We are living in a time in which the NHS is facing many economic and social challenges. Our healthcare system is suffering budget constraints, an increased and aged population, higher patient expectations, nursing staff shortages and we are now treating more complex illnesses than ever before (Rivett 2015). In order to implement the changes needed to address these issues the government has put its focus on leadership and developing strong leaders in the NHS (NHS England 2014). However, the term leadership is a wide concept and throughout history, there have been many lines of thought on what leadership means and what attributes a good leader must-have. For the purpose of this essay, the focus will be on transactional and transformational leadership because according to the literature those are the leadership styles most prevalent. The current policy agenda regarding leadership in the UK encourages skills attributable to transformational leadership to address the challenges the NHS is currently facing, as opposed to transactional leadership. Nevertheless, the literature suggests that transactional leadership is still the leadership style most followed among nurses. In this essay, I argue why transformational leadership is the way forward to address the leadership crisis in the NHS.
First, I give an overview of the theories of transformational and transactional leadership linked to the context of an operating theatre department. Then, I describe the NHS policy framework in relation to leadership, its origin, and its links to the transformational leadership theory. This leads to a discussion of the further benefits of transformational leadership which I argue comes in the form of increased theatre staff development, motivation, and engagement. Following on from this, I discuss the objection that transformational leadership is insufficient to address challenges such as national nursing staff shortages, meeting surgical targets, or lack of funding, and training a manager with the transformational theory requires more training and time. Transactional leadership on the other hand can more easily achieve short-term goals, it’s more structured and easier to implement. I reject this by arguing that transformational leadership can lead to more productivity and efficiency, therefore, minimizing the effects of reduced budgets and the lack of nurses and can lead to better outcomes in the long term. I conclude that transformational leadership is the way forward to archive the NHS vision for the future despite the economic and socio-cultural challenges the UK is facing.