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Your leadership style: why understanding yourself matters
  1. Clare Felicity Jane Price-Dowd
  1. People Directorate, NHS England and Improvement, Leeds, West Yorkshire, UK
  1. Correspondence to Dr Clare Felicity Jane Price-Dowd, People Directorate, NHS Improvement, Leeds LS1 4HG, West Yorkshire, UK; clare.price-dowd{at}


Understanding of personal leadership style has been shown to be a key part of effective leadership practice. It has been a topic of interest for many decades as we have tried to understand, and replicate, what makes those considered to be ‘great leaders’ so successful. This article gives a brief introduction to different leadership ‘theories’, leadership ‘styles’ and the effect they have on the ‘climate’ in organisations. Having an understanding of the different approaches can help leaders be more effective through comprehending how and why they do what they do, as well as helping them identify where and when they need to adapt their style. By considering how our understanding of leadership has evolved, it is possible to show how effective leadership is not linked to one approach. It is a combination of knowledge, attitudes and behaviours with a focus on both the task in hand and concern for those undertaking that task. Furthermore this understanding supports impactful personal development, which creates positive climates in organisations where compassionate and inclusive leadership behaviours can, and do result in better outcomes for staff and patients.

  • effectiveness
  • leadership assessment
  • role modeling

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Who, when flipping through a publication has not been tempted by the ‘personality quiz’, hoping to get the ‘mostly A, B or C’ that indicates we have the attributes for long and successful careers or lots of friends? While this level of ‘knowing how we are’ could be dismissed as flippant, when it comes to leadership, understanding our personal approach can be invaluable. If you asked people around you ‘what sort of leader do you think you are?’ they would most likely answer in the singular ‘I lead by example,’ ‘I build relationships with people,’ or ‘I don't tolerate underperformance’. They are unlikely to say ‘I do this here, and that on other occasions’ yet the most effective leaders are those who attune to their context, consciously adapt their practice and have an awareness of how their own style effects others. This article introduces the different theories and styles of leadership and how they can be used to create positive work climates. The key terms are given in table 1.

Table 1

Key terms

Evolution of leadership theory and understanding of style

A desire to understand what makes a successful leader is not new. For centuries there has been debate about what differentiated leaders from non-leaders, and leaders from followers. In a comprehensive review of leadership theories by Stogdill,1 a number of categories were identified and in the 80+ years since Lewin et al 2 published their theory on patterns of behaviour in 1939, we have seen an evolution from trying to identify ‘common traits’ based on inherent characteristics of ‘great men and women’ through to the what we now understand to be the successful combination of person, place and approach. Looking further into this evolution, although this is not a comprehensive list, it is possible to group the stages of development as follows:

  • Trait theory—for example as seen in the work of Carlyle3 and Stodgill1 is concerned with the type of person that makes a good leader and the innate qualities and associated leadership traits they have. A meta-study by the Centre for Excellence in Management and Leadership4 identified over 1000 leadership traits in the literature, which they distilled to 83 more or less distinct attributes. While no specific trait or combination was found to guarantee success, trait theory did help in identifying qualities that are helpful when leading others such as integrity and empathy.

  • Later, behavioural theory identified what good leaders do—effectively how they ‘lead well’. Examples include the Tannenbaum and Schmidt continuum5—seven stages of reducing control namely Tells, Sells, Suggests, Consults, Joins, Delegates and Abdicates; the Action-Centred Leadership Model of Adair6 which sets out the three responsibilities of the leader—‘achieving the task, managing the team and managing individuals’ and the Blake Mouton Managerial Grid7 also referred to as ‘The Power to Change’ which outlines two behavioural dimensions: Concern for Results and Concern for People.

  • Situational and contingency theory: looks at the leader in the context of where they lead. By considering how the leader’s success is directly influenced by their environment, it became possible to identify the conditions that support or constrain leaders as seen in work including Feidler8 Vroom and Yetton9 Yukl10; Hersey and Blanchard11; Thompson and Vecchio.12

  • Transactional theories—as seen in the work of Weber13 and later by Bass,14 focuses on the leader getting results by using process and structures while applying reward and penalty in response. Within this are power and influence theory, exchange and path-goal theory by House15 16 which concentrate on the relationship between leader and led as a series of trades or ‘leader-member exchanges’.

In more recent years, while the transactional and positive view of hero leadership has never entirely gone away, the notion of ‘Hero to Host’17 which describes the move to transformational and ‘new wave’ styles outlined by Burns18 Bass14 and Kouzes and Posner19 among others. Transformational leadership not only serves to enhance the motivation, morale, satisfaction and performance of followers, but also sees the leader role model compassionate and inclusive behaviours, which are valued. In ‘Good to Great’ by Collins,20 the Level 5 leader is described as possessing both indomitable will, but also humility and is often self effacing and shy, the opposite of what we might have previously described as leadership traits!

Relevance for leaders

Every day, leaders in healthcare must constantly analyse complex situations, engage, motivate, empower and delegate. Many leaders now operate within complex adaptive systems—organisations that are an interconnected whole of many parts, which may and may not function effectively together depending on changing circumstances. This calls for leadership skills and behaviours that can move between each required activity with seemingly effortless ease and without loss of effectiveness.

Having an appreciation of different theories and styles also helps us identify our reaction to these changing situations. In considering the global COVID-19 pandemic, the leadership behaviours required, and experienced, may be different to anything encountered before. The effect of leadership in this situation is profound and will have a lasting impact. Displaying command behaviours may be necessary but uncomfortable, while teams may not be used to being directed with minimal consultation. Sustained pressure may have a negative effect, but it does not follow that leadership behaviours slide into being disrespectful or non-inclusive—it is about the leaders focusing on the task and ensuring individuals and teams are clearly instructed on the part they have to play; consulted where possible and informed of when and when they need to do as instructed.

However, knowing about ‘how we are’ is only part of the picture, equally important is understanding the effect we have on other. Goleman21 found that the one of the biggest mistakes leaders make was to default to a style of personal choice rather than responding with the most appropriate in the situation, while Blanchard22 suggests that 54% of leaders only ever apply one preferred leadership style regardless of the situation. The result is that almost half of the time, leaders are using the wrong style to meet their current objective or lead the people around them well.

The danger here is trying to be the most popular leader and everyone’s favourite, rather than developing an authentic repertoire of skills. If you have never considered your leadership style or the types of leadership behaviours you have there are a number of tools to help such as the National health Service Healthcare Leadership Model. Based on research of the behaviours of effective leaders, Storey and Holti23 defined nine domains (Inspiring shared purpose: leading with care: evaluating information: connecting our service: sharing the vision: engaging the team: holding to account: developing capability and influencing for results) against which can leaders can self assess and gain pointers on how to strengthen their style.

Relevance for the work environment

Research by KornFerry Hay Group24 shows an up to 70% of variance in climate and an up to 30% increase business performance can be directly attributable to the climate leaders create through their style of leadership. This includes feeling included, supported and having a role that is meaningful. To help leaders create a positive climate, Goleman21 defined six leadership styles—see table 2—which he then correlated with the type of climate each created for those around them. Those able to deploy the styles in the left column have been shown to create high performing teams in positive climates.

Table 2

Leadership Styles and the climate they support (adapted from Goleman21)

These are not the only leadership styles: others include Autocratic leadership where leaders/managers make the decisions and employees follow orders as previously stated; laissez-faire leadership where the manager empowers employees but gives them few rules to follow with little oversight or direction: bureaucratic leadership where hierarchies and job titles to determine responsibilities and rules and servant leadership which focuses on the needs of employees, seeing them as the organisation’s most important resources and often treating them as clients, but only the six here were included by Goleman.

The effects of the leadership styles displayed and the effects they have on the climate within organisations has far reaching impact for team members. The ability to flex your leadership style and create a positive climate has been shown to create greater job satisfaction and pride in work, greater collaboration and creativity. Having an awareness of the effects of personal style, is therefore an essential part of a leaders toolkit and something every leader should have awareness of

In practice

Delivering health and care is highly complex and effective leadership calls for a match of style and approach to context and presenting challenge. Leadership styles is not a neat category of things, the increasingly interconnected world with ever-evolving technology has dictated a need for leaders who can adapt effortlessly as the situation dictates. Daniel Goleman21 likens leading to being a golfer—one game but choosing the right club, at the right moment, for the next shot. Lets think about what this could look like: again, thinking about the COVID-19 pandemic the deteriorating clinical condition requires a leader who draws on all their experience, interprets the situation, takes control and ‘tells’ in order to get the best outcome for the patient—transactional and it’s wholly appropriate. At other times, that same leader will need to take time to build relationships and coach others in order to give the best care possible.

We all have a natural tendency towards our preferred style and when under pressure, there is evidence that we ‘revert to type’, relying on the most comfortable part of our personality to see us though. Unfortunately this means using fewer of the leadership skills that usually provide balance. Skilful, mature leadership is about leading ourselves as much as leading others. This level of understanding our style helps us recognise triggers that support adopting the right style for the given situation.

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Different situations require different leadership style and each style can be considered a tool in itself. How we lead needs to be a combination of concern for the task in hand and also the people undertaking it, as both individuals and collectively as teams. We have looked briefly at small number of the plethora theories and styles that can help us understand how we lead. Leaders who understand themselves and can move effortlessly between a range of styles in response to changing situations have been found to have more positive outcomes for their teams and patients.



  • Twitter @clarepricedowd

  • Contributors CFJP-D completed all part of this paper:

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.