Perspectives on the role of an NHS chief executive officer: insights from experience

Background/Aims Senior NHS leaders hold highly pressured roles and are responsible for making decisions that affect patients, staff and services. However, there is a lack of research about how NHS chief executive officers (CEOs) conceptualise these roles. This study aimed to investigate the experiences of NHS CEOs. Methods A phenomenological study was conducted, with 20 NHS CEOs recruited through a combination of convenience sampling, snowball sampling and promotion through two national bodies. Data were collected using semi-structured interviews, which were recorded and transcribed verbatim. Data were analysed using the interpretative phenomenological analysis process, producing a narrative account to present analytical interpretations. Results Data provided empirical insights regarding participants’ personal experience of the CEO role, their leadership style, decision-making processes and staff engagement. Participants articulated personal vulnerability, a clear understanding of the need to deploy a range of leadership styles and a commitment to empowering staff. Conclusions NHS CEOs appeared to reject the idea of an ‘all-powerful leader’ who could solve all organisational problems, and reflected grounded optimism in their responses. These findings contribute to the important field of study regarding how public sector organisations such as the NHS are led. Implications for practice Leaders play a central role in creating the conditions for the NHS to adapt, innovate and change. The notion of grounded optimism at senior level is an important area for further exploration, specifically in terms of the balance between acknowledging challenges while holding hope for the future.