The NHS is a large complex system, with a multitude of services that have to be delivered alongside a range of competing priorities that have to be managed such as engaging the public and patients in shaping local services, delivering national policy requirements, improving organisational performance and productivity, working across boundaries with partners, innovating and developing high quality care for service users and patients and actively engaging staff in generating the ways in which all of this can be achieved.
When current health service reforms - arguably the most radical and demanding organisational development challenge that has been tackled by the NHS - are added to this context, then this places enormous demands and expectations on those people leading the NHS. Today's NHS leaders - whether they are a GP, Clinical Director, Head of Service, Chief Executive, Executive Director or General or Service Manager, have to enable and empower their staff to adapt to, and to be capable of working in, a rapidly changing, unpredictable environment.
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