Leading in the NHS during the Covid-19 pandemic: A leader-member exchange perspective

This commentary paper provides a comparison of the leadership approach used in the NHS pre and during the COVID-19 pandemic from the experiences of an NHS leader through the lens of the Leader-Member Exchange (LMX) theory (Dansereau, Graen, & Haga, 1975). LMX theory recognises the importance of the leader-follower relationship on the achievement of shared goals, performance management and delivery of outcomes. During the COVID-19 pandemic, it was experienced that in the NHS, the safety, wellbeing and resilience of the employees took precedence over individual performance achievement. Patient care and safety always remained the highest priority for the NHS, but without the staff to deliver that care, the NHS would not have been able to cope with the challenges that the pandemic created. The leadership style required during this time was therefore one of compassion, kindness, support and trust. This can be associated to an authentic, paternalistic leadership style. LMX theory has been used in this commentary paper as the framework in describing how the leader-follower relationship was either developed, changed, maintained or strengthened during the COVID-19 pandemic from a first-hand account of an NHS leader. By recognising the shift in focus of the leader-follower relationship in the NHS, it can be suggested that there has been a change in the NHS culture. A call for research is made to ascertain whether the cultural change in the NHS is recognisable across the entire national institute and whether the leader-follower relationship is at the centre of this change. Additionally, a call for further research is made in relation to the development and sustainability of the relationship between leaders and followers during times of intense pressure, and connecting the emotional, social, influence to management science.