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Hospital [...] should do the sick no harm (Nightingale, 1859, p. iii).
Background
Many government health publications indicate that strong leadership is essential to safeguard vulnerable adults (Department of Health (DoH), 2010, 2011a, 2012, 2013). Learning from serious case reviews (Orchid View, West Sussex Adults Safeguarding Board, 2014) and serious incidents recorded in healthcare organisations also suggest that the absence of leadership can result in poor practice. The Francis (2010, 2013) reports into failures at Mid-Staffordshire hospitals also indicate that leadership was inadequate and this impacted on the Trust's ability to maintain safe services.
As there is this widespread belief that effective leadership results in safeguarding vulnerable adults (or that a lack of leadership results in a lack of protection), this study aims to uncover the existing evidence-base that leadership can safeguard vulnerable adults in health care organisations. It provides a timely study as failures in health care (Mid-Staffordshire hospitals, Winterbourne View) have received a lot of media attention and it must now be a priority to seek improvements in healthcare systems and for the vulnerable adults that they serve.
The method undertaken by this study was a critical review of literature. This was selected in order to gain an informed analysis (based on a variety of perspectives) to influence professional practice. The knowledge from the literature review has subsequently been utilised to propose a framework for leadership that can be applied in practice within healthcare organisations. This framework also has relevance for organisations working across wider safeguarding adults partnerships.
This paper poses the research question:
RQ1. How does leadership contribute to safeguarding vulnerable adults within healthcare organisations?
Definitions
In order to answer the research question it is first important to define key terms.
Leadership
Grint (2000) believes leadership is a contested subject and Stogdill (1974) states there are many definitions of leadership. Many people also attempt to differentiate leadership from management (Bennis, 2009; Rost, 1991; Kotter, 1990; Northouse, 2010).
As leadership is not universally agreed, the definition of leadership that this study utilises was deliberately kept broad to encompass many traits, qualities and skills and is therefore defined as "showing the way" (Sturmberg and Martin, 2012, p. 18).
Safeguarding
The definition of safeguarding that this paper utilises is taken from the Department of Health,...