The NHS is entering a new era of leadership. With the launch of the NHS Leadership and Management Framework, NHS England has set out a clear ambition: to create a consistent, professional approach to leadership and management across health and care, grounded in accountability, collaboration, inclusion and continuous improvement.
For those of us who have spent years championing collaborative leadership, community participation and learning across boundaries, much of this feels familiar. In many ways, the new framework formalises what some of the most effective leaders and organisations have already discovered: complex challenges cannot be solved by heroic individuals working in isolation. They require people to learn together, lead together and create change together.
This is why the principles behind Collaborate Out Loud feel particularly relevant at this moment.
A Shift from Individual Leadership to Collective Leadership
The NHS Leadership and Management Framework was developed in response to the Messenger and Kark reviews and aims to establish a common set of standards for leaders and managers across the NHS. At its heart is the recognition that excellent leadership is not simply about authority or hierarchy. It is about behaviours, relationships, trust and creating the conditions for others to succeed.
The framework highlights the importance of:
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- Collaborative working
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- Building productive relationships
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- Inclusive leadership
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- Continuous learning and development
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- Accountability and integrity
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- Improvement and innovation
These themes align strongly with the Collaborate Out Loud philosophy, which is built around creating simple, surprising and social spaces for change, where people can connect, learn, share and act together.
Both recognise that leadership is less about having all the answers and more about creating environments where collective intelligence can emerge.
Working Out Loud in a Complex System
One of the defining principles of Collaborate Out Loud is to “work out loud as we go”. This means sharing learning, amplifying voices, making thinking visible and being open about both successes and failures.
In a health and care system facing increasing complexity, no single organisation has a complete picture of the challenges ahead. Whether we are tackling health inequalities, workforce pressures, prevention, community wellbeing or integrated care, progress depends on how effectively we share knowledge and learn from one another.
The NHS framework places significant emphasis on development, reflection and learning. The introduction of a national leadership and management code, competency standards and self-assessment process encourages leaders to continuously reflect on and improve their practice.
Working out loud is therefore not just a communication choice. It is a leadership practice. It helps organisations move from isolated expertise to shared learning, from duplication to collaboration and from compliance to genuine improvement.
Collaboration as a Core Leadership Capability
Perhaps the strongest connection between the framework and Collaborate Out Loud is the explicit focus on collaboration.
The framework identifies collaborative behaviours and relationship building as essential leadership capabilities. Effective leaders are expected to work across organisational boundaries, build trust and create partnerships that deliver better outcomes for staff, patients and communities.
This mirrors many of the approaches embedded throughout the Collaborate Out Loud portfolio, including:
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- Place-Based and Collaborative Leadership
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- Social Leadership
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- Communities of Purpose
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- Collective Impact Lab
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- Collaboration Sprints
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- Trust Out Loud
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- Learning Out Loud
These approaches recognise that sustainable change rarely comes from traditional top-down approaches. It emerges through relationships, shared ownership and collective action. In essence, collaboration is no longer a “soft skill”. It is increasingly a strategic capability.
Amplifying Lived Experience
One of the most encouraging developments in both NHS policy and leadership thinking is the growing recognition of lived experience as a form of expertise.
Collaborate Out Loud places significant emphasis on participation, fair exchange and valuing lived experience alongside professional knowledge. Its work around Community Voices, participatory approaches and fair exchange seeks to ensure that people are not simply consulted but actively involved in shaping decisions.
The new NHS leadership agenda similarly recognises the importance of responding to the needs of patients, communities and staff and creating more inclusive ways of working.
The future of NHS leadership will depend not only on clinical and operational expertise but also on leaders’ ability to listen, convene and co-create solutions with the people most affected by decisions.
Building Cultures Rather Than Programmes
One of the risks in leadership development is focusing solely on programmes rather than culture.
The NHS framework is significant because it seeks to embed leadership expectations into recruitment, appraisal, talent development and organisational practice.
Similarly, Collaborate Out Loud is less interested in one-off interventions and more interested in nurturing cultures where:
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- Learning becomes everyone’s responsibility
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- Curiosity is encouraged
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- Diverse perspectives are welcomed
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- Trust is intentionally built
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- Knowledge is shared openly
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- Collaboration becomes part of everyday practice
These are not project outcomes. They are cultural conditions that enable innovation and improvement to flourish.
The Opportunity Ahead
The NHS Leadership and Management Framework represents an important opportunity to professionalise leadership and management while creating greater consistency across health and care.
Yet frameworks alone do not create change. Real transformation happens when leaders choose to work differently. When they prioritise relationships alongside performance. When they create space for reflection alongside delivery. When they value community wisdom alongside professional expertise. And when they are prepared to collaborate out loud rather than lead alone.
As the NHS continues its journey towards more integrated, place-based and community-centred care, the principles of Collaborate Out Loud offer a practical way of bringing the framework to life.
The challenge for all of us is simple. How do we create leadership cultures where learning is shared, voices are amplified, trust is built and collaboration becomes the default?
Because ultimately, the future of the NHS will depend not just on better leaders, but on our ability to lead together.
