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Title: Heads above the parapet : identity construction and enactment in midwifery leadership
Author: Divall, Bernie
ISNI:       0000 0004 5357 5780
Awarding Body: University of Warwick
Current Institution: University of Warwick
Date of Award: 2014
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Within the NHS, there has been endorsement of a central role for clinical leaders in the organisation, where clinical leadership is defined as leadership for clinicians, by clinicians. This is a reflection of recent attempts by the NHS to move from a hierarchical, command-and-control, transactional model of leadership, to one based on a transformational, distributed approach. Assumptions have been made that new models can be adopted within the organisation at clinical level, but literature has identified significant challenges in the introduction of a clinical leadership model. Notable is the long-standing divide between clinicians and managers, with clinicians tending to denigrate the role of managers in the organisation. In addition to this, leadership development has often been unstructured and post hoc in the NHS, but recent policy has suggested a new approach, where clinical leaders are offered timely and appropriate development. The question arises, how do clinicians make a transition to clinical leadership, and what factors influence the construction and enactment of a clinical leader identity? To address issues of identity construction in clinical leadership, I focus on the case of midwifery, where there has been a struggle to attain a distinctive professional identity within the NHS. The profession has been singled out for attention in recent reports, on the basis of concerns relating to the ageing workforce profile and the devastating impact of poor or ineffective leadership. I use an in-depth case study approach, incorporating observation of three midwifery-focused leadership development programmes, narrative interviews with nine midwifery leaders, and interaction with an online midwifery forum, in order to gain insight into the challenges facing midwives who make the transition to leadership roles in the NHS. Using role and social identity perspectives, I explore the complex interaction between individuals, professional group and wider organisational structures in clinical leadership identity construction and enactment. I challenge ideas of shared language and identity within the midwifery profession, demonstrating the destructive nature of conflict within the professional group, and I address the challenges faced by the profession in establishing a distinctive identity at the organisational level. Both of these issues are found to be important in the construction and enactment of a clinical leadership identity.
Supervisor: Not available Sponsor: Economic and Social Research Council (Great Britain)
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: HD28 Management. Industrial Management ; RG Gynecology and obstetrics