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Does Leadership Matter for Healthcare Service Quality? Evidence from NHS England

Author

Listed:
  • Shimaa Elkomy

    (Surrey School of Economics)

  • Zahra Murad

    (Portsmouth Business School)

  • Veronica Veleanu

    (Surrey Business School)

Abstract

In this paper we provide first-hand evidence that leadership quality matters for the quality of healthcare provision, based on NHS England hospital trust data between 2010 and 2014. This is the first paper to study this relationship using individual leadership styles, namely, task-, relations-, change- and integrity-oriented, and for different metrics of quality of healthcare provision, including staff and patient satisfaction survey measures and clinical performance indicators. We find that task-oriented leadership has the strongest relationship with staff-rated hospital quality while change-oriented leadership relates most to patient satisfaction and the clinical measure. We also find some evidence that organizational autonomy and competition across hospitals moderates the effect of leadership quality on healthcare quality. Overall, our results indicate that ideal healthcare leaders should behave as integrated leaders and that leadership matters at all levels of organizational hierarchy. This has important policy implications for continued support for the development and funding of integrated leadership programs in healthcare.

Suggested Citation

  • Shimaa Elkomy & Zahra Murad & Veronica Veleanu, 2018. "Does Leadership Matter for Healthcare Service Quality? Evidence from NHS England," Working Papers in Economics & Finance 2018-08, University of Portsmouth, Portsmouth Business School, Economics and Finance Subject Group.
    • Handle: RePEc:pbs:ecofin:2018-08
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    1. Cooper, Zack & Gibbons, Stephen & Skellern, Matthew, 2018. "Does competition from private surgical centres improve public hospitals' performance? Evidence from the English National Health Service," Journal of Public Economics, Elsevier, vol. 166(C), pages 63-80.
    2. Christiane Bradler & Robert Dur & Susanne Neckermann & Arjan Non, 2013. "Employee Recognition and Performance: A Field Experiment," Tinbergen Institute Discussion Papers 13-038/VII, Tinbergen Institute.
    3. Nguyen Thi, Phi Linh & Briancon, S. & Empereur, F. & Guillemin, F., 2002. "Factors determining inpatient satisfaction with care," Social Science & Medicine, Elsevier, vol. 54(4), pages 493-504, February.
    4. Brown, Michael E. & Trevino, Linda K. & Harrison, David A., 2005. "Ethical leadership: A social learning perspective for construct development and testing," Organizational Behavior and Human Decision Processes, Elsevier, vol. 97(2), pages 117-134, July.
    5. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    6. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 82(2), pages 457-489.
    7. Mannion, R. & Davies, H.T.O. & Jacobs, R. & Kasteridis, P. & Millar, R. & Freeman, T., 2017. "Do Hospital Boards matter for better, safer, patient care?," Social Science & Medicine, Elsevier, vol. 177(C), pages 278-287.
    8. Christiane Bradler & Robert Dur & Susanne Neckermann & Arjan Non, 2016. "Employee Recognition and Performance: A Field Experiment," Management Science, INFORMS, vol. 62(11), pages 3085-3099, November.
    9. Propper, Carol & Burgess, Simon & Green, Katherine, 2004. "Does competition between hospitals improve the quality of care?: Hospital death rates and the NHS internal market," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1247-1272, July.
    10. Ekvall, Göran & Arvonen, Jouko, 1991. "Change-centered leadership: An extension of the two-dimensional model," Scandinavian Journal of Management, Elsevier, vol. 7(1), pages 17-26.
    11. Pérotin, Virginie & Zamora, Bernarda & Reeves, Rachel & Bartlett, Will & Allen, Pauline, 2013. "Does hospital ownership affect patient experience? An investigation into public–private sector differences in England," Journal of Health Economics, Elsevier, vol. 32(3), pages 633-646.
    12. Veronesi, Gianluca & Kirkpatrick, Ian & Vallascas, Francesco, 2013. "Clinicians on the board: What difference does it make?," Social Science & Medicine, Elsevier, vol. 77(C), pages 147-155.
    13. Kessler, Daniel P. & McClellan, Mark B., 2002. "How liability law affects medical productivity," Journal of Health Economics, Elsevier, vol. 21(6), pages 931-955, November.
    14. Goodall, Amanda H., 2011. "Physician-leaders and hospital performance: Is there an association?," Social Science & Medicine, Elsevier, vol. 73(4), pages 535-539, August.
    15. Amy C. Edmondson, 2003. "Speaking Up in the Operating Room: How Team Leaders Promote Learning in Interdisciplinary Action Teams," Journal of Management Studies, Wiley Blackwell, vol. 40(6), pages 1419-1452, September.
    16. Leonard, Kenneth L., 2008. "Is patient satisfaction sensitive to changes in the quality of care? An exploitation of the Hawthorne effect," Journal of Health Economics, Elsevier, vol. 27(2), pages 444-459, March.
    17. Antje Hammer & Onyebuchi A Arah & Maral DerSarkissian & Caroline A Thompson & Russell Mannion & Cordula Wagner & Oliver Ommen & Rosa Sunol & Holger Pfaff & on behalf of the DUQuE Project Consortium, 2013. "The Relationship between Social Capital and Quality Management Systems in European Hospitals: A Quantitative Study," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
    18. Fraser Macfarlane & Joanne Duberley & Chris Fewtrell & Martin Powell, 2012. "Talent management for NHS managers: human resources or resourceful humans?," Public Money & Management, Taylor & Francis Journals, vol. 32(6), pages 445-452, November.
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    More about this item

    Keywords

    Healthcare Leadership; Integrated Leadership; Service Improvement; Public Service; England;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • H57 - Public Economics - - National Government Expenditures and Related Policies - - - Procurement

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