Does a new leader need a new direction?

One of the easiest mistakes in senior appointments is to assume that a new leader arrives to invent a new future. Leadership interviews often reinforce that assumption. Candidates are expected to present a diagnosis, identify priorities and explain what they would change. Boards want confidence and clarity, particularly when an organisation is under pressure.

The difficulty is that certainty is easier to display than judgement. A leader can arrive with a compelling account of everything that needs to be different before they have properly understood the organisation they are being asked to lead. In those circumstances, confidence may tell us less than curiosity.

Writing for The King’s Fund earlier this year, Kathryn Perera and Simon Newitt challenged the idea that healthcare leaders should be all-knowing problem-solvers. They argued instead for leadership that draws on the expertise of others and remains open to learning. That raises an uncomfortable question for appointments: how do we assess someone’s ability to learn when so much of the process rewards what they already know? Leila Morris’s recent article, also for The King’s Fund, provides a useful illustration. She describes a community mental health centre established in Lewisham during the 1980s, bringing together mental health care, housing advice and welfare support. Many of the ideas now associated with neighbourhood health were already present. Her account prompts a simple question: why do some promising approaches repeatedly fail to become embedded? The answer is not always that the original idea was wrong. Sometimes good work struggles because it loses sponsorship, patience or organisational focus.

That has implications for how we think about leadership. The most valuable contribution a new chief executive or director makes may not be identifying something entirely new. It may be recognising something worthwhile that already exists, understanding why it has faltered and creating the conditions for it to succeed.

 

The real test is whether leaders can distinguish between what is ineffective and what is simply under-supported.

 

We do not always celebrate that form of leadership. New strategies, restructures and transformation programmes have obvious authors. Reviving a neglected partnership, backing an effective team or giving an existing approach time to mature is less visible. Yet those decisions can require just as much judgement. None of this is an argument against change. Some organisations need substantial change, and listening should never become an excuse for avoiding difficult decisions. The real test is whether leaders can distinguish between what is ineffective and what is simply under-supported. Are they prepared to challenge their first assumptions? Can they recognise when the right answer is to persist rather than replace?

For those involved in appointments, these are questions worth exploring more deliberately. We routinely ask candidates what they changed. We ask less often what they chose not to change, whose advice altered their plans or when they concluded that an existing approach deserved more time. Those answers can reveal as much about judgement as any transformation story. Boards have a role as well. If success in the first six months is measured largely by visible departures from the previous regime, new leaders have little reason to acknowledge strengths they inherit. Boards can encourage a different approach by signalling that thoughtful assessment is valued alongside decisive action.

Healthcare needs leaders who can make difficult choices. It also needs leaders confident enough to recognise when the right course was started by somebody else.