Everyone's Talking About

Leadership and management: what’s the difference?


There has been much debate and research into the theory of leadership vs. management over the past 40+ years, and this is no different in healthcare settings . This article aims to look at the differences and similarities between the two roles and their importance for the NHS long-term plan.

Leadership vs. management

In healthcare, there are those who lead and those who manage. Both roles are critical to the delivery of best and effective patient care.

A manager’s focus is on service delivery, finance, resources, staffing and practical issues. They may be a senior level of staff with authority.

Healthcare managers ensure effective organisation and utilisation of resources to achieve results.

There needs to be someone who does the practical management of change, finance organisation, structure and certainty – all offered by effective managers. In some cases, these roles will be carried out by the same individuals; in others, there will be separate leaders and managers. This will depend on the circumstances at the time.

There may be times where things are beyond the managers’ jurisdiction, for instance, national decisions or targets that must be instigated. This requires a combination of both skill sets – managerial and leadership. Communication is vital so everyone knows what is needed and expected of them.

A leader is not defined by their position in the hierarchy, but a capability to lead and inspire others.

To have a well-balanced, effective team, I believe we need management and leadership from across the service. We need the vision, the support and motivation offered by effective leaders, and the organisation, structure and certainty offered by effective managers. All this is essential, alongside teamwork, including supporting and listening to each member of the team.

Finding leaders from within

Regardless of structure, working together as a team is required to deliver the best care to respiratory patients. With this in mind, it is important to ensure teams are both managed well, but also have clear leadership. There’s much evidence that teamwork is an important contributor to health care quality,[1] which makes good team dynamics even more important.

Leadership may take different forms within a team. For example, the staff actually doing a job, working directly with respiratory patients to help manage their conditions, will often have ideas on improvements. We must listen to them, giving them opportunity to lead on a project, to see if their suggestions work or not, or if they need adapting.

Identifying areas for those working within teams to  take the lead on will help engage staff and make them feel valued, motivating them to embrace change to improve safe and effective patient care. Staff are more likely to find new and improved ways of doing things if they feel they are listened to, valued and supported as this provides a sense of psychological safety.[2]

Think about the team you work in. Who is the manager and who the leader(s)? Are they the same person? Does this alter? Where do you sit in the team? Sometimes it may be the manager, someone else or you who leads.


In the NHS long-term plan, respiratory disease is identified as a clinical priority, [3]  and there’s huge focus on strengthening and supporting compassionate and diverse leadership at all levels.[3] These two elements in combination show the need for nurturing leadership talent within the respiratory specialism.

With the constant changes happening across the NHS, leadership is vital to ensure staff are always up to date with developments. High-quality, compassionate leadership will be essential if the NHS is to deliver on the many ambitions set out in the NHS long-term plan.[4]

There will always be discussion and dispute about the nature of the relationship between leadership and management. However, there’s more consensus about the view that to be successful, organisations require a combination of effective leadership and management.[5]

There is a plethora of leadership training available, including the NHS Leadership Academy. Take advantage of the training available to develop your leadership skills for the future.

Effective leadership is vital in these times of change and pressure on the NHS – and we need to be ready to provide this.

Any advice given and opinions expressed in this article are those of the author and do not reflect the view of Chiesi Limited (Chiesi).  All content in this article is for informational and educational purposes only.  Although Chiesi strives to always provide accurate information, it is not responsible for and does not verify for accuracy any of the information contained within.

[1] The King’s Fund. Leadership and Leadership Development in Health Care: The Evidence Base. Available at: https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/leadership-leadership-development-health-care-feb-2015.pdf

[2] The King’s Fund. Caring to change: how compassionate leadership can stimulate innovation in health care. Available at: https://www.kingsfund.org.uk/publications/caring-change

[3] NHS. The NHS Long Term Plan. Available at: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf

[4] The King’s Fund. NHS leadership and culture: our position. Available at: https://www.kingsfund.org.uk/projects/positions/NHS-leadership-culture

[5] Algahtani, A. Are Leadership and Management Different? A Review. Journal of Management Policies and Practices. 2014; 2(3): 71-82

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UK-RES-2300626 May 2023