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Skip to 0 minutes and 4 seconds The question of what distributed leadership is, is an interesting question. And it’s a much more complex question than you assume. Distributed leadership is often used very loosely.

Skip to 0 minutes and 17 seconds And there are a plethora of other terms around: collective leadership, participative leadership, team leadership, strategic leadership, pluralistic leadership. I can go on and on. Now, these aren’t all the same thing. They have specific meanings. Now, I don’t want to be an academic pedant, but I am going to layout that specific meaning for you. For those of you who want to look at what the other forms of leadership mean alongside distributed leadership, go and look at Jean Louis Denis’ synthesis of this in the Academy of Management Perspectives in 2012. But I’m just going to focus on distributed leadership. That’s the question you asked me. I draw on John Peter Gronn’s work, which was published in Leadership Quarterly in 2002.

Skip to 1 minute and 4 seconds And Peter Gronn defines distributed leadership in the following way. And I think this is the most accurate definition. Distributed leadership has two dimensions. One, as it suggests, it’s distributed. So it’s about the extent, the extent horizontally across the organisation or across organisations if it’s a network of organisations and the extent to which it’s distributed vertically. So what you should see with distributed leadership is a vertical slice of actors across the organisation or organisations that lack leadership influence. But it’s more than that, because, if you just distribute leadership, it may have the effect of being fragmented or dispersed, i.e., people are pointing in different directions.

Skip to 1 minute and 47 seconds So a second dimension of distributed leadership that’s important is the extent to which the leadership actors align in their influence. So you should have this sort of what’s called conjoint agency and concertive activity so that everything’s going in the same direction. Yeah. I mean, not just in healthcare but more broadly, if you were to make the case for distributed leadership, there is some limited evidence that distributed leadership has a performance effect, i.e., improves organisational performance. And when you start unpicking why that’s so, you’d go, well, the decisions that are made, if leadership influence is distributed widely are more likely to be sensitive to context. And healthcare context is very specific.

Skip to 2 minutes and 35 seconds So you need a decision made with a lot of people exerting influence so that any decision– let’s say about service development, innovation– sits nicely in that healthcare context, which is heavily professionalised and heavily performance managed from the top. The second reason is– and this is quite intuitive– if you get people exerting leadership influence over decisions about service development and innovation, then they’re going to be more committed to that decision when you try and operationalise it. The third reason for distributed leadership– and I think this is particularly important in the development and delivery of public services– is we’ve got a democratic deficit in this country.

Skip to 3 minutes and 13 seconds So what the distribution of leadership allows is other actors to have leadership influence upon the decision, in particular users of service. So in healthcare, you know, we’ve got the patients and public. They should be involved, you know, for normative reasons. In education, you’d have the parents and the students. So it’s part of democratic governance. Typically, if we think of professional organisation in healthcare, it consists of a myriad of professions. So in a hospital, for example, there might be 100 different clinical professions, let’s say. And what typically happens with clinical leadership is we operate in silos. So, for example, if you have a nurse team leader, the nurse team leader in the main will manage his or her peers.

Skip to 4 minutes and 2 seconds So as far as the leadership influence is concerned, it will be orientated towards other nurses. The doctors will do the same. The dietitians will do the same, et cetera. So typically what you get, even where you do engender a cohort of strategic leaders, is they tend to focus on their own group. So what you need in terms of clinical leadership is someone who is prepared to and a context that allows clinical leadership to enact influence across a myriad of professions. And, of course, in healthcare that can be stymied by the way the professions are organised hierarchically. So it can be very difficult, for example, for a nurse to exert influence upon a doctor. So you think about this carefully.

Skip to 4 minutes and 55 seconds And if you’re having a multi-disciplinary team, either you co-opt a doctor into the leadership of that team and/or you co-opt a nurse to work alongside that doctor and/or you co-opt a manager to work into that clinical team, a traditional tripartite arrangement where there’s three people working together in that synergistic way, aligned in the right direction that cover management and two of the main clinical professions. And that’s the way to go about it.

Alternative notions of distributed and collective leadership

Now we will consider alternative perspectives on leadership, which have become popular in healthcare and other public services, associated with the notion of leadership that is ‘distributed’ or ‘collective’. In this video you will hear from Professor Graeme Currie, Warwick Business School.

The origins of the term ‘distributed leadership’ (DL) can be traced back to the work of Peter Gronn (2000) who described it as an alternative to existing views of leadership as exclusively understood in terms of the traits or behaviours of individual ‘leaders’. Gronn and others argue that management thinking has been enamoured with the ‘romance of leadership’, the idea of leaders as great men or heroes (such as Gandhi and Luther King, Jr). This idea is central to the traditional trait, situational, style and transformational theories of leadership which we described earlier this week. However, while individual leadership should not be ignored, the risk is that it may be too narrow and underestimates the contribution of other actors.

As an alternative Gronn and others propose a more systemic perspective, in which ‘leadership’ is conceived of as a collective social process emerging through the interactions of multiple actors. In this way leadership can be be understood in a holistic sense rather than simply as the aggregation of individual contributions. Implied is that the work of groups or teams may also be conceived of as forms of leadership or that leadership is not just the preserve of those who hold formally designated ‘leadership’ (or management) roles.

In a summary of the literature Boldem (2011) suggests that most accounts of DL share three broad assumptions:

  1. ‘Leadership’ is not a fixed trait or capability, but emerges from groups or networks of people who interact together,
  2. The boundaries of this emergent ‘leadership’ are open and fluid, depending on the situation;
  3. The expertise needed to perform this leadership is potentially distributed across many people and is not restricted to a select few.

A key implication therefore is that leadership may be both ‘vertical’ (top down) and ‘horizontal’ and that it is essential to recognise informal, emergent and collective acts of influence as well as those initiated by managers or people in formal positions of authority.

As noted, these ideas have become increasingly popular in the context of public services, notably healthcare. In the NHS, for example the Kings Fund has developed a series of reports calling for notions of collective leadership, with less reliance on heroic individuals. Collective leadership they argue can be defined as:

“…everyone taking responsibility for the success of the organisation as a whole – not just for their own jobs or work area. This contrasts with traditional approaches to leadership, which have focused on developing individual capability while neglecting the need for developing collective capability or embedding the development of leaders within the context of the organisation they are working in.”

It is suggested that collective leadership has the potential to transform the way in which care is provided and may hold the key to unlocking cultural change. Some argue that this approach to ‘collective’ or ‘team’  rather than individually based change leadership forms is also more appropriate to health organisations and is more likely to achieve results (Fitzgerald et al., 2013). In this way, collective leadership models have the potential to overcome many of the problems of coordination between different worlds of care, cure, control and community, outlined in the previous week’s materials.


Bolden, R. (2011) Distributed Leadership in Organizations: A Review of Theory and Research. International Journal of Management Reviews, 13: 251–269.

Denis, J.L., Langley, A. and Sergi, V. (2012). Leadership in the Plural. Academy of Management Annals, 6 (1): 1-73.

Fitzgerald, L. Ferlie, E., McGivern, J. & Buchanan, D. (2013) Distributed leadership patterns and service improvement: Evidence and argument from English healthcare. The Leadership Quarterly, 24 (1): 227-239.

Gronn, P. (2002) Distributed Leadership as a Unit of Analysis The Leadership Quarterly, 13 (4): 423-451.

Gronn, P. (2000) Distributed Properties: A New Architecture for Leadership Educational Management & Administration 28 (3): 317-338.

West, M., Eckert, R., Steward, K. & Pasmore, B. (2014) Developing Collective Leadership for Health Care, London: Kings Fund

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Leadership for Healthcare Improvement and Innovation

The University of Warwick