ABSTRACT
All health organizations are going to get stuck because of the impact that the work is having on individuals. Although there are no magic solutions to the structural problems of managing healthcare, the proposal is that managers – whether clinical or not – should reorient away from targets towards teams using a tried and tested model of interdisciplinary and interorganisational team working. The Dutch system protects carers from falling into in-work poverty and de-skilling by having higher protections and investment in skills development. The research indicates that there has been a growth in a hierarchical 'command and control' system of management from national to local levels in the NHS. The team's management of cases sets the targets and therefore the measurements, rather than the other way around. Democratic leadership prioritizes practices of listening, observing, auditing, self-awareness, social-awareness and emotional management techniques. For the people working as frontline managers and team leaders, taking up leadership positions is a big task.
