CEO competence and development is a continuing concern in the NHS. As a
key feature of any CEO leadership role is responsibility for organisationally
critical decisions, and there is an increasing recognition of the role context plays
in effective leadership behaviour. This study examines the role of contextual
intelligence in relation to PCT CEO decision making behaviour. To do this, the
research addresses four questions: a) what does the literature say about CEO
contextual intelligence? b) what factors do PCT CEOs say they take into
account in different decision making contexts? c) what contextual factors do
they actually take into account? and d) what impact do the contextual factors
have on their decision making behaviour. A systematic literature review
resulted in a model of CEO contextual intelligence for CEO decision making.
Semi-structured interviews with 24 PCT CEOs in a NHS region about factors
influencing their decisions on generic strategies, national policies, regional
strategies and local plans revealed a hierarchy among contextual factors
applying to different decision strata. Semi-structured interviews and analysis of
CEO diaries two months later of the same focal decisions show the real critical
factors to be:- national policies themselves, the Strategic Health Authority and
the decision making process, for regional strategies; and Top Management
Team and structure for local plans.
Altogether, the research reveals that the PCT CEO’s decision making context is
rationally bounded; the relevant contextual factors differed significantly from the
literature derived model; the actual factors in practice differed from what were
espoused; choice of factors vary depending on decision trigger strata which
links to degrees of CEO autonomy; and macro level factors which were
indicated as significant from the systematic review were in fact ignored in
practice. A PCT CEO model of contextual intelligence is developed together
with a two dimensional model of underlying structures guiding PCT CEO
decision making behaviour. The findings have implications for governance
structures in the NHS, CEO decision making and senior leader development in
ii
the NHS in the context of the 2012 Health and Social Care Act. Areas for further
research in public sector, NHS and contextual intelligence are also identified.
| Identifer | oai:union.ndltd.org:CRANFIELD1/oai:dspace.lib.cranfield.ac.uk:1826/10451 |
| Date | 03 1900 |
| Creators | Koh, Yi Mien |
| Contributors | Bailey, Catherine |
| Publisher | Cranfield University |
| Source Sets | CRANFIELD1 |
| Language | English |
| Detected Language | English |
| Type | Thesis or dissertation, Doctoral, DBA |
| Rights | © Cranfield University, 2012. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder. |
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