Table 2

Followership and leadership approaches

Leadership approachesFollowership approachesWhat they value from their leader
Caring, compassionate leadership21 22 A caring, compassionate follower is invested in people (patients, families and colleagues), wants to relieve their suffering, and support, enable and improve the life of others.A leader who displays compassion and caring behaviour to all
Opportunities to be able to provide and improve care
Collaborative, collective, shared leadership23
Distributed, dispersed leadership24
A collaborative (collective) follower sees the advantages of working closely with others.
Willing to help develop a culture that shares and distributes power throughout the organisation
Offers to take leadership even if low in the hierarchy
A leader who works in a collaborative way in multidisciplinary teams and projects
Involves and empowers them in initiatives and projects as an equal
Asks them to take on leadership roles within their scope of competence
Relational, transformational leadership25 26 A transformational follower is heavily invested in people, relationship building and helping others achieve their own potential.A leader who pays attention to them, their career development and personal growth, who gets to know them as a person, who stretches them, provides effective feedback, and communicates regularly and appropriately
Complex, adaptive leadership27–29 A complex, adaptive follower is willing to work with ambiguity and ‘mess’, has ‘cognitive complexity’, seeing the system as a complex, interconnected whole and promotes interdependent working.A leader who operates at system level, understands the interdependency of teams, departments, services and organisations
Involves them in service change and new pathways
Inclusive, person centred30 31 An inclusive, person-centred follower welcomes and values true diversity (of ideas, views and personal characteristics) and is focused on involving people in decisions, cocreating ideas and initiatives.A leader who clearly values people, includes everyone in conversations and developments
Does not pay lip service to listening to ideas that are different from their own
Servant leadership32 A servant follower is one who works with humility, integrity, wisdom and altruism for the greater good, wants to make a difference (to lives and to services) and leave a lasting positive legacy.Leaders who are humble and who can articulate their core values around why they became (and still are) doctors or health professionals
Willing to go the extra mile for their patients/service and value followers who do so
Value-led, ethical, moral leadership33–35 Value-led, ethical followers are highly driven by their core values and sense of purpose, want to do ‘the right thing’, and may be activists or whistle-blowers in driving change and tackling injustice.Leader who hold and demonstrate core values, have an ethical stance and attention to rules
Support their followers in challenging injustice or poor care
Willing to speak out