1. What is the perceived contribution of coaching to leaders in transition to more senior roles in the NHS?
Anne Gill
MA Coaching and Mentoring Practice
19th January 2017
Kinisi Ltd

2. WHY LEADERSHIP TRANSITION COACHING IN THE NHS?
I had worked in the NHS coaching leaders newly appointed to senior executive roles
Observed at close hand the significant challenges they faced in adapting to their new role.
Many newly appointed senior leaders struggled to cope with the demands of the role, public scrutiny, regulatory burden
Lack of support for senior accountable officers in the NHS ‘woefully inadequate’. Hunter Healthcare/HSJ 2015; Timmins 2016 (1)
High turnover in senior roles creating a leadership crisis in the NHS Janjua, 2014; Rose 2015 (2)
Kinisi Ltd

3. RESEARCH QUESTION AND AIMS
What is the perceived contribution of coaching to leaders in transition to more senior roles in the NHS?
In what ways does coaching help their transition?
What elements of the coaching process are most helpful for them?
Kinisi Ltd

4. Leadership literature relevant to role transitions
Literature review
Leadership literature relevant to role transitions
Psychological theory
NHS Literature
Coaching literature
Kinisi Ltd

5. Literature review highlights and Gaps
Evidence of executive derailment and failure
Significant adaptive challenges during transition from middle management to executive level
Evidence that executive coaching can deliver positive outcomes
Issue of transition under researched in coaching literature
Limited research on the client perspective

6. Methodology Interpretivist-constructivist paradigm
Qualitative research using case study method
Research subjects - 7 senior leaders in the NHS
Semi-structured interviews, face to face lasting between 60 – 90 minutes
Thematic analysis to analyse/interpret interview scripts

7. Research PARTICIPANTS
Role
Male
Female
NHS Org
Chief Exec 2
NHS Foundation Trust 1
NHS Trust
Ambulance Trust
Director of Nursing
Medical Directors
Total 4 3
Data collection
Sample
Coaches experienced in transformational learning
Clients who experienced a transformation during coaching
Face to face/ Skype interviews, taking between minutes
Open inquiry followed by direct questions about emerging categories
Data analysis
Initial coding of transcripts
Specific eye for action
Focused coding
Creation of mind-maps
Preliminary model developed
Memo’s
Exploring relevant literature
Range of senior leaders, male, female and from different organisations – seven in total
Very generous with their time, open about their transition challenges and the contribution of coaching
Kinisi Ltd

8. Research findings Providing a reflective and supportive space
Three key overlapping themes emerged
Providing a reflective and supportive space
Developing new role identity
Learning through the coaching process
Kinisi Ltd

9. In what ways did coaching support their transition?
KEY THEMES
 SUB-THEMES
Providing a reflective and supportive space
“ it’s having a safe space in which to talk about things and reflect on them, it’s an opportunity to spill your guts out on the table and hear yourself saying things”.
Developing capacities:
Relationship building
Managing expectations
Facilitating decision making
Adapting personal style and skills development
Developing new role identity
“being a clinician and going into leadership and the differences and all the rest of it, it was a coach that helped me unlock some of that”.
“I’ve always been very open, but when you’re under that level of pressure and scrutiny, it’s quite hard to be your authentic self because people are trying to push you to do something else. .that’s where the coach helps, ‘so what is the right thing? What happens in you down that path? How are you going to feel?”.
Dealing with self-doubt and confidence building
Developing new perspectives
Shift from clinician to leader
Discovering authentic self
Learning through the coaching process
“I think being an adult has been the absolute classic learning thing for me, just remembering to stay adult”.
Taking time out for reflection and thinking
Developing resilience and well-being
Facilitating transfer of learning

10. What elements of the coaching process were most helpful?
Providing a safe and supportive space
Developed self-efficacy, strength, resilience to cope
Focus and prioritisation
Taking time out for reflection and critical thinking
Combination of support and challenge, encouraged self-reflection
Engage in critical thinking, stand outside/gain distance, different perspective, change mindset
Facilitating new learning
Challenges/difficulties presented by the participants created emergent learning opportunities
Experimentation, trying new things, exploring choices
Developing learning agility
Coach as guide on journey of self-discovery
Kinisi Ltd

11. “the coach was just organising the traffic to make sure my journey was smooth. It’s like having a brilliant tour guide through all the different phases of the journey”. Medical Director “going from senior nurse to a director on the board, I thought I had most of the tool-kit, but actually what I needed was a whole set of other tools and some of my approaches that absolutely worked in the past, just wasn’t getting me where I needed to be”. Director of Nursing “he provided interventions that absolutely changed the course of my thinking and my approach to the role. I wouldn’t have been able to succeed without his support”. Chief Executive “new chief executives need a safe sounding board, someone who they are comfortable to talk to and admit at times they don’t know what they’re doing and should be provided with a coach or mentor”. Hunter Healthcare/HSJ Survey, 2015 (3)
Kinisi Ltd

12. Implications
Coaching plays a powerful part in supporting senior leader transitions in the NHS
Coaches need to understand the dynamics of transitions and the leadership challenges it presents
Importance of creating an environment that encourages reflective learning through challenge and non-judgmental questioning
Coaching contract needs to be minimum of 6 months, with months to help achieve real change
Kinisi Ltd

13. LIMITATIONS AND FURTHER RESEARCH
Single case study with a small number of participants
Perceptions limited to a range of new senior leaders
Future research might focus on gaining the views of the leaders’ manager, team members and other important stakeholders
Further research amongst newly appointed leaders who have derailed to understand if they had received coaching
Contribution of coaching in supporting the transition of female leaders in the NHS
Developing the capacities needed to operate at a senior level
Helping new leaders unlearn and learn new skills and behaviour
Kinisi Ltd

14. Your questions

15. REFERENCES (1 & 3) Hunter Healthcare/HSJ survey2015
Timmins, N (2016). The Chief Executive’s Tale, views from
the front line of the NHS. London: The Kings Fund
(2) Janjua, A. (2014). Leadership Vacancies in the NHS. What
can be done about them? The Kings Fund, London
Rose, L. (2014). Better Leadership for Tomorrow. NHS
Leadership review.
Kinisi Ltd