In this chapter:

We examine the challenges, or purposes, of leadership. What is it that leadership is trying to achieve?

First, we examine the challenge of ‘sense-making’ – how do leaders make sense of the context and the purposes they are trying to achieve, and how do they communicate this to others to create a clear sense of common purpose? We examine ‘big picture sense-making’ and then turn to consider the different types of problems that leaders may face, and the degree of match between their leadership strategies and the problem, or challenge, to be addressed. How do leaders think about and orchestrate the work to be done? We distinguish between technical and adaptive challenges (sometimes called tame and wicked problems) and the leadership approaches that seem to be most effective in tackling each of these two types of problem.

We then turn to examine five concrete leadership challenges for healthcare organisations. These are: the merger/acquisition challenge; leading partnerships and networks; leading organisational turnaround; leading organisational change, innovation and improvement; and nurturing future leaders in the organisation.