Shared Leadership Culture and Transformation of a Public Health Organisation. An Ethnographic Case Study of London’s NHS Nightingale Education Department

This thesis investigates the enabling conditions of shared leadership culture within healthcare organisations during times of crisis, with a particular focus on lessons from the NHS Nightingale London – Education Department (NLE) that may inform transformative change across the NHS and the wider health and social care system. The study is rooted in the researcher’s lived experience of leading collaboratively during the Covid-19 pandemic, which served as both context and catalyst for inquiry.<br/><br/>Addressing a critical gap in leadership literature, the research explores how shared leadership emerges, evolves, and functions as a social construct within crisis settings. The thesis examines leadership from the lens of social capital theory as a construct of interactions and relations within organisational networks founded on trustworthiness and reciprocity which foster collective agency – elements that are essential for resilient and inclusive leadership cultures. The central research question asks: “What are the antecedents and elements influencing the culture of shared leadership in a healthcare organisation during crisis and the lessons from leadership in NLE that can mobilise change in the NHS and the wider health and social care?”<br/><br/>Employing a dual-methodology approach - ethnography and autoethnography - the study captures both collective and personal narratives of leadership within NLE. Ethnographic data were gathered through creative conversations and semi-structured interviews and analysed thematically to identify eight key themes: Leadership Mindset, Structure, Context of Crisis, Situational Awareness, Social Capital, Trust, Communication, Personality. <br/><br/>The autoethnographic approach provides first-person narratives that examine leadership as a lived experience and evoke meaning that can carry impact across organisational settings and context. <br/><br/>The study presents the model of shared leadership in crisis that is founded in trust, solidarity and reciprocity, and proposes that shared leadership culture in NLE was the team’s social capital. The cyclical dynamic between the model’s antecedents – which are represented in the eight emergent themes – and the mutually reinforcing nature of their interplay fostered inclusive decision-making, collaboration and a supportive workplace environment, which are the desired change to the workplace practices that managers would like to see as a result of the pandemic.<br/><br/>The study contributes to leadership development discourse by demonstrating how organisational storytelling and lived experience can serve as tools for cultivating shared leadership cultures, with implications for policy and practice across health and social care.<br/>

Name dc:type.qualificationname

Doctoral Thesis

Level dc:type.qualificationlevel

Student thesis

Year dc:date.issued

2026

Author dc:creator

• Piera, Emilia

Advisors dc:contributor.advisor

• Thomas, Simon
• Abdullah, Ahmed
• Parkes, Elizabeth

Language dc:language

eng

Identifier

oai:pure.atira.dk:studenttheses/4807199a-a415-4e49-b39c-9f85e73f53e0

OAI identifier oai:identifier

oai:pure.atira.dk:studenttheses/4807199a-a415-4e49-b39c-9f85e73f53e0