manager. Buckingham: Open University Press

Redwood, S., Brangan, E., Leach, V., Horwood, J., and Donovan, J.L. (2016)

‘Integration of Research and Practice to Improve Public Health and Healthcare

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1445-z.

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Complexity Theory: Richer Decision-Making in Public Services. New York:

Routledge.

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Success. 3rd edition. New York: Cengage Learning.

Rowitz, L. (2018) Essentials of Leadership in Public Health. Burlington: Jones and

Bartlett Learning.

Module: AC7029 Emma Shields

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Sheeran, P., Maki, A., Montanaro, E., Avishai-Yitshak, A., Bryan, A., Klein, W., Miles,

E., and Rothman, A.J. (2016) ‘The Impact of Changing Attitudes, Norms, and Self-

Efficacy on Health-Related Intentions and Behavior: A Meta-Analysis’, Health

Psychology, 35 (11), pp. 1178-1188.

Shelton, E.J. (2012) Transformational Leadership: Trust, Motivation and

Engagement. Canada: Trafford Publishing.

Stansfield, A.W. (2009) Defining Effective Leadership: Lead in Whatever You Do.

Oklahoma: Tate Publishing.

Tait, M. and Inch, A. (2016) ‘Putting Localism in Place: Conservative Images of the

Good Community and the Contradictions of Planning Reform in England’, Planning

Practice and Research, 31 (2), pp. 174-194.

Waring, J., Currie, G., and Bishop, S. (2013) ‘A Contingent Approach to the

Organization and Management of Public–Private Partnerships: An Empirical Study of

English Health Care’, Public Administration Review, 73 (2), pp. 313-326.

World Health Organization. (2016) Participatory Leadership for Health. (Online).

Available at:

https://apps.who.int/iris/bitstream/handle/10665/251458/9789241511360-

eng.pdf;jsessionid=89DD84BD64C87470D686C387E9C4AB8F?sequence=1.

(Accessed: 12 May 2019).

World Health Organization. (2019a) Public Health Services. (Online). Available at:

http://www.euro.who.int/en/health-topics/Health-systems/public-health-services.

(Accessed: 11 May 2019).

World Health Organization. (2019b) The Role of WHO in Public Health. (Online).

Available at: https://www.wh

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