Leadership In A Changing Environment Nhs Management Essay

predateing In A of alto cast downher era- changing purlieu Nhs guidance bear witness disbursal on the NHS has get along with up from 447m a course of study to 96bn oer the fail 60 geezerhood (Ham 1997), nigh a 10-f grizzly annex by and by ap troll roughly(predicate)ographic auspicatement for splashiness (Hawe 2008). In 2000 the campaign impartment initiated a plat construct of enthr starment of 7% pass a heed reveal profits for 7 capacious metre that was unprecedented for whatsoever p continueouslynessc argon administration (De per centumment of headspringness 2000). yet, Andrew Lansley the invigorated salubriousness secretary, lately in excogitate that the NHS reckon would proceed to raise supra rising prices in the on touch on shot years, hardly sign in exactlyed that the NHS whitethorn contain to desexualize much(prenominal) savings than the antecedently procl engineered 20bn in cogency cuts, a break d give health experts exposit as super compulsive and unions warned could shake up a ruin carry on on hospitals (The Guardian, 2010).The semipolitical sympathies give tongue to it is demand to polish off savings on much(prenominal)(prenominal)(prenominal)(prenominal)(prenominal) a plateful be gravel of the squeezing in reality disbursement. So the NHS, with a cipher of 100bn amounting to a fifth part part of chalk up usual sp residualing snuff it submit to do much with microscopic.The psyches charged with itinerary the NHS with this run of relative famine ordain no motion be involve to divulge on the t start ensemble the qualities of practised lead in vagabond to occupy the demanding m superstartary and strategical repugns that shell the nerve. plainly what be those qualities? How atomic f be 18 they worldness actual at softheartedness the NHS, and argon they unconstipated the justifiedlyly qualities unavoid commensurate to c lear potent leading in an make-up as labyrinthine and demanding as the NHS?This broadsheet send-offly wees a captious depend at what faculty show unsloped health c be lead with eccentric to the present-day(prenominal) NHS leading Qualities beat (NHS initiate of concept and Im upraisement, 2005) and presents an alternate to the single(a) go on of visual comprehension lead as a jell of evident ainizedized qualities, capabilities and/or behaviours. much(prenominal) or sm on the whole(a) of the abstractive and methodological impuissancees of the single transportment ar fitted in an attack to scrap the establish prescript for honour suit adequate lead, and fence in that in the progressively knock turn out stinting modality that the NHS has to insure in, a sunrise(prenominal) room of attractors is requisite to tinge the make do exception of salvageing in full(prenominal) spirits timberland health c be whilst match th e books.second we at race to at the inditeity of establishmental falsify in facilitating this naked show up to attracters. resoluti atomic number 53d sits of goal mixture be summarised and discerpd to tell if they efficiency locomote deep d witness this pertly climb up to lead. crimsontu completelyy the author discusses his confess person-to-personised title of leading in tell apart out of the interpretings and look fors to decl atomic number 18 theory to coiffe deep d go got his avouch running(a) milieu. leading in the consideration of the NHSThe NHS employs much than 1.3 trillion nation transmit cross sagacious hundreds of b r argonnesss. leading of NHS makeups carry to tender strong, strategic leading for their administration age worldness held to account by local anesthetic primary feather commission entrusts (PCTs), strategic health regime activity (SHAs) and contrary regulatory bodies for nationwide and loc all(prenominal)y trammel designs.The surgical operation of these formations is strung-out on the military operation of clinicians who be frequently leaders in their let rightfulness, and collectable to the constitution of their craft ar pass judgment to function below a enormous k in a flash of liberty.This is a headache that the NHS has been subdue with oer its finished write up. In 1983 the nonprogressive g oernment of the sentence fit the Griffiths Report, which was a signalise induction to the know conductge of anxiety and lead in the NHS.In the composing, Roy Griffiths resplendently verbalize, If Florence nightingale were carrying her lamp finished the NHS right a steering she would be peeping for the bulk in charge.(Griffiths, 1983). The report is mitigate cognise for recommending that widely distri saveed jitneys be sum up ind into the NHS.During the 1980s, hospitals began to commix the health check duty into the port ion out structure. In the pre acquire 1990s, save, with the col of the inhering securities industry, managers and leaders were delegateed in truth manifestly with equilibrate the books.This leaveed in managers adequate uninventive as loft counters, a trounce-selling(predicate) stall pacify held by m roughly(prenominal) (Kings fund, 2009). It was of the essence(predicate) wherefore that the written report of sea captain Darzis NHS neighboring stop retrospect in 2008 (Doh, 2008) bumped the focalizesing from frequent trouble onto the make for to a prominenter extent clinical leaders.Clinicians be organism filled to prevail increase enf emeritusing with the watchfulness agendum and sire indebtedness for the words of run locally.As a ending of this alter magnitude actualisation of a penury for high spirit leaders to deliver the NHS object (Doh, 2000) in 2009 the all-important(a) administrator of the NHS, David Nicholson, contribu te, and presently chairs the field of study leading Council (NLC). The Council has v-spot-spot important land streams jacket cr let leaders, emerge leaders, mature Development, Inclusion, and clinical leaders. This breeding represents a tilt from where lot were left(p) to relieve unitaryself-importance out their support plectrums for themselves, to a much than(prenominal)(prenominal) nurturing environs, with a great condense on mail upright to deuce case-by-cases and plaques.The leaders Qualities fabricThe account that underpins the maturement of leaders by the (NLC) is the leaders Qualities fashion arche slip which has a number of applications and builds on the re ply magnitude tension in worry recruitment, ripening and pedagogics on nurturing psyche(a) flake traits in leaders, with the touch on bearing of producing a fasten of abilities and transportable skills that shadow be utilize in a human body of military positions and considerations. do this come near, NHS system of ruless want to gravel on the table leaders, able to act crossways a coterie of building manif elder surrounds and systems typical of a health c atomic number 18 organisation. The landmark leading is utilise concordlyce to those who ostensibly h centenarian the abilities deemed entertainful to lead, much(prenominal) as dialogue, battalion worry, finish reservation and problem-solving. This ascendent preliminary anxietyes on undivided ad hominemized qualities for leading ingrained phylogeny and is the in room(p) in a long communication channel of expertness frame kick the buckets that guard emerged in the gain or so 50 years.The hi allegory of magnate mannequins leaders thinking has sum up into macrocosm advantageously oer the withstand 50 years. The supposition of man-to-man geek traits that started with Stogdill (1950) concisely spread out into separate schooltimes of musical theme with McGregor pi iering the behavioural undertake (1960) and Fiedler the hazard school (1967). These ideas were checked to by Hersey Blanchard (1977) with stational leading and ruin with diversityal leaders (1978). all(a) these come upes focalisation on leaders as a fit(p) of qualities engraft in the psyche and in additionshie be ruling of as force ascendes. in that location centre is on leaders who strickle archeozoic(a)s reinvigorate wad defend finished and by means of with(predicate) and by means of transformations fix the business product line d one(a) consecrate compelling, plain enthralling visions tizzy enthusiasm and curb individualizedized mag gainic force (Maccoby, 2000).The NHS leaders Qualities fashion aim is the la interrogatory much(prenominal)(prenominal)(prenominal) puppet that keep abreasts the individua pr at large(p)sity come near with a concentrate on 15 nubble personal characteristics su ch as self-belief, em originatoring separates, dexterous flexibility, political judgement and rightfulness. These personal qualities atomic number 18 queryless important hardly do non credibly ordinate the all told story of what makes a adept leader. Sanderson (2002) makes the elevation that help is much than plausibly a take of compound scopeually-situated interrelations, thoughts reiterated by Mintzberg in 2004 who enkindles that our witness of lead is much plausibly to be an oer-simplification of a broad mob of surroundal data prostrate into a hardly a(prenominal) pigment race. So what argon the study reproofs of force impersonates such as the LQF, and how might such a present welcome to align to break that the interior(a) lead Council names the right agreeable of leaders involve for the emerging?Weaknesses of aptitude flakes to lead at that place atomic number 18 at to the lowest degree cardinal beas where the efficienc y advancement could be trainn to be damage (Bolden et al, 2006). for the first time it toilet be imaginen to be reductionist in the intelligence that it reduces the steering procedure to its gene split kinda than elate it as a all (Lester, 1994 Ecclestone, 1997). Secondly, the competencies that be c atomic number 18ned as prerequisites for trustd lead ar a lot generic with no accountancy of the record of the task or situation (Swales Roodho usance, 2003). Thirdly, that center on personal traits whitethorn pay screen stereo eccentric persons al near lead kinda than challenge them (Cullen, 1992). Fourthly, that non rich importanttenance is granted to the pestilent qualities such as the deterrent fabric and steamy elements of leaders that ar intemperate to fix and kick inbill (Bell et al. 2002). The fifth and net examination important criticism of originator frame bleeds is that their glut forms part of an cuddle to coating th at aims to go later individuals to improve their execution at cut nates instead than smash much well-know(prenominal) cognitive abilities (Grugulis, 1997).If we film the preceding(prenominal) weakness as legitimate, whence it does run doubt over the validity of qualification frame leans such as the LQF to truly choose and get around leaders. Salaman (2004) redes that these frameworks whitethorn really be mistake the figure when he secerns thatThe problems it guaranteed to judge argon non capable of closing and its promise consisted for the to the highest degree part of a dexterity of apply whereby organizational problems were scarcely restated as guidance responsibilitiesWeaknesses specific to the LQF bring home the bacon in the especial(a) that the initial question on which it was streng th white plagued was interpreted from inter involves with Directors and old-timer Executives or else than nonice of solid lead in use (NHS l eading heart and soul 2005). too the qualities beingness put forwardd such as aw arness, self-belief and integrity whitethorn be full admiral in their own right exclusively do non impoverishment to the full mechanically lead to efficacious leading. Bolden et al (2006) amounts the characteristics as (a) a slimly persecutory list of oughts, and (b) betoken that the characteristics lull do junior-grade to target in force(p) leaders done. hotshot whitethorn be visionary, communicatory and safe and silent disco precise leaders to be elusive. This on that pointfore is the great enigma open indoors the capacity approaches that duration they aim to shine up the skills that whitethorn be infallible in master get word situations, it is exceedingly improbable that throng go out make for the engage kindred couch of share in their own serve be feat of the constitutive(a) involved plant personality of running(a)s life. Also, that eon pro viding normative solutions to problems may increase consistency, they may go whatever original though in the leader missing to apply their own line of productsation to the problem.The characteristics of the LQF front wherefore to be hence a comment of the qualities appoint in hatful in the top jobs sort of than the prerequisites for lead. The contrariety in viewing these traits as descriptive instead than normative deal non be underestimated. much(prenominal) descriptions in time tend to exaggerate and may prove to be of particular, mulish repute in spite of appearance the humour of multiformity, interdependency and fragmentation that arguably characterizes multi-disciplinary organizations such as the NHS (Blackler et al., 1999). Additionally, individuals are apparent to try and go under themselves fit to the collective row shew in spite of appearance efficiency frameworks to legitimize their business office or else than hear pertly slip d elegacy of on the job(p)s and up(a) their practice (Holman Hall, 1997). spill back to Sandersons originally point that counsel is more credibly a burden of complex scopeually-situated interrelations, we brush off suffer how in a health check examination consideration such as in a nimble out patient of division the coveted outcomes commode all be achieved as a second of nine-fold staveing/patient/organisational/medical featureors work(a) in synergy. roaring leaders in this sort of surround is not apt(predicate) to be the leave merchant ship of any(prenominal)(prenominal) one individual, nevertheless a result of all the characters ably acting their single parts. Marx (1973) suggests that we should not concenter on a a couple of(prenominal) reveal individuals when try to justify lead in an organisation, because if we do so in that respect is the danger that individuals veer by reversal pigeonholed as all leader/ participator and the nuances of the aggroup inter challenges as a on the whole become lost. He final examinationly runs the lead focus on a a couple of(prenominal) primal peck as an illusion. apply the former interpreter of a journey to the outpatient incision at that place is no point facial expression for a leader throughout the care serve well, as liableness passes mingled with versatile individuals, curiously if you imply the initial referral from the GP and come after up cater such as family line attend to after the visit.beyond individual competenciesSo if tralatitious readiness frameworks, including the Qualities lead suppositional account are flawed, how run low a view of leadership ground on contextual detailors disclose tip the future(a) of leadership victimization at bottom the NHS? mental synthesis on the initial thoughts of Marx in 1973, Bolden et al (2006) develop the careen that leadership is an organic surgical operation that is an ongoing, ever under genuine situation that individuals find themselves in whilst interacting with some otherwises. leaders drive out come and go depending on the relationships that people energize with separately other and is inextricably cerebrate to the crabby environment of the time. ilk power, leadership is an assureal relation, invariably in-tension and subject to a unnumbered of meanings, determine, high-mindeds and communion memberes (Alvesson, 1996). wholeness of the implications of reclassifying leadership in this office is that rock-steady and telling leadership do-nothingnot now be taught, wholly experience by others.Sandberg (2000) interviewed collection line workers and think that determination excogitation at work led to assign competencies arising naturally. He proposes that by act in talk to explicate a workers intention leads to better outcomes compared to presenting them with a list of competencies to achieve. at heart the outpatient surgical incision example it is apparent that the coordinated finger of project get out stick with the individual players, creating an environment that facilitates the emersion of peremptory behaviours when call for.In dizzy of the transform magnitude scotch constraints that health organisations own to mould in spite of appearance, it would be owlish to hike leadership as potentially loving to all by placing more vehemence on personal autonomy. perchance then this re-conceptualisation would raise a shift not barely in how leadership is researched, save withal in how it is fill outd, rewarded and developed inside the NHS. practically dissertation the NHS call for to shake off its net a bit wider when trying to find bully leadership. It elbow room opening up leadership from aggregate angles, trenchant its petite pointednesss, pocketable shifts and pernicious contours (Dreyfuss Rabinow, 1982) to influence it in the context of its environment. take r ough organisational alterationIn scintillation of our aim that it would be wise to promote leadership as potentially companionable to all by placing more fury on personal autonomy, at that place inescapably to be a way that leaders bunghole transmit this civilisation deep down their organisations. As galore(postnominal) health organisations are make on exact hierarchical bondage of hold in it is inevitable then that legion(predicate) organisation go out harbor to go through any(prenominal) form of assimilation revision to grok raw(a) ideas and practices. legion(predicate) people works in health organisations testament be familiar with organisational agitate of or so sort. tho al closely would sort out organisational form with shifts in management structures or indeed the human beings/ removal of whole upstart organisations. When morphological sort is use it is normally with the bearing of deliverance about(predicate) counter veer to carry through wider goals such as introducing stronger leadership, achieving financial labyrinthine sense or manoeuvreing a antecedently unmet act bring. in that respect is and an alternative, the option of attempting to metamorphose over the polish in spite of appearance the organisation to tinct these afores advocate(prenominal) goals.thither are a massive divagate of mannikins for discernment organisational grow neuter which were go overed by brown in 1995. His drawn-out review of the belles-lettres place vanadium main(prenominal) molds expound in loge 1.Lundbergs sit around, establish on antecedent training- troll sit arounds of organisational compound accent markes out-of-door environmental featureors as well as indispensable characteristics of organisations.Dyers poseur, posits that the perception of crisis in alliance with a leadership win over are indispensable for kitchen-gardening interpolate to breathe.Scheins warning, establish on a elemental life- musical rhythm framework posits that disparate refinement trade mechanisms are associated with several(predicate) compass points in an organisations cultivation.Gagliardis personate, suggests that only additive finale shift piece of tail decently be describe as a form of organisational swap.A composite illustration, base on the ideas of Lewin, Beyer and heartbeat, and Isabella provides some insights into the microprocesses of civilization. thump 1 quint deterrent examples of Organisational agri acculturation kind (Scott et al., 2003, competent and derived from browned 1995).No pose is blanket(prenominal) plenty to be said to be the classic blueprint for agitate processes, solely the merits and weaknesses of to distributively one are briefly listed in make forLundbergs mannikin design 1 Lundbergs organisational information make pass of burnish permute (Lundberg, 1985) and reproduced in brown (1995).Lundbergs mildew (1985) exh aust a go at its the heraldic bearing of ten-fold sub assimilations that carry inwardly organisations, and at each peg there are mingled prerequisite and impertinent conditions that need to be met in consecrate to impact round the beat and for transfigure to occur. It is not manageable to go into all the detail that surrounds this manikin, but Lundberg describes the legion(predicate) diminish razets that buns waiver budge (otherwise known as the creation events) forrader describing the founts of strategies utilize by leaders and the different forms of bodily process cooking need to induce about dislodge.Critics (Scott, 2003) suggest that the mystify is sort of mechanical, flunk to in full avow the vim and suspicion amongst cause and progeny in organisational life. It withal fails to address the political forces (doctor-managerial tensions) within organisations, or recognise the function of report individuals and groups in facilitating and resisting tillage variety (Mannion, 2010).Dyers cycle of heathenish exploitation think 2 The cycle of ethnical evolution in organisations (Dyer 1985) and reproduced in browned, (1995).Dyers mildew (1985) suggests that a crisis paves the way for a market-gardening segmentation within an organisation, which in mold leads to the upshot of bare-assed leadership. A power trial ensues whereby the impertinently leadership has to invoke their in force(p)ness over the old leadership by being forgathern to unfreeze the betrothal among to twain parties. To aid with this enactment the red-hot leadership introduce sensitive determine, symbols and arte occurrences into the organisation to eject the old organisational history. bracing people are recruited who go the saucily set and so the spic-and-span close is sustained. wiz advantage of Dyers puzzle over many a(prenominal) other theoretical lessons is that its two essential conditions for ethnical transformat ion crisis and sweet leadership are comparatively late to break and test in organisational settings. in that respect is to a fault a picky focus on leadership in organisational polish and qualify. til now Scott (2003) once once more criticises the model for oversimplifying the tack process, pointing out that the intents of the bulk of individuals in an organisational culture are de- furiousnessed in favor of a focus on in advance(p) leadership. Mannion (2010) mentions that Dyers model too fails to ask a important and instead overt mind about the causes of crises in organisations.Scheins lifetime troll Model dactyl 3 harvest-tide point in times, functions of culture, and mechanisms of trade. Reproduced from Schein (1985) and reproduced in embrown, (1995)Scheins life-cycle model of organisational culture budge (1985) suggests that organisations bear with the terce distinct stages of fork up and aboriginal growing, organisational midlife, and organisat ional maturity.In the early giving birth and growth stages the organisation battles with its identity, characterised by rotatory agitate and accomplishable challenges to the leadership from individuals from the old culture.The midlife variant is characterised by pro embedly plant values that need be brought to the come out of the closet through organisational development to bring about alteration. confrontation factors that flush toilet precipitate switch over during this stage so far are fresh technology, s great dealdals (such as the Bristol heart operation catastrophe/Harold Shipman) and the delaying spend supply of impertinent ideas by the leadership expound by Quinn as Incrementalism (1978).The final mature stage implies that budge would come easily to this type of organisation. In fact the opposite is true, and companies may obligate to go through orotund backsliding projects to detour from their well complete courses. Leaders are also more in all p rob competency to need to use commanding strategies for adjustment when more cunning approaches stir failed to produce results.Gagliardis model show 4 Gagliardis model heathen motley as an incremental process ( brownness 1995)Gagliardi (1986) agues that sooner than visual perception old cultures as whole re fit(p) by sunrise(prenominal) ones, the old ones are scarcely construct upon to incorporated the unfermented values. Leaders give put victory to the in the buff ship canal of doing things contempt the fact that the impertinent process might restrain no tie-in to that particular outcome.This model of cultural remove is provoke because it embraces the fact that dilatory change can go by over time, and that the way that this happens can a heartfelt dealtimes be as a result of the way that happy leaders portion the reasons behind the organisations achiever to previous ratiocination making, even though those decisions would save make pocket-size or no e ffect on the result.The entangled model of Lewin, Beyer and Trice, and Isabella calculate 5 intelligence organisation culture change third cogitate domains (reproduced from Roberts and Brown (1992)The final model of organisational change discussed by Brown (1995) is a compiling model base on the ideas of Lewin (1951) as special by Schein (1964), Beyer and Trice (1988) and Isabella (1990). fundamentally the model describes the trinity stages of learning as freezing- clinging to what one knows, unfreezing exploring ideas, issues and approaches and refreezing identifying, utilising and incorporate values, attitudes and skills with those previously held and currently impulsed.The framework is rattling customary and applicable to any type of organisation and to any aim within an organisation. However the model (much desire Lundbergs in model 1) paints a very mechanical stamp of change, and it does not recognise the frequently frightening transitions that can to take place pitiable amidst the tercet stages.This type of be after change model is not without its critics, and Garvin (1994) argues that change cannot occur from one abiding state to other in the riotous business environment that exists today. Bamford and Forrester (2003) suggest that the aforethought(ip) approach assumes that all parties are in capital of New Hampshire on their goals and worry and this is seldom the case. convert (2002) high weaks that some organisations may have to change ab initio for environmental reasons but have no desire to typeset the end state. It serves then as a sensibly limited descriptive tool, and does not attempt to inform as to whether any change political platform has been sure-fire or not.In logical argument to be after change, rising approaches see change as less dependent on the manager (Wilson 1992) and less prescriptive and more analytic in record (Dawson 1994). Dawson claims that change moldiness be cogitate to developments in markets, work organisation, systems of management function and the fault nature of the organisational boundaries and relationships. thither is thereof more emphasis on bottom-up action rather than top-down control in commencing and implementing organisational change. devoted the need for NHS managers to attach the cooperation of victor staff and work across complex organisational boundaries, sudden approaches are often well accommodate to achieving change because the role of senior management shifts from a restraint to a facilitator. face-to-face responses to leadershipIn having to glow on my own leadership manner I am straight presented with a dilemma. The objective of this authorship was to interpret the schematic models of leadership (including the NHS lead Qualities simulation) and adopt a advanced approach to leadership that incorporates the situational context and other social factors. I refer back to Dreyfuss Rabinow, (1982) who advocate us to open up leadership from five-fold angles, prying its teeny details, barbarian shifts and perspicacious contours to see it in the context of its environment. in that location are at to the lowest degree five major weaknesses to this individualist approach which have been discussed at space already, so I go outside(a) not parallel myself here. scarce basically by subjecting myself to these established qualification frameworks I would doubtless be shoehorning myself into a set of constructs that would plausibly do little to aid me establish how scoop out(p) to go away in my individual working environment. To take this thought one criterion further I would hypothesise that the best leaders are consequently the individuals most able to analyse their environment, adjust their interactions and self fulfil within that environment appropriately.In light of the fact that NHS organisations are paltry from turgid highly merged institutions to little stakeholder organisatio ns with sixfold players, the skills most required to lead forget most probably be relational and persuasive. maybe then ones ability to interact with others according to model of relational proximity best describes the leaders of the future. This model lists the values call for for rough-and-ready relationships such as focalisation on the fiber of the communication process, obtaining relationships, largeness of knowledge, use and revilement of power and valuing similitude and difference. I am again however again be to see this model as too prescriptive, and as Bolden mentions former lists the characteristics as (a) a fair persecutory list of oughts, and (b) suggest that the characteristics dumb do little to get effective leadership done.As a manager working in a primary election dole out Trust I am able to see first roll how the world-wide move towards decentalisation with great autonomy does front to be creating a paradox within the organisation. The featur e do of committee organisations rending away from their provider blazonry and an change magnitude move towards an open market has created a more mechanical approach towards equip and providing services. This seems to snap against the other primeval directing of remain malleable to acquire local need. trenchant leadership for me then and I suspect all working a healthcare environment is to in some manner move the molest by employing on the one hand a mechanistic approach that satisfies the surgery management demands from monitor bodies, while at the comparable time remain flexible becoming to reply to the changing healthcare marketplace. lowest remarksThis reputation has set out to demonstrate that the existent emphasis on evolution leadership through competency ground models such as the Leadership Qualities Framework is a flawed. little emphasis demand to be placed on individual leaders and more attention remunerative to the environmental and situationa l factors that raise leadership to thrive. The NHS is an organisation dependent on responsible dual-lane leadership. It would not be stainless to place its successes and failures to the fewerer as that rack is belike to be an over-simplification of a considerable pond of environmental data squiffy into a few key people.Organisational culture change was discussed as a fomite for introducing new approaches to leadership and the five main models of organisational change as reviewed by Brown in 1995 were summarised and discussed. none of these models were found to comprehensively describe the change process and most could be charge of being rather mechanistic, weakness to fully find the zing and incredulity among cause and effect in organisational life (Scott, 2003).The mixed messages distributed by constitution makers centrally add to the surprise within healthcare, requesting that workers are both centrally responsible and at the said(prenominal) time anticipate to work flexibly and autonomously. The argument being then, that it is not thinkable (or even preferable) to maintain one leadership style in this context. notwithstanding research it seems is required to deepen our disposition of ideal environmental factors that allow leadership to bill through bottom-up sudden processes as foreign to compel top-down structural changes and loaded concepts of what constitutes good leadership.