Healthcare leadership with political astuteness

Healthcare organisations are complex political arenas in which actors struggle to shape the organisation and delivery of care. There is growing interest in the idea that those leading change need a distinct set of political skills to understand and navigate the politics of change. This chapter introduces the concepts of political skill and astuteness and shows their relevance to healthcare leadership. It demonstrates the relevance of these skills by looking at the forms of healthcare politics found at the interpersonal, inter-professional and inter-organisational levels, and how different sets of skills help deal with the common and distinct political issues at each level. At the interpersonal level, interpersonal skills in persuasion and influence are important for dealing with ‘difficult’ or ‘influential’ people. At the inter-professional level, skills and strategies for understanding and managing the prevailing political landscape are important. At the inter-organisational level, it is important to build legitimacy through coalitions of actors, especially when faced with limited formal authority. Although a political skill ‘playbook’ might be relevant to leaders, the context-specific nature of change means that leaders will more likely benefit from reflective learning as they refine and hone their skills.