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nhs leadership essay

How to Write the National Honor Society Essay + Example

nhs leadership essay

What’s Covered:

National honor society: four pillars and essay, five tips for writing your nhs essay, nhs essay example, time well spent.

What do former first lady Michelle Obama, actor Chadwick Boseman, singer-songwriters Taylor Swift and Carrie Underwood, and baseball legend Cal Ripken Jr. have in common?  They were all members of the National Honor Society (NHS).

As you apply for membership in this national organization, remember NHS membership is based on meeting criteria in four areas that the NHS calls its four pillars: Scholarship, Service, Leadership, and Character .  

Scholarship 

The first pillar, scholarship , requires that a student earns a minimum cumulative grade point average (GPA) of 3.0 on a 4.0 scale or equivalent. Many high schools set a higher GPA bar for their school’s chapter. If you meet your school’s academic requirement, congratulations, you’ve passed the first hurdle. 

Now it’s important that you carefully complete the application and write a compelling essay.  Most high schools require students to write a 300-500 word essay that showcases their commitment and accomplishments in the other three pillars.

Service refers to the contributions you make to your school and or community on a volunteer basis, without receiving any compensation. For your most significant service activities, be sure to explain why you choose to support certain organizations and why you chose specific roles. 

Showcase your leadership in your school and or community while working with or for others. Remember, stating that you are the captain of a team, president of a club, or supervisor of a shift does not prove that you are a leader. A leader makes things happen, sets a good example, and inspires others to give their personal best. Clearly state why you were selected to hold a leadership position and how you effectively lead. There are many successful leadership styles. Communicate your unique brand of leadership. 

Character is how you conduct yourself with high standards of honesty, reliability, and respect for others. Many attributes define good character, and they all reflect a personal commitment to ethical and compassionate interactions with others as well as how you treat yourself. Results are only part of the story.  How you achieved them is critically important to communicate.

Think about how many NHS applications your school counselor reviews each year. Not every student who completes an application is selected for the honor. So how do you make your essay stand out?  Here are five strategies:

1. Make it Personal and Individual  

Your application form provides the facts about the scope and range of your involvement and contributions to your communities. Be sure that you write your essay in a way that brings this data to life. A compelling essay enables the reader to feel a strong connection to you. Express your unique values, aspirations, and priorities. State the motivation behind your choices and the trade-offs you’ve made. Be honest about challenges and what you have learned through your mistakes. And be sure the tone of the essay sounds like you and nobody else. 

2. Share Your Stories

People love to hear and remember stories, not simply facts and figures. Express themes and points that you want to share by relaying stories that bring these concepts to life. Stories can be poignant, funny, suspenseful, or surprising. Any approach that makes a reader want to continue reading is a great one.

3. Be Humble and Bold

Many students find it hard to express their hard-earned accomplishments without sounding boastful. Proudly stating your achievements without sounding brash is possible and important. Clearly state your motivations, your challenges, your vulnerabilities, and your mistakes to mitigate any concerns.  

4. Follow Tried and True Essay Guidelines

Channel all the advice you’ve received over the years about how to write a great essay. Do you have a clear thesis around which you have organized your thoughts? Compelling topic sentences to hook your reader? Strong supporting sentences to back up your reasoning? Have you avoided clichés? Do you vary your sentence structure and word choice? Does the text flow and keep the reader engaged? Last, but not least, have you checked and double-checked your grammar, punctuation, and spelling?

5. Draft, Edit, Edit, Edit, Polish

Writing is an iterative process so give yourself the time necessary to land on the best approach for explaining why you are deserving of the NHS honor. There are many ways to tackle an essay. Try a few to determine which is the most effective. Then, when you determine the best approach and are satisfied with your latest draft, share it with someone whose opinion you value. 

Looking for someone to read over your essay? Check out Collegevine’s free essay help ! Our peer review system will help you get feedback from other students so that you can improve your NHS essay and college essays.

While there is not a single template for a strong essay, here is an example of an NHS essay written by an 11th-grade student who was accepted into NHS.

Success is not only about improving yourself, but also about improving life for others. While my GPA shows my commitment to academics, how I spend my time and conduct myself outside of school reveal my commitment to making the world a better place, consistent with the values of the National Honor Society. 

For the two years my grandfather lived in a nursing home, each weekend I took my dog EJ to visit him. I witnessed first-hand the healing power of animals as EJ lifted his and the other residents’ spirits. Because of this experience and because monkeys are my favorite animal, when I heard about Helping Hands (HH), the only organization in the world that raises capuchin monkeys to be live-in assistants to people with spinal cord injuries, I reached out to volunteer. 

Both in the summer and during the school year, I assist the trainers. Monkeys begin training when they are teenagers. It typically takes three to five years until they are ready to be placed with a person. My first job is to clean the cages of 60 monkeys. (Not my favorite responsibility.) I also prepare meals and construct and distribute dexterity “toys.” 

While not glamorous, my work is critical to the success of the initiative. The physical support the monkeys provide is unbelievable. They turn pages of books, scratch itches, pour water, and retrieve dropped items… Most importantly, I have seen the life-changing impact a monkey’s companionship has on a partner, including a college-age student confined to a wheelchair after a spinal cord injury from hockey. 

In the spring, summer, and fall I also volunteer at Gaining Ground (GG), a non-profit that grows organic produce to donate to food pantries, shelters, and meal programs. When I volunteered at a local food pantry, it struck me that recipients receive mostly canned and packaged food. I think it is important that people in need receive fresh fruits and vegetables, and I enjoy the physical work of weeding, harvesting, cleaning, and packing produce.

Soon after I began volunteering at GG, my rabbi gave a sermon about the working conditions of tomato farmers in Florida. (It reminded me of Grapes of Wrath, and I couldn’t believe inhumane practices continue.) Her sermon motivated me to support the Coalition of Immokalee Workers by distributing postcards urging Trader Joe’s and Stop & Shop to only buy tomatoes from farms that agree to fair wages and human rights. Both chains have now agreed, showing that a little effort by many people makes a difference.

Last, I believe a story is the best way to explain my “behind-the-scenes” leadership. At the annual nighttime football game, one of my soccer teammates (not someone I hang with) was drunk. When our principal came over to the bleachers, my teammate’s friends fled. Concerned that my teammate would fall and hurt herself, I brought her outside the stadium, called her parents, and waited with her until they came — without worrying about social retribution. Despite getting grounded, she thanked me for my help.

I would be honored to be recognized by NHS for my service, leadership, and character. Thank you for your consideration.

The time you invest in composing an effective NHS essay will help you when you’re ready to write your college essays! Essays are important components of applications to selective colleges. Getting into NHS is also an honor that may boost your application at some schools. Remember, you can estimate your chance for acceptance using Collegevine’s free chancing calculator . This tool will factor in your GPA, test scores, extracurriculars, and more to calculate your odds of admission at hundreds of schools across the country.

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nhs leadership essay

May 1, 2023

How to Write an Impressive National Honor Society Essay: Examples and Tips

Membership in the National Honor Society is a prestigious achievement that recognizes exceptional academic achievement, leadership, service, and character. But to earn this distinction, students must first write an impressive essay that demonstrates their qualifications and sets them apart from the competition. If you're ready to take on this challenge and earn your place in this esteemed society, you've come to the right place. In this article, we'll provide you with expert tips and real-world examples of successful essays that will help you craft an essay that showcases your unique strengths and accomplishments.

Are you a high school student with a passion for excellence, a track record of leadership , and a burning desire to make a difference in your community? Are you ready to join the ranks of the best and brightest students in your school and beyond? If so, the National Honor Society may be the perfect fit for you. But before you can don that coveted NHS sash, you'll need to write an essay that will knock the socks off the selection committee. 

No pressure, right? Well, don't worry, because we've got you covered. In this article, we'll provide you with expert tips and real-world examples of successful National Honor Society essays that will help you craft an essay that's worthy of your many talents.

 We'll cover everything from the essential elements of a strong NHS essay to tips for effective writing and editing. And hey, if all else fails, you can always bribe the selection committee with cookies. (Okay, maybe not. But it's worth a shot, right?) So grab a pen, fire up your laptop, and let's get started on your path to NHS greatness!

What is the National Honor Society?

National Honor Society (NHS) is an organization that recognizes and encourages academic achievement while developing the essential qualities of leadership, scholarship , service, and character in high school students.

NHS is an invitation-only organization that recognizes students who have demonstrated excellence in academics, leadership, service, and character. Membership in NHS is a significant achievement and serves as recognition for students who have worked hard to excel in their studies and to make a positive impact in their school and community.

In this essay, we will discuss the importance of leadership, scholarship, service, and character, how to apply for the NHS, and tips for writing an impressive NHS Essay.

Leadership is an essential quality that the NHS recognizes in its members. Leadership involves the ability to motivate others, take initiative, and work collaboratively towards a common goal.

Leadership can be demonstrated in a variety of ways, such as leading a team, organizing an event, or advocating for a cause. NHS values leadership because it is essential for achieving success in academics, personal growth, and community involvement.

To demonstrate leadership, NHS requires that applicants have held leadership positions in their school and community. This can include serving as a team captain, organizing a community service project, or leading a school club or organization.

However, it is important to note that leadership is not limited to formal positions of authority. Leaders can emerge in any situation, and the NHS recognizes that leadership can be demonstrated in many different ways.

Scholarship

Scholarship is another important quality that the NHS recognizes in its members. Scholarship involves a commitment to academic excellence, a desire for knowledge, and a willingness to engage in intellectual pursuits. Scholarship is essential for success in higher education and for developing the skills and knowledge needed to make a positive impact in society.

To demonstrate scholarship, NHS requires that applicants have a minimum GPA of 3.0 on a 4.0 scale. However, NHS values scholarship beyond just grades. NHS recognizes that scholarship involves a desire for learning and intellectual curiosity. This can be demonstrated through taking challenging courses, pursuing independent research projects, or participating in academic competitions.

Service is another essential quality that NHS recognizes in its members. Service involves a commitment to giving back to the community and making a positive impact on the lives of others. Service is essential for developing empathy and compassion, and for building strong and supportive communities.

To demonstrate service, NHS requires that applicants have completed a minimum of 40 hours of community service. However, NHS values service beyond just the number of hours completed. NHS recognizes that service involves a commitment to making a difference in the lives of others.

This can be demonstrated through volunteering for organizations that align with personal values, initiating community service projects, or engaging in advocacy work.

Character is the final quality that NHS recognizes in its members. Character involves a commitment to ethical behavior, honesty, and integrity. Character is essential for building trust and fostering strong relationships with others.

To demonstrate character, NHS requires that applicants have a positive disciplinary record and a recommendation from a teacher or school administrator. However, NHS values character beyond just avoiding negative behaviors.

NHS recognizes that character involves a commitment to doing the right thing, even when it is difficult. This can be demonstrated through acts of kindness, ethical decision-making, and demonstrating honesty and integrity in all aspects of life.

Application and Membership

To apply for NHS, students must meet the minimum requirements for leadership, scholarship, service, and character. In addition, students must complete an application, submit a personal statement, and provide letters of recommendation.

The application typically includes basic information such as name, address, and GPA. It may also ask for information about leadership positions held, community service activities completed, and academic achievements. The application may also include short essay questions to allow students to showcase their strengths and accomplishments.

NHS Essay Guide

If you are looking to write an NHS essay, here is a guide that can help you craft an impressive and professional essay:

Understanding the NHS pillars

The National Honor Society is based on four pillars: leadership, scholarship, service, and character. Before you begin writing, it is important to understand what each of these pillars means and how you have demonstrated them in your life.

Brainstorm your accomplishments

Once you understand the pillars, make a list of all the activities and accomplishments that you have achieved in each of the pillars. This could include things like holding a leadership position in a club, achieving academic excellence, volunteering in your community, or demonstrating integrity and honesty in your personal life.

Write a rough draft

Once you have your list of accomplishments, begin drafting your essay. Start by introducing yourself and explaining why you are interested in joining the NHS. Then, use specific examples to demonstrate how you have demonstrated leadership, scholarship, service, and character. Be sure to use strong, descriptive language and avoid vague statements.

Edit and revise 

Once you have a rough draft, take the time to edit and revise your essay. Read it out loud to catch any awkward phrasing or grammatical errors. Make sure that your essay is well-organized and that each paragraph flows smoothly into the next. Make sure to remove any unnecessary information or repetition.

Be Humble and Bold

Many students find it hard to express their hard-earned accomplishments without sounding boastful. Proudly stating your achievements without sounding brash is possible and important. Clearly state your motivations, your challenges, your vulnerabilities, and your mistakes to mitigate any concerns.

Get feedback

Once you have edited and revised your essay, get feedback from others. Ask a teacher, parent, or mentor to read your essay and give you their honest feedback. Use their feedback to make any necessary changes and to strengthen your essay.

Write a strong conclusion

End your essay with a strong conclusion that summarizes your achievements and explains why you would be a good fit for the NHS. Thank the reader for considering your application and expressing your excitement about the opportunity to join the NHS.

By following these steps, you can write an impressive and professional NHS essay that demonstrates your commitment to leadership, scholarship, service, and character. Remember to be specific and use strong language, and get feedback from others to ensure that your essay is the best it can be.

Tips for Writing NHS Essay

The National Honor Society (NHS) is a prestigious organization that recognizes high school students who have demonstrated excellence in academics, leadership, service, and character.

Being a member of NHS is a significant achievement and can provide many opportunities for personal and professional growth. To become a member of NHS, students must apply and write a personal statement. In this section, we will discuss some tips on how to write an impressive NHS essay.

Step 1: Understand the Purpose of the NHS Essay

The purpose of the NHS essay is to demonstrate to the selection committee that you possess the qualities of leadership, scholarship, service, and character. The essay is an opportunity for you to showcase your achievements, skills, and experiences that align with the NHS values. The essay should also highlight your personal goals and how being a member of NHS can help you achieve them.

Step 2: Brainstorm Ideas

Before writing the essay, take some time to brainstorm ideas. Think about your achievements, experiences, and skills that align with the NHS values. Consider examples of how you have demonstrated leadership, scholarship, service, and character in your school, community, or personal life. This will help you to organize your thoughts and create a clear and concise essay.

Step 3: Structure Your Essay

The NHS essay should have a clear structure that includes an introduction, body, and conclusion. The introduction should provide a brief overview of the essay and grab the reader's attention. The body of the essay should focus on the four NHS values: leadership, scholarship, service, and character. Use examples and anecdotes to demonstrate how you have demonstrated each of these values. 

Step 4: Be Specific and Concise

When writing your NHS essay, be specific and concise. Use specific examples and anecdotes to demonstrate your achievements and skills. Avoid using general statements that could apply to anyone. Also, be concise and avoid using unnecessary words or phrases. The essay should be clear and easy to read.

Step 5: Show, Don't Tell

When writing your NHS essay, it is essential to show, not tell. Instead of saying that you have demonstrated leadership, provide an example of a time when you led a team or organized an event. Use descriptive language to paint a picture of the situation and show how you demonstrated leadership.

Step 6: Be Honest and Authentic

When writing your NHS essay, be honest and authentic. Don't exaggerate your achievements or skills, but also don't be too modest. Be genuine and let your personality shine through in the essay. This will help the selection committee get to know you better and see why you would be an excellent fit for NHS membership.

Step 7: Proofread and Edit

Before submitting your NHS essay, make sure to proofread and edit it carefully. Check for grammar and spelling errors, and make sure the essay is well-organized and easy to read. You may also want to have someone else read the essay and provide feedback. This will help you to identify areas that need improvement and ensure that your essay is as impressive as possible.

Writing an impressive NHS essay requires careful planning, organization, and attention to detail. By following these tips, you can create an essay that showcases your achievements, skills, and experiences and demonstrates why you would be an excellent candidate for NHS membership. Remember to be specific, concise, honest, and authentic, and to show, not tell your achievements and skills.

Personal Statement

Here is an example of a personal statement for your NHS: “I am thrilled to submit my statement for consideration as a potential member of the National Honor Society. As a student who is deeply committed to the ideals of leadership, scholarship, service, and character, I believe that I would be an ideal candidate for this prestigious organization.

In addition to my academic and extracurricular pursuits, I believe that my personal qualities make me an ideal candidate for the National Honor Society. I am a natural leader who can inspire others and work collaboratively toward a common goal. I am also highly organized, disciplined, and self-motivated, which allows me to juggle multiple responsibilities and stay on top of my commitments.

Above all else, I believe that my commitment to character is what sets me apart as a candidate for the National Honor Society. I believe that integrity, honesty, and respect are the foundation of all meaningful relationships, and I strive to embody these values in everything that I do.

Whether I am working on a group project with my peers or volunteering in my community, I am always mindful of the impact that my actions have on those around me.

In conclusion, I believe that I would be an ideal candidate for the National Honor Society based on my academic achievements, extracurricular activities, personal qualities, and commitment to service and character. I am deeply honored to have the opportunity to apply for membership in this esteemed organization, and I look forward to contributing to the National Honor Society in a meaningful way.”

NHS Essay Examples

Essay example 1.

As a dedicated student, committed volunteer, and aspiring leader, I have always strived to make a positive impact in my university and community. The National Honor Society has always been an organization that I have admired and respected, and I am excited about the opportunity to join such a prestigious group of individuals.

Throughout my bachelor studies, I have been actively involved in various extracurricular activities and clubs, including serving as the president of the university sports society. In this role, I have organized numerous fundraising events, community service projects, and volunteer opportunities for my peers, inspiring them to take action and make a difference in our community.

I have also served as a mentor and tutor to underclassmen, providing guidance and support to help them achieve their academic and personal goals.

Academic excellence is something that I have always prioritized, and I have worked hard to maintain a good GPA throughout my university career. I have taken on challenging coursework, including honors and Advanced Placement courses, to further develop my intellectual curiosity and critical thinking skills. 

As a member of the National Honor Society, I hope to continue to challenge myself academically and inspire others to do the same.

I believe that giving back to my community is not only a responsibility but also a privilege. I have volunteered at various local organizations, including the food bank, animal shelter, and community garden, and have helped to raise money for numerous charities.

Additionally, I have been involved in a peer mentoring program that offers guidance and support to students struggling academically or personally.

Integrity, honesty, and respect are values that I hold dear, and I strive to demonstrate these qualities in everything that I do. I have participated in various character-building programs, including the school’s conflict resolution program and the Rotary Youth Leadership Awards program, which have helped me to develop strong communication and problem-solving skills.

I believe that my commitment to these values will make me a valuable member of the National Honor Society.

As a well-rounded student and active member of my community, I am excited about the opportunity to join the National Honor Society. I am confident that I have demonstrated excellence in leadership, scholarship, service, and character, and I look forward to further developing these qualities as a member of this prestigious organization. Thank you for considering my application.

Essay Example 2:

Dear National Honor Society Selection Committee,

I am honored to apply for membership in the National Honor Society, as I believe that this prestigious organization aligns with my values of leadership, scholarship, service, and character. I am confident that my academic achievements, community service, and leadership experiences demonstrate my commitment to these values and make me a strong candidate for membership.

Throughout my high school career, I have demonstrated leadership skills in various extracurricular activities and organizations. I have served as a captain of my school’s varsity basketball team for two years, where I have not only led my team to multiple championships but also served as a role model for my teammates by demonstrating a strong work ethic, positive attitude, and sportsmanship

Academic excellence is a top priority for me, and I have consistently maintained a high GPA throughout my high school years. I have taken on challenging coursework, including Honors and Advanced Placement classes, to further my intellectual curiosity and challenge myself.

Furthermore, I have actively participated in academic competitions, including the National Science Olympiad, where I have won multiple medals and awards.

I have always been passionate about serving my community and making a positive impact on the lives of others. I have volunteered at various local organizations, including the food bank, homeless shelter, and community garden, where I have helped to feed the hungry, care for the less fortunate, and create a sustainable future.

Furthermore, I have served as a mentor and tutor to younger students, providing guidance and support to help them achieve their academic and personal goals.

Integrity, honesty, and respect are values that I hold dear, and I strive to demonstrate these qualities in everything that I do. I have participated in various character-building programs, including the school’s peer mediation program, where I have learned effective communication and problem-solving skills.

In summary, I believe that my leadership, scholarship, service, and character make me a strong candidate for membership in the National Honor Society. I am excited about the opportunity to further develop these qualities and contribute to the mission of this esteemed organization.

I thank you for considering my application, and I look forward to the opportunity to represent the National Honor Society with honor and distinction

In conclusion, the National Honor Society is an esteemed organization that recognizes high-achieving students who demonstrate excellence in the pillars of leadership, scholarship, service, and character. Writing a brilliant NHS essay requires thoughtful reflection on your accomplishments and an ability to effectively communicate how you embody these pillars in your life.

By following the tips and guidelines provided in this article, you can craft an impressive and professional essay that showcases your dedication to these pillars and your potential as a valuable member of the National Honor Society.

If you're ready to take the next step in your academic and personal journey, we encourage you to apply to the National Honor Society. As a member, you will have the opportunity to engage in meaningful service projects, connect with other high-achieving students, and further develop your leadership skills. 

Don't let this opportunity pass you by - take the time to write an exceptional NHS essay and join the ranks of some of the most accomplished students in the country.

So what are you waiting for? Start crafting your NHS essay today and take the first step towards achieving your goals. We wish you the best of luck in your application and hope to see you among the distinguished members of the National Honor Society.

With the help of essay writing tools , writing an NHS essay can be made easier and quicker. Jenni.ai's AI-powered writing tools can help you develop a strong thesis statement and produce high-quality articles. 

By utilizing these tools, you can save time and energy while still producing top-notch work. By following the steps outlined in this blog and using the features offered by Jenni.ai, you can master the art of writing NHS essays and achieving academic and professional success.

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How to write the National Honor’s Society Essay

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Being recognized as a member of the National Honor Society (NHS) is a testament to a student’s academic achievements, leadership, and service in their community. The NHS recognizes outstanding high school students for their dedication and challenges them to develop further. An important component of the application process is the NHS essay, which is an opportunity for candidates to detail their accomplishments and explain how they align with the NHS’s core values. This essay plays a significant role in the selection process, as it allows the applicant to showcase the individual behind the grades and other achievements on paper. This blog post aims to demystify the writing process by providing step-by-step guidance on crafting a strong NHS essay. 

Understanding the NHS Essay

4 pillars of nhs, scholarship, polishing your essay, common mistakes to avoid with the national honor’s society essay, wrapping up.

National Honor's Society Essay

Before diving into the pillars that form the backbone of the National Honor Society (NHS), it’s crucial to grasp what the NHS essay entails and what it aims to achieve. The NHS essay is more than just a writing sample; it is a narrative that encapsulates your journey, achievements, and the alignment of your personal values with the core principles of the NHS. This essay is your opportunity to communicate directly with the selection committee, offering a glimpse into who you are beyond your academic scores and extracurricular activities. The prompt for the NHS Essay is to detail how you represent the Four Pillars of NHS Membership: Scholarship, Service, Leadership, and Character in 300-500 words. In doing so, here are some key components that are good to include:

Personal Introduction: Begin with a brief introduction of yourself, highlighting your academic and personal background. This sets the stage for a deeper dive into your achievements and how they reflect the NHS values.

Impact and Personal Growth: Discuss the impact of your contributions on your community and personal growth. Reflect on how your actions have made a difference and what you may have learned from them. This will show the selection committee your potential for future leadership and service.

Future Plans and Contributions: Briefly outline how you plan to continue your commitment to the NHS’s principles by contributing both to the organization and to your community. This will underscore your dedication to the NHS’s mission.

Staying Authentic: Your essay should reflect your own authentic voice and perspective. The selection committee is solely interested in understanding who you are as an individual.

Alignment with NHS Values: It is important to explicitly detail how your experiences embody the NHS’s core values of scholarship, leadership, service, and character. Rather than simply listing your accomplishments, delve deeper into how these experiences have shaped you and prepared you to contribute to the NHS while remaining as concise as possible.

When addressing the pillar of Scholarship in your National Honor Society essay, it is important to go further than just listing your academic achievements on paper. This section should detail your personal affinity for learning and intellectual growth. Highlight your areas of curiosity, your passion for gaining knowledge, and how you have been able to apply your knowledge outside of the classroom. Obviously you should discuss any academic awards or recognitions you have received, but also delve into how these accomplishments reflect your attitude towards learning.

In demonstrating Leadership, your writing should detail both formal leadership positions and informal leadership roles you have taken. Leadership is not just about being the head of a club or student organization: it is about influencing others positively, driving initiatives, and setting a good example in your community. Share specific instances where you led by example, overcame challenges, or motivated others toward a goal. Whether it’s captaining a sports team, leading a group project, or taking the initiative in organizing an event, include any instances that highlight your ability to lead.

The Service section of your essay is your chance to show how you have contributed to your community through volunteer work or service projects. Describe the types of service activities you have experience in, the impact these activities had on your community, and any other insights or knowledge you gained in the process. 

Reflecting on Character involves a deep dive into your the ethics and moral principles that guide you. The NHS values members who exhibit a strong character in both their personal and academic lives. Discuss situations where you’ve had to make difficult choices and/or stand up for what you believe in in the face of challenges. Your character is at the center of your personality, so share anecdotes that best illustrate how you personally embody the values the NHS holds dear ( like honesty, respect, and responsibility).

Crafting a strong conclusion for your essay is crucial in reinforcing your case for membership. This final section should serve as a summary of your narrative, reiterating how you align with the NHS’s core values of scholarship, leadership, service, and character. Begin by concisely restating the key experiences and achievements you’ve discussed throughout the essay. Then, synthesize this information and emphasize your readiness to take on the responsibilities of NHS membership. Articulate a clear vision of how you intend to contribute to the NHS, drawing on specific examples from your past experiences to illustrate your capacity for leadership, service, and continued personal and academic growth.

Revision is a vital step in crafting a good NHS essay. It is imperative to revisit your essay with a critical eye, assessing the coherence of your writing and ensuring that each paragraph flows logically and smoothly to the next one. We recommend doing at least two drafts, and the more the merrier. Make sure your essay comprehensively details your achievements and character, and make adjustments to enhance your message’s delivery and effectiveness.

NHS Essay

Simply Reiterating Your Resume: One of the most common mistakes is simply listing your academic achievements and other roles as one might on a resume and not delving into the experiences. Your writing should go beyond listing accomplishments, explaining how these experiences have effected you and/or how they might align with the NHS values.

Lack of Personal Reflection: Not including enough personal reflection on how your experiences have contributed to your growth or demonstrated your alignment with NHS values is a missed opportunity to show your unique perspective. Share insights into your personal journey, any challenges overcome, and how these experiences impacted you.

Ignoring the NHS Core Values: Each section of your essay should clearly relate to one or more of the NHS pillars: Scholarship, Leadership, Service, and Character. Failing to explicitly connect your experiences to these values will weaken your essay. Make sure to keep in mind how your experiences and actions embodied these core principles while you are writing.

Overlooking the Importance of Character: While it’s crucial to highlight your leadership, service, and academic achievements, neglecting to adequately address your character and personal ethics is a mistake. The NHS values integrity, honesty, and respect, so be sure to reflect on moments that have shaped your character.

Neglecting the Essay Structure: A well-organized essay that flows logically and linguistically from section to section is essential for clarity and impact. Jumping randomly between topics or cluttering your essay with too much information will confuse readers, and ultimately weaken your essay. Use a clear structure, with each paragraph smoothly transitioning to the next, ensuring your essay is coherent, and in turn, compelling.

Failing to Proofread: Grammar mistakes, typos, and awkward phrasing can distract from the content of your essay and give the impression of carelessness. Take the time to thoroughly proofread your essay, and write multiple drafts. Consider asking a teacher, parent, peer, or other mentor to review it for errors you might have missed.

Not Showing Authenticity: Trying to fit a perceived ideal or exaggerating experiences will come off as insincere. Be authentic in your writing. The NHS values honesty!

In conclusion, when writing your NHS essay, embrace the opportunity to not only detail your accomplishments but to give readers an understanding of what makes you unique. This essay is your stepping stone towards becoming a part of a community that values not just academic excellence, but the development of character and the commitment to making a difference in communities. Through your words, make it clear that you embody 4 central tenets of the NHS, but also document your unique perspective and how you personally will contribute to its mission. If you follow these steps and proofread effectively, you should be well on your way to producing an excellent NHS essay! Good luck!

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National Honor Society (NHS) Essay Examples & Expert Advice

July 8, 2023

nhs leadership essay

Every year, high school sophomores, juniors, and seniors write National Honor Society essays in the hopes of becoming a member. It’s certainly an admirable recognition. Joining the ranks means partaking in an interscholastic tradition alongside future movers and shakers. Past National Honor Society (NHS) members have consisted of Olympians, astronauts, senators, neurosurgeons, Nobel prize winners, Navy admirals, and more. Some of the more celebrity-famous NHS-ers include journalist Katie Couric, writer, and comedian Tina Fey, and poet Robert Warren Penn. Former first lady Michelle Obama, of course. Even Taylor Swift joined the NHS in high school. You can bet her songwriting skills came in handy for the National Honor Society essay. Intimidated? Don’t be. View our NHS essay example below as well as our more general advice for the National Honor Society essay.

Before composing your own NHS essay, you may want to ask yourself, “Why should I join NHS ?” Your answer to this question will help determine if, and how, you should craft a relevant NHS essay.

The NHS in Brief

It all began with a high school principal in Pittsburgh, Pennsylvania, who founded the National Honor Society in 1921. Today, this hundred-and-two-year-old society boasts local chapters in all 50 U.S. states and territories. It also has chapters in American and international schools abroad. Membership, open to select high school students, can open doors to interesting service and leadership opportunities. In fact, service and leadership form the cornerstone of NHS.

The one million plus students who participate in the NHS yearly have service and leadership in common. That’s because the NHS requires demonstrated community service, and demonstrated leadership. It also requires a GPA of 3.0 on a 4.0 scale (though this number varies depending on the chapter) and demonstrated good character. You’ll want to check your local chapter’s specific guidelines when beginning the NHS application.

Other reasons to join the NHS include gaining access to the NHS network, an array of college planning tools, and the chance to apply for hefty scholarships. These perks naturally make for a competitive acceptance rate. So, the best way to make your application stand out involves crafting a stunning NHS essay. Here’s how.

Quick Tips for Drafting the National Honor Society Essay

1) Structure your NHS essay around the NHS Pillars: Scholarship, Service, Leadership, and Character. A high GPA acts as an indicator of your “scholarship”, or dedication to academia. This pillar must appear in your essay as well, in the form of impeccable writing skills. Demonstrate your service and leadership through the content of your essay. In other words, service and leadership form the action, or plot, of your essay. Finally, infuse your character throughout your essay, by showing how your behavior indicates your values and integrity.

2) Write from your heart, and make your NHS essay personal. The most memorable essays rely on a sincere writing voice and contain personal details. But note that by “personal,” I don’t mean you must share your deepest secrets. Rather, ground an event in your own experience by incorporating your emotions, thoughts, and sensations. This will make your essay unique to you.

3) Weave together a story; don’t make a list. As you tell your story, pull from your strongest experiences. Perhaps you have a handful of leadership and service roles. Pick only a few that say something about your interests and personality, and develop your story by threading these ideas together. While a list might look impressive, a story will come across as better crafted and more captivating. If, however, none of your service activities seem significant enough to single out and describe on their own, weave these activities together through a theme. For example, the theme could be how you overcame shyness to lead.

Quick Tips for Drafting the National Honor Society Essay, Continued

4) Mind your audience. In this case, your audience is your school’s faculty member who’s taken on the role of chapter adviser. You may want to meet with them ahead of time to let them know you’re applying. This initiative on your part will look impressive. Moreover, you can ask in person what they look for in an NHS essay. Certainly, they’ll want to know how you stand out from the other applicants. So, you’ll also want to keep your competition in mind. As with college application essays, the tone of your NHS essay should be polite, formal, and charismatic.

5) Brainstorm, draft, edit, and repeat. A National Honor Society essay isn’t written overnight. Once you have your initial ideas down on paper, return to the page for a round of editing. Ask yourself where you can expand and where you sound redundant. Look for common threads and themes to enhance. Create transition sentences between paragraphs. Revise your conclusion. Next, show your essay to someone you trust. Their feedback will indicate where your essay excels and where you need to improve.

NHS Essay Example

My grandmother, or Ma-Maw , was the kind of generous busybody who made six different pies for her granddaughters’ birthdays. She invited everyone on the block, so nothing went to waste. Once, when we both went to shovel up the last slice of pie, she laughed, and said, “ noblesse oblige .” She often spoke French, a Louisiana French foreign yet familiar to me. I didn’t think to ask what she’d meant. Did she think I was noble? Was that why I got to scarf down the last of the cherry pie?

Ma-Maw died the summer before I entered high school. I missed her terribly, long after my parents sold her house. Receiving her redirected mail felt like a blow. So many newsletters from Friends of the New Orleans Public Library! Since I loved books as much as Ma-Maw, I opened these up. Inside, I read about a partnership program, Start the Adventure in Reading (STAIR). They needed in-person volunteers to tutor second- and third-graders in reading.

Before I knew it, I was cracking open vocabulary books twice a week with a kid named Harper. When I wasn’t tutoring, I was lesson planning, going over Harper’s writing journal, and scouring shelves for more early reader books. This got me thinking about literacy in New Orleans. 39% of high school students my age have the reading level of a 5 th grader—or worse. Harper lived in a part of town that didn’t even have bookstores. Would she keep up her reading once the tutoring was over, despite the odds? I also thought about representation and accessibility. If Harper had more books about people like her, and if those books were all over the place, and easy to take home, would things change?

NHS Essay Example, Continued

Due to this newfound interest in advocating for literacy, I decided to build a Free Little Library (FLL). To do so, I needed help. That spring, I founded a school club, Reading the World, and convinced 8 members to join. Together, we dismantled one of Ma-Maw’s kitchen cabinets and incorporated other used materials to build an upcycled stand that could fit 20 books.

Next, we got in touch with the program Read for Color, which helps make BIPOC, LGBTQ+, and other diverse and marginalized voices heard. I believe their initiative parallels our own, which is to provide a diversity of voices through language itself. Our FLL features books in Cajun French and Creole and works in translation. With permission, we installed the FLL outside Ma-Maw’s old home. For its inauguration, our club invited the local organizations Youth Empowerment Project, One Book One New Orleans, and Read in Color. We plan to collaborate with these groups next year.

Now a sophomore, I’ve continued literacy advocacy by volunteering at Alliance Française events. This has given me new ideas about how to run Reading the World. I’ve added monthly book club events. Furthermore, every club member tutors a STAIR student. Finally, we’ll visit local senior homes at Thanksgiving and Christmas and read to the residents.

Ma-Maw would be happy to hear I won the L’Union Française’s Prix d’Excellence this year. She’d be even more thrilled to see how I’ve shared her love of reading with my community. Now I understand noblesse oblige : if you believe you are someone of noble character, then you must act accordingly. This NHS motto was easy for Ma-Maw to follow. She gave everything and led by example. I plan to follow in her footsteps. It would be an immense honor to do so through the National Honor Society.

NHS Essay Example, Dissected

This National Honor Society essay succeeds for many reasons. First, the student structures her essay around the theme of language and literacy. (Perhaps she also captains her softball team and volunteers for the Red Cross. But the student has correctly judged that these elements would distract from her story.) Rather than list her achievements and service, the student builds every element into a journey. It has a beginning, a middle, and an end. It shows how the student evolved to be someone who wants to make a difference. The ending completes the story by circling back to the beginning, through the idea of “noblesse oblige.” The student also manages to state clearly her thesis: she deserves acceptance into the National Honor Society.

This student’s story also centers around an emotional current, that of the student’s grandmother. The reader wants to invest in the story more because of this emotional aspect. Literacy is clearly not a random activity, but a meaningful one for the student. Including a role model allows the student to avoid bragging by transferring her praise to her grandmother.

Finally, the tone of the essay is formal (“It would be an immense honor”). Meanwhile, the unique voice of the student comes through (“We both went to shovel up the last slice of pie”). She accurately cites the names of the organizations she’s involved with and uses specificity (such as her grandmother’s kitchen cabinets) to draw the reader in.

Finished Your National Honor Society Essay?

Hopefully, you found our NHS essay example to be helpful. Now, feel free to check out our list of academic contests for more ways to boost your academic profile.

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Kaylen Baker

With a BA in Literary Studies from Middlebury College, an MFA in Fiction from Columbia University, and a Master’s in Translation from Université Paris 8 Vincennes-Saint-Denis, Kaylen has been working with students on their writing for over five years. Previously, Kaylen taught a fiction course for high school students as part of Columbia Artists/Teachers, and served as an English Language Assistant for the French National Department of Education. Kaylen is an experienced writer/translator whose work has been featured in Los Angeles Review, Hybrid, San Francisco Bay Guardian, France Today, and Honolulu Weekly, among others.

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'People judge you and your values on the way you spend your time'

The 10 essential qualities for leadership in the NHS

I n the 37 years I have worked for the NHS , I have developed a number of leadership maxims to help me address the huge complexity and challenge of public sector leadership. Of course, I don't do all of them. I often fail. But they are what I aspire to.

1 Demonstrate shared values The NHS is a system of interdependent parts, and the success of one part is dependent on the success of another. The glue that binds these together is a set of values, so leaders need to demonstrate these values in all that they do.

2 Don't be, or become, cynical Even against the sombre background of last week's Francis report , there is no place for cynicism in a leader. It can sap energy from everyone around you and certainly those who work for you.

3 Build bridges Commit to working across the silos that bedevil the public sector. Patients need seamless care, not care in silos. NHS staff must connect across boundaries to achieve this. Inside the NHS, this might include surgery and medicine, primary and secondary care, mental health and community care; outside the NHS, connecting with social services and education.

4 Be resilient Be willing to absorb uncertainty as a leader, and give as much certainty as you can to others. Do not lie, and make it clear if you don't understand, or don't know, something. Absorbing general uncertainty, especially at times of change, enables a leader to provide some stability, allowing staff to be effective in difficult circumstances.

5 Support new ideas Support people to take risks, because risk is crucial to innovation. But be clear about the difference between good people taking risks, and sometimes failing, and incompetence.

6 Communicate clearly and honestly Try to communicate to staff, patients and other parts of the public sector with as much clarity, simplicity and honesty as you can. Too often in the NHS we hide behind our structures, processes, jobs and jargon, which act as barriers.

7 Manage upwards Take "managing up" seriously whether it is your line manager or the board. Challenge where it is appropriate and right to do so, but by delivering on what is required, you can create the maximum possible space to do what you want to do in your organisation.

8 Manage time carefully Think about how you use your time. It is easy to focus on what seem like important meetings, but people judge you and your values on the way you spend your time.

9 Say sorry and thank you These are the most important words in the language of leadership. Some behaviour can be interpreted as bullying very quickly if you don't go back and say sorry. And no matter how senior, everyone enjoys getting a handwritten note to thank them for something they have done.

10 Build a team that will challenge you Develop a real insight into your weaknesses. Make sure when you construct a team that you recruit people who can compensate for these weaknesses and challenge you on things you are not good at. One of the most distressing things about the reforms in the NHS is, having put huge energy into working honestly with a team of people who genuinely compensate for each others strengths and weaknesses, how easily that is dissipated and how hard it is to rebuild.

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Scholarship Essays

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National Honors Society Scholarship Essay Example on Being a Strong Candidate

Why do you feel you are a strong candidate for selection to the nhs how do you personally define scholarship, leadership, character, and service, and how do you exemplify these qualities.

The National Honor Society is an exceptional organization that allows students to help the needy, children, the elderly, and nonprofit organizations. I would be excited to join such a society because of the limitless opportunities it would present to me. Joining NHS would allow me to grow as a person and do as much as I can for others. In my years as a student, I have shown great examples of scholarship, leadership, character and service that I believe would qualify me to join this prestigious society.

As Wikipedia defines it, the word “scholarship” means “academic study or achievement; learning at a high level”. I consider myself a great scholar because I strive for excellence. I always aim to be the best in everything I do. As for effort, I make sure to fill my schedule with the most rigorous classes I can handle. I have taken all honors classes since the beginning of high school, and I aim to continue taking honors and AP classes in the future to reach my true potential as a student. I have also been on the honor roll since freshman year at my local high school, which demonstrates my eagerness to perform at the highest level I can. I believe that all students should try their best in everything they do, as I have demonstrated. As a scholar, I believe I am qualified to join this society.

In addition to being a scholar, I can definitely be considered a leader. Recently, I was invited to participate in the National Young Leaders Conference in Washington, D.C. This invitation indicates that I place emphasis on standing out from the crowd and demonstrating my unique qualities. For example, I cofounded an Indian dance club at my high school. This club is important because it is the first dance club at my school. It allows members of all ethnicities and races to enjoy and learn Indian dance, thereby promoting cultural diversity. In addition to school-related activities, I also bring my passions to the outside community. One example of this is my role as a youth leader at the temple that I regularly attend. This position allows me to explore my interest in Hindu mythology with other members. I am able to translate this attraction into classical dance, skits, lectures, and musical instruments that help young members embrace their cultural identity.

I consider myself to have a great character to join NHS. I embrace all ethnicities and celebrate the differences within everyone that ironically bring us closer. I have a positive attitude that comes in handy when communicating with others. I definitely believe in the idea that each person shapes his or her own destiny. This means that I recognize the importance of always doing my best so that I may shape my life into what I want it to be.

Finally, I have helped my community by volunteering in the medical field. I spent the last summer working at a home for the elderly, where I was able to listen to life stories, participate in activities -- be more specific, and learn about working in the healthcare field. Volunteering is a valuable experience that has helped me become a better person. I look forward to continuing my volunteer work in the medical field in the future.

Because of my abilities and experiences as a student, I believe I can be considered a strong candidate for the NHS. I have demonstrated the scholarship, leadership, character, and service qualities necessary to join the society. I hope to be considered for placement in this prestigious organization.

Original Source: College Confidential

How to Write a Leadership & Character NHS Essay

Greg tepper.

Writing a list or outline before composing your essay can be helpful.

Writing a “Leadership and Character NHS Essay” for the National Honor Society can be an intimidating endeavor in part due to the significance of the NHS, as well as the introspection necessary for completion of your essay. Don’t worry, though. If you’re writing for the NHS, then you've most likely written essays before. This one won’t differ too much, at least in structure, from what you probably already know.

Explore this article

  • Writing Your Essay
  • Consider the traits
  • Write your introduction
  • Construct the body of your essay
  • Write your conclusion

1 Writing Your Essay

Thinking out a subject matter can be very helpful before writing.

2 Consider the traits

Consider the traits of character and leadership you would like to examine in your essay. Try to think of people you admire and people who admire you (you might be surprised at the number of people who come to mind). After taking some time to think things out, write the word “Traits” as a subject heading on the top left side of a piece of paper. Draw a line down the middle of the paper, from top to bottom. Under “Traits,” create a numbered list of the traits you come up with.

Think of why each trait is important and consider actions or situations in which you or someone you admire exhibited those traits through action. For instance, if you find kindness to be an important trait, find an example of kindness in action. On the top right side of your divided page, write the subject heading “Action" and list a corresponding action for each trait. If you think of multiple actions that correspond to a particular trait, write up to three in your "Action" list.

4 Write your introduction

Write your introduction, the first paragraph of your essay, either on a fresh piece of paper or type it out on your computer. After considering and listing traits and actions, you have an idea of what you want to discuss in your essay. The first part of your introduction should introduce your reader to the reasons you consider leadership important. The second part of your introduction should include your thesis. Here you should explain why the traits you chose are important. You don’t have to list all the traits you’ll be discussing in the essay, but you should try to mention at least three. Finally, conclude your introduction with a sentence that prepares the reader for the body of your essay.

Don't forget to constantly save your work if writing on a computer!

5 Construct the body of your essay

Construct the body of your essay, which should be three paragraphs long. Each paragraph should discuss one or two traits. If you choose two traits, they should complement one another or show that a certain person can be dynamic in character. For each paragraph, refer to your list of traits and corresponding actions. Once you have used a trait and action, check them off so as to not accidentally use them twice. Remember to conclude each paragraph in such a way as to prepare your reader for the next paragraph.

6 Write your conclusion

Write your conclusion. The last paragraph of your essay should remind the reader of your thesis and demonstrate how you succeeded in proving it. You may remind your reader of traits discussed, but be careful not to simply repeat what you already wrote. Remember that writing is a process. After you've finished your conclusion, your first draft will be complete. Review is carefully for mistakes and make corrections. Ask a friend, parent or teacher to review it as well. Remember: no essay is complete without review and correction.

  • If you read example essays to get ideas for your own, be careful not to plagiarize. This can even happen accidentally if you are not careful.
  • If you find yourself unable to think of traits or actions or you simply can't write, get up from your chair and stretch or go for a walk. Take a few minutes break. Physical activity and time away from the page or screen can help cure writer's block.

About the Author

Greg Tepper has been writing since 2005. He has been published in "The Jerusalem Post," "The Forward" and Jerusalemite culture guide. He received a Bachelor of Arts in political science and history from Hebrew University of Jerusalem.

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Home — Essay Samples — Education — National Honor Society — Four Pillars of NHS and Life Lessons

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Four Pillars of Nhs and Life Lessons

  • Categories: Academic Achievements High School National Honor Society

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Updated: 9 November, 2023

Words: 1035 | Pages: 2 | 6 min read

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Models of leadership and their implications for nursing practice

S'thembile Thusini

MSc Student, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London

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Julia Mingay

Lecturer, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London

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Leadership in today's NHS, either as a leader or follower, is everybody's business. In this article, an MSc student undertaking the Developing Professional Leadership module at King's College London describes two leadership models and considers their application to two dimensions of the NHS Healthcare Leadership Model: ‘Engaging the team’ and ‘Leading with care’. The author demonstrates the value of this knowledge to all those involved in health care with a case scenario from clinical practice and key lessons to help frontline staff in their everyday work.

The Ely inquiry into the systematic brutal treatment of patients in a Cardiff mental institution was the first formal inquiry into NHS failings ( Department of Health and Social Security, 1969 ). Since that time there have been more than 100 inquiries with inadequate leadership persistently identified as a major concern ( Sheard, 2015 ). National responses have included the NHS Healthcare Leadership Model, delivered by the NHS Leadership Academy and its partners (2013) . A range of online and face-to-face programmes aim to increase an organisation's leadership capacity by developing leaders who pay close attention to their frontline staff, understand the contexts in which they work and the situations they face and empower them to lead continuous improvements that enhance patient outcomes and safety ( NHS Leadership Academy, 2013 ).

At King's College London, ‘Developing Professional Leadership’ is a core module of the Advanced Practice (Leadership) pathway. The module critically appraises theoretical and professional perspectives on leadership and supports participants to take up leadership roles with attention to ethical practice. Both national and college leadership activities promote an understanding of vertical transformational leadership (VTL) and shared leadership (SL).

Vertical transformational leadership

VTL is a hierarchical leadership model that describes an individual leader who, through various influences and mechanisms, elevates himself or herself and followers towards self-actualisation ( Pearce and Sims, 2000 ). VTL values collaboration and consensus, integrity and justice, empowerment and optimism, accountability and equality, and honesty and trust ( Braun et al, 2013 ). A vertical transformational leader inspires others by interpreting complex data, creating a vision and formulating a strategy for its attainment ( Avery, 2004 ). They aim to create an organisation that is agile, responsive, open to learning and future ready through innovation and creativity. They do this by appealing to followers' emotions and internal motivations, and by building rewarding relationships and raising morale. They use delegation, consultation and collaboration to engage followers but retain power so that responsibility and accountability for a vision and its strategy rests with the leader ( Avery, 2004 ).

Behaviours associated with this leadership style have been classified by Avolio et al (1991) as the four ‘I's: idealised influence, individualised consideration, inspirational motivation, and intellectual stimulation:

  • ‘Idealised influence’ represents the charismatic part of VTL. Leaders model integrity, optimism and confidence, and act with courage and conviction demonstrating their intellectual and technical skills
  • ‘Individualised consideration’ requires self-awareness and an appreciation of the values, aspirations, motivations, strengths and weaknesses of others. From this perspective leaders need to be able to listen and communicate effectively, and may be called upon to teach, coach, mentor or counsel
  • ‘Inspirational motivation’ necessitates a clearly communicated vision and belief in a team's abilities to achieve a desired goal
  • Through ‘intellectual stimulation’ leaders support and facilitate independent thinking, encouraging followers to be more rational, creative and innovative in their decision-making and problem-solving.

Tse and Chiu (2014) have advised that leaders adopt a balanced approach to the use of the four Is that is contingent upon their followers' orientation. For example, if group cohesion is required then idealised influence and inspirational motivation are appropriate leader behaviours. However, if greater creativity is needed from staff, then a leader is advised to exhibit individual consideration and provide intellectual stimulation. Conversely, mismatching leadership behaviour to follower orientation can have detrimental effects. For example, providing intellectual stimulation with high expectations but offering insufficient individualised consideration.

During times of large-scale dramatic organisational change an effective vertical leader is necessary for recalibrating and reviving an organisation ( Binci et al, 2016 ). They can provide clarity, motivation and empowerment. There are several examples of positive VTL outcomes in NHS trusts that have managed to improve their Care Quality Commission ratings. This was achieved through measures to revive cultures and empower staff with open communications and active support ( Health Foundation, 2015 ). Critics argue that VTL dependence on a single figure can be futile for an organisation, especially if the individual is prone to dysfunctional behaviour ( Wang and Howell, 2012 ). In response, an ‘authentic leader’ is proposed ( Jackson and Parry, 2011 ); this is someone with a ‘high socialised power orientation’, who is humble, modest, deflects recognition for achievements, who celebrates the team, and exhibits vertical and shared leadership behaviours. Through self-awareness and reflecting on actions a VTL leader can exhibit authentic leadership behaviour.

VTL overlaps other leadership approaches including authentic, servant, charismatic, inspirational and visionary ( Avery, 2004 ). What often differentiates VTL is its motivation or focus, which is typically on achieving organisational goals. VTL is also associated with pseudo-transformational and transactional leadership. The former is a dysfunctional form of charismatic leadership, characterised by narcissistic behaviours associated with dictators and sensational political and corporate leaders. Transactional leadership is practised by positional managers whose job it is to set expectations and engage in corrective or autocratic measures that aim to maintain efficiency. Transformational leaders do utilise some transactional methods to achieve goals and the two leadership styles can be complementary. However, VTL is two-way leadership with follower influence whereas transactional leadership represents one-directional hierarchical leadership.

Shared leadership

SL is a non-hierarchical leadership model that describes leadership that emerges within a group, depending on the context and skills required at a given time ( D'Innocenzo et al, 2016 ). SL values openness and trust, engagement and inclusiveness, reciprocity and fluidity, democracy and empowerment, and networking and support ( Jameson, 2007 ). Shared leaders are peers who possess no authority over the group outside the context of their shared contribution. Individual leadership is de-emphasised and a vision and its strategy are created and owned by the group. Open discursive engagement is favoured for mutual sense making through the pooling of diverse skills, knowledge and experience. SL is dynamic, multidirectional and collaborative. Power is shared so that responsibility and accountability for a vision and its strategy rests with the group ( Avery, 2004 ).

SL is often associated with, but different conceptually from, co-leadership, distributed leadership, and self-managing teams. Carson et al (2007) suggested that these all lie on a continuum with co-leadership at one end and shared leadership at the other. Participation, consultation and delegation are used in SL as are the four Is of transformational leadership. SL has been described as a type of group transformational leadership as transformational behaviours within a shared leadership model achieve similar results to VTL ( Wang and Howell, 2012 ). SL necessarily exists in organisations such as the NHS where different professional groups with their own leadership structures need to collaborate. Transforming a culture through shared leadership requires patience and investment. It is an iterative process involving cycles of learning and reflection that require trust, personal and professional maturity, and organisational support.

SL leadership behaviours can become widespread within teams, lessening their dependence on one leader and the potential effects of rogue single leaders ( The King's Fund, 2011 ). This is vital in environments where problems are increasingly complex and leaders are required to possess multiple problem-solving skills. Cost efficiencies can result from diminishing hierarchical leaders' workloads and a consequent reduction in their posts among highly skilled cohesive groups ( Tse and Chiu, 2014 ). Critics argue that SL efficiency is influenced by group dynamics, which may be prone to relationship conflicts that lead to decision paralysis ( Pearce and Sims, 2000 ). Additionally, the emergence of a vertical leader who could manipulate the workforce for political or corporate gain may be an unintended consequence of SL.

Both VTL and SL are moderated by internal and external factors. VTL is influenced by levels of trust, follower receptiveness, personality traits, task complexity and urgency. Stress and burnout can lessen leadership benefits while trust can enhance performance outcomes ( Robert and You, 2018 ). SL is moderated by trust, time, group size and cohesion, skill mix, confidence, task complexity and interdependence ( Nicolaides et al, 2014 ). Trust, sufficient time, a balanced skill mix and group cohesion have a positive influence, while task complexity, especially at formative stages, hinders effective SL.

The two approaches are complementary. During the formative stages of shared leadership, a vertical leader is crucial to guide and sustain shared leadership. Some final decisions will need to rest with the hierarchical leader. As the team gains confidence, a vertical transformational leader's role evolves to consultant, mentor, facilitator and, at times, recipient of group leadership. A significant body of evidence associates VTL and SL with positive individual, group and organisational outcomes ( Wang and Howell, 2012 ; Nicolaides et al, 2014 ; D'Innocenzo et al, 2016 ). VTL predominantly influences individual and organisational outcomes while SL is more influential at the group and organisational levels. Table 1 summarises some of the differences between the approaches, although they share much more in common.

VTL and SL are both appropriate in healthcare contexts and can be complementary under the right circumstances. The key is being able to recognise appropriate opportunities to develop and utilise each as either a leader or follower ( Binci et al, 2016 ). Familiarity with the models, their methods and uses are important in these respects. It is equally important to recognise and engage in any cultural change that may be necessary for leadership to be effective. Transformational change does not have to be revolutionary or top-down. Minor changes at the frontline can deliver significant benefits if team members are engaged and led with care.

  • Whether you are a leader or a follower, leadership is at the heart of NHS activity and all nurses have a responsibility to ensure it is effective
  • Vertical transformational and shared leadership models are promoted by national leadership programmes that support the development of NHS staff
  • The two models are complementary, and it is important to be aware of opportunities to develop and utilise each as either a leader or follower
  • Leading with care can inspire and motivate teams to engage in transformative change
  • Familiarisation with leadership models and their application in practice is important for the development of nurses and the organisations in which they work, and for the assurance of patient safety

CPD reflective questions

  • What can you do to demonstrate leadership within your own capacity in your clinical setting?
  • Considering that ‘followership’ is an integral part of NHS leadership, what can you do to demonstrate responsible followership?
  • Reflect on a time where you demonstrated leadership or observed leadership in your clinical area; what leadership qualities can you recognise from that scenario?

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  • Exploration of the representation of the allied health professions in senior leadership positions in the UK National Health Service
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  • Nicola Eddison 1 , 2 ,
  • Aoife Healy 1 ,
  • Nina Darke 3 ,
  • Mary Jones 4 ,
  • Millar Leask 2 ,
  • Gwen L Roberts 5 ,
  • http://orcid.org/0000-0002-7072-1271 Nachiappan Chockalingam 1
  • 1 Centre for Biomechanics and Rehabilitation Technologies , Staffordshire University , Stoke-on-Trent , UK
  • 2 Royal Wolverhampton NHS Trust , Wolverhampton , UK
  • 3 Yeovil District Hospital NHS Foundation Trust , Yeovil , UK
  • 4 Royal Berkshire Foundation Trust , Reading , UK
  • 5 Cardiff and Vale University Health Board , Cardiff , UK
  • Correspondence to Professor Nachiappan Chockalingam, Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, ST4 2DF, UK; n.chockalingam{at}staffs.ac.uk

Background Allied health professionals (AHPs) are an important group within the National Health Service (NHS) in the UK and make up a large portion of the workforce. Investment in AHP leadership is believed to lead to improvements in patient care, resource use, collaboration and innovation. This study aims to assess the current state of AHP strategic leadership within the NHS.

Methods A freedom of information (FOI) request was sent to all NHS Trusts and health boards (HBs) within the UK NHS. The questions focused on the AHP workforce, with a particular interest in the chief AHPs (or equivalent roles) working in an NHS setting. Analysis of the FOI used a range of descriptive statistics.

Results Of the 217 Trusts/HBs contacted, responses were received from 160 (74%). The majority (81%) reported that they employed a Chief AHP or equivalent role, with only 14% of these having a position on the Trust/HB executive board. There were 50 different job titles reported as the titles for the chief AHP or equivalent roles: with director of AHPs (18.6%), lead AHP (13.9%) and chief AHP (11.6%) being the most reported titles. The results identified an inequity of representation of AHP professions within senior AHP leadership; with most of these roles (70%) held by physiotherapists and occupational therapists.

Conclusion Changes in AHP strategic leadership are needed to address the inequities identified in this study. Addressing these issues is required to enable inclusive leadership, which is crucial to improve the contribution of AHPs to healthcare.

  • leadership assessment

Data availability statement

Data are available on reasonable request. The data used within the study is received via a freedom of information (FoI) request. All NHS trusts and health boards will have this publicly available through their websites.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ .

https://doi.org/10.1136/leader-2023-000737

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WHAT IS ALREADY KNOWN ON THIS TOPIC

Allied health professionals (AHPs) are a group of distinct and diverse healthcare professions and together form the third biggest workforce in the UK National Health Service (NHS). Despite this, strategic leadership positions for AHPs within the NHS have been relatively small. From a systems perspective, understanding the current state of AHP strategic leadership within the NHS and the barriers to training and success will help.

WHAT THIS STUDY ADDS

This study provides comprehensive data on how many NHS Trusts/health boards (HBs) have appointed a chief AHP (or an equivalent role), and whether that role has a position on the Trust’s/HB’s executive board. Also, the report highlights, the diversity of professions represented across this role.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

Changes in AHP strategic leadership are needed to address the inequity in the AHP professions represented in the chief AHP role, the non-standardisation of a title for chief AHPs and the lack of representation of chief AHPs on Trust/HBs executive board identified in this study. Addressing these issues is required to enable inclusive leadership, which is crucial to improve the contribution of AHPs to healthcare.

In recent years, the National Health Service (NHS) has increasingly focused on the importance of allied health professionals (AHPs) in transforming healthcare, 1 2 partly driven by the changing pressures on the healthcare service such as increased life expectancy, alongside increasing comorbidities such as obesity 3 and diabetes. 4 AHPs are a group of distinct and diverse healthcare professions, totalling 185 000 professionals currently working within the NHS. 5 In England, there are 14 allied health professions (art therapists, drama therapists, music therapists, chiropodists/podiatrists, dietitians, occupational therapists, operating department practitioners (ODPs), orthoptists, osteopaths, paramedics, physiotherapists, prosthetists and orthotists, radiographers and speech and language therapists). 6 This varies in Wales as they include practitioner psychologists but not ODPs, osteopaths or radiographers and categorise prosthetists and orthotists separately. 7 In Northern Ireland and Scotland, prosthetists and orthotists are also categorised separately and ODPs and osteopaths are not included. 8 9 The professions vary in workforce sizes, the largest workforce is physiotherapists, at 61 132, with the smallest workforces, orthoptists and prosthetists/orthotists, numbering between 1000 and 2000. 10 In comparison, there are 704 520 registered nurses. 11

Although AHPs are the third largest workforce in the NHS, 12 traditionally strategic leadership positions for AHPs within the NHS have been relatively small in number. 13 The majority of NHS leadership positions have historically been filled by medical professionals. 14 As healthcare providers adapt to the changing health requirements of the nation, AHPs have been identified as ideally placed to meet these needs and drive change. 2 15 Since 2017, NHS England has published documents promoting the benefits of professional diversity at the executive board level and the recommendation of a chief AHP role in each Trust to help use the potential of this workforce. 12 14

The lack of leadership within the allied health professions is not specific to the UK and current literature, 16–20 is unequivocal in identifying this issue. Previous reports focus on local leadership, 21 leadership in multidisciplinary teams and leadership education. 22 Information is lacking on AHP strategic leadership at the executive board level, such as Chief AHPs. There are a multitude of reasons why strategic leadership for AHPs is essential. Clinical leaders in healthcare are at the forefront of decision-making and have significant responsibilities such as organisational planning 15 and deciding how limited funding is spent. 17 23 They ensure that an organisation is ready to meet future healthcare challenges 24 and have the power to drive change and facilitate the work of their colleagues. Leadership from those who understand the capabilities of the workforce they represent are essential to influence decision-making within strategic leadership. 24

Furthermore, effective strategic leadership has been shown to improve performance and quality of care and promote efficient use of resources. 25 26 It also ensures that represented professions can compete for the resources they require. 15 Competent leadership may also improve AHP visibility, influence, profile, and status, 27 improving job satisfaction, engagement, and motivation 26 28 and subsequently improving staff retention rates. 15 Therefore, representation within strategic leadership roles is key in demonstrating the value of AHPs. 29

In England, NHS Trust executive boards are required to include a medical and a nurse director, but there is no obligation to include clinicians from other professions. As a result, board-level accountability for AHPs is the responsibility of the director of nursing or chief nurse. 20 This differs in Wales where, since 2009, boards must include an officer responsible for therapies and health sciences. 30 The lack of diversity within senior leadership roles hinders the ability of AHPs to develop and demonstrate the skills required to become leaders at the executive board level. 2 31 In turn, this shortage of AHP leaders in strategic roles creates a lack of role models and mentors to inspire and give AHP clinicians the confidence to pursue leadership opportunities.

When AHP clinical leaders are integrated into operational governance systems, they are influential in supporting models of care that improve outcomes for patients. 15 In contrast, when allied health leaders were not included in planning, some patients who would have benefited from allied health intervention were not offered access to the service. 15 Where Trusts have appointed a chief AHP, there is significant evidence that the ‘value and contribution of the workforce is immediate’ 28 ; including, unlocking the potential of AHPs within the Trust and influencing the AHP workforce, and increasing its engagement in improving services. 13 The Allied Health Professions Strategy for England 1 states that evidence now demonstrates that having a chief AHP role in an organisation is crucial to the delivery of quality care. Similarly, the literature shows where there is a lack of AHP strategic leadership there is reduced visibility and utilisation of this workforce, including patients not benefiting from AHP services, and preventing opportunities to identify benefits from these professions’ skills and expertise. 15

Allied health professions into action 12 encouraged AHPs to fill formal leadership positions to deliver change and produce a more balanced representation within management structures. The AHPs strategy for England 1 stated that diverse board and senior teams increase the likelihood that the ambitions of the NHS Long Term Plan are realised and that AHPs needed to have diverse leadership and opportunities to become leaders. However, one should note that there are variations in the starting grades and the progression through their careers across all 14 allied health professions. This could contribute to difficulties in eligibility to apply to senior leadership roles. There has been a plethora of research to explore the links between leadership and identity focusing on belongingness and the value of diversity 32 which leads to psychological empowerment and work group identification. Further work highlights the importance of leader inclusion for employees who are members of marginalised social identity groups. 33

This study aims to determine the current state of NHS AHP strategic leadership including how many NHS trusts/health boards (HBs) have appointed a chief AHP (or an equivalent role), and whether that role has a position on the Trust’s/HB’s executive board. This study also investigates the diversity of professions represented across this role. The exploration of professional diversity in AHP strategic leadership roles aligns with the recently published NHS England AHP strategy. 1 It is important to ensure AHP professions are not inadvertently overlooked, by a lack of representation, to ensure all the constituent professions have a voice and influence. There is currently no available data on the professional background of those who currently occupy chief AHP (or equivalent) roles in the NHS. It is important to capture this data to understand whether there is a disparity of representation and whom this might impact.

In March 2022, a freedom of information (FOI) request 34 was sent to the 217 Trusts and HBs within the NHS in the UK. 35 Due to the nature of this work, there was no patient and public involvement.

The FOI consisted of 12 questions in total, 9 of which were closed-ended questions and 4 were open-ended questions (see online supplemental material ). The survey focused on the AHP workforce, with a particular interest in the chief AHPs (or equivalent roles) working in an NHS setting. The questions focused on the following areas: (1) if the Trust or HB had a role which resembled the Chief AHP description provided, (2) the job title of the role, (3) the professional background of the post holder (if applicable), (4) if the position was included on the Trust board, (5) which of the allied health professions the Trust/HB employed and (6) If the Trust/HB does not have a chief AHP role (or equivalent) the reason(s) for this. While the data itself do not lend itself to formal statistical analysis, we have used a range of descriptive statistics such as percentages and range to showcase the data.

Supplemental material

Of the 217 Trusts/HBs contacted, 160 responses were received, a 74% response rate. Most responses did not provide an answer for Q 3.3 which asked for an opinion and is therefore beyond the remit of an FOI request, consequently, this question was excluded from the analysis. The majority of the Trusts/HBs included in the analysis (130/160; 81%), reported that they have a chief AHP role or equivalent which was comparable to the job summary included in the FOI request. Nearly one-fifth of Trusts/HBs (30/160) reported that they did not have a comparable role. Regarding job titles pertaining to the role of ‘chief AHP’ (or equivalent), 50 different titles were reported across the 130 Trusts/HBs reporting to have such a position. The most common titles were director of AHPs (24/130; 18%), lead AHP (18/130; 14%) and chief AHP (15/130; 12%), these titles accounted for 44% (57/130) of all responses (see figure 1 ).

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Variation in job titles for roles matching the description of "chief AHP". AHP, allied health professional; CSU, Clinical Service Unit; HCS, Health Care Science.

The results showed that the first job roles matching the description of a chief AHP (or equivalent) role were created in 2005 (2/130; 1.5%), with 67% (87/130) of roles created in the last 8-year period (see figure 2 ). In 2021, 16% (21/130) of chief AHP (or equivalent) roles were created, which constitutes the largest growth in a single year. In the NHS across the UK, of the Trusts/HBs with chief AHP role (or equivalent) roles who responded to this study, 96% (125/130) reported that the role was currently occupied.

Breakdown of the year each position matching the ‘chief AHP’ role description was created. AHP, allied health professional.

Most of the people (110/130; 85%) who currently occupy these roles were registered AHPs, with the majority being physiotherapists (51/110; 46%), followed by occupational therapists (26/110; 23.6%). Thus, 70% (77/110) of the AHP registered staff occupying a chief AHP role (or equivalent) as reported by the Trusts/HBs in this study, are physiotherapists and occupational therapists. While drama therapists, music therapists, operating department practitioners, orthotists/prosthetists, orthoptists and osteopaths do not hold any of the 110 AHP occupied chief AHP (or equivalent) posts in the NHS in the UK, included in this study. Of the remaining 13% of occupied posts, the post holders are registered nurses, clinical psychologists, health scientists, healthcare sciences and pharmacists, with registered nurses accounting for the largest proportion at 8% (10/130) (see figure 3 ).

Professional background of chief AHP role (or equivalent). AHP, allied health professional.

Only 17% (22/130) of the Trusts/HBs who responded to the FOI employed a minimum of 10 of the AHP professions and only one employed all 14 professions. While 12% (16/130) of Trusts/HBs employed at least five AHP professions with a mean average of 7.9 different AHP professions being employed across the UK NHS Trusts/HBs. Dietitians (96% 125/130), occupational therapists (95%; 123/130), physiotherapists (94%; 122/129) and speech and language therapists (92%; 120/130) were the most employed AHP professions across the UK. While paramedics (45%; 59/130), prosthetists/orthotists (43%; 56/130), art therapists (30%; 39/130), music therapists (18%; 24/130), drama therapists (18%; 23/130) and osteopaths (8%; 11/130) are employed by less than 50% of NHS Trusts/HBs in the UK (see figure 4 ).

AHP professions employed by each Trust/HB. AHP, allied health professional; HB, health board.

Of the 24 Trusts/HBs employing 10 or more of the AHP professions, physiotherapy and occupational therapy accounted for 54.2% (13/24) of the AHP disciplines occupying the chief AHP role (or equivalent) at these Trusts/HBs. A minority of the roles (3/24; 12.5%) are occupied by staff from a non-AHP background. Of those Trusts/HBs employing five or fewer of the allied health professions (15/129), 60% (9/15) of the chief AHP roles (or equivalent) are occupied by physiotherapists and occupational therapists. While 20% (3/15) of the roles are occupied by staff from a non-AHP background.

Within the Trusts/HBs who reported having a chief AHP role (or equivalent), 86% (112/130) did not have a position on the Trust board. Of the 17 chief AHP roles (or equivalent) with a position on the Trust board, 8 were occupied by a staff member with a non-AHP background; 7 had a nursing background and 1 with a health scientist background. Of the nine roles occupied by a staff member with an AHP background six were from Welsh HBs.

Finally, of the 30 Trusts/HBs that reported that they do not have a current job role equivalent to a chief AHP role, 24 (80%) did not envisage advertising or creating a similar job role within the next 6 months. Although 19 of the 24 Trusts/HBs (79.2%) reported they are aware of the NHS England and NHS Improvement (NHSI) strategy to have designated senior AHP leads. 36

An ‘enhanced foundation’ of the 2022 AHP Strategy for England 5 is the promotion of diverse and inclusive leadership of AHPs within executive boards and senior teams, along with the removal of practices that ‘prevent AHPs from harnessing their leadership ability’. The importance of effective clinical leadership cannot be underestimated. A lack of effective clinical leadership has been seen as a contributing factor in incidents of poor-quality care and adverse outcomes. 37 38 While investment in leadership is considered to promote innovation, collaboration, improved care and better use of resources. 19

In 2018, NHS England recommended that strategic AHP leaders were appointed within provider organisations, 1 and more recently, within integrated care systems. 39 The aim is to provide the AHP workforce with greater visibility and voice and to ensure that the workforce can contribute to system-wide policies and initiatives. 39 However, the diversity of the allied health professions means that each group might need its own representatives to ensure the priorities and needs of each group are heard, and their individual contributions to Trust/HBs priorities are not overlooked.

The results of this study confirm that there is an inequity of representation of the allied health professions within senior AHP leadership. It was found that physiotherapists (who account for 25% of registered AHPs 40 ) occupy 46% of the Chief AHP roles occupied by AHPs and occupational therapists (who account for 17% of registered AHPs 40 ) occupy 24%. Therefore, with 70% of the AHPs in chief AHP (or equivalent) roles being from either a physiotherapy or occupational therapy background, questions must be asked regarding why clinicians from other allied health professions are not being represented within these leadership positions.

Further, seven of the allied health professions were not represented at all, our results show that the professions with the smallest workforces (those with under 5000 registrants) are not currently represented. These include drama therapists, music therapists, prosthetists and orthotists, orthoptists and osteopaths. 40 However, it is not quite as straightforward as just the size of the workforce being the reason for the lack of representation. For example, the AHP profession with the third largest workforce is radiography with a very similar number of registrants compared with occupational therapy. However, just two chief AHP roles are currently held by radiographers while 26 are held by occupational therapists. Conversely, dietitians have a workforce of just over 10 000 registrants but currently hold 10 chief AHP roles while operating department practitioners have a workforce of 15 000 but are not represented within chief AHP roles.

The results from this study show that not all AHP professions were employed by all the Trusts/HBs who responded. We found that dietitians, occupational therapists, physiotherapists and speech and language therapists were employed by the most Trusts/HBs and it is these four professions which were also found to occupy the four highest numbers of chief AHP roles. Likewise, prosthetists and orthotists, music therapists, drama therapists and osteopaths were among those employed by the least numbers of Trusts/HBs. In the instances where the chief AHP role has been filled by a member of a profession with a small workforce that is, art therapist, three of the four Trusts/HBs who responded were specialist Trusts/HBs (ie, they specialise in a specific condition such as cancer or neurology). Anecdotally, based on the authors’ experiences, in some Trusts/HBs, due to workforce shortages, sometimes AHPs are used to cover service provision typically provided by a different allied health profession (eg, a specialist podiatrist prescribing ankle foot orthoses which would typically be provided by an orthotist). While there are instances where this might be acceptable, further forward referrals should be organised either to multidisciplinary teams or specialist services for the benefit of the patient. This seldom happens and appropriate AHP leadership would have the potential to change this dynamic.

The combination of being both part of a smaller workforce and not being employed by the majority of Trusts/HBs may mean there is less familiarity with and understanding of these allied health professions among senior management, other clinical teams within the Trust/HB, and patients. Potentially resulting in those professions being less well integrated within the hospital structures, creating a potential barrier to those in the professions with smaller workforces reaching senior leadership roles. This is exacerbated in the case of some professions (such as prosthetists and orthotists) which are often contracted services meaning that their workers are not direct employees of the Trust/HB. 41 There is also the potential that unfamiliarity is a reason that these smaller workforces are employed by fewer Trusts/HBs. In a survey investigating occupational therapists’ contributions to palliative care, it was noted that when colleagues had an increased understanding of what an occupational therapist can contribute, it led to occupational therapists expanding their scope of practice. 42 Raising the profile of AHP skillsets may lead to their specialisms being used in a wider scope of healthcare environments.

The presence of AHPs within senior leadership roles increases the visibility of the AHP professions and provides credibility with Trust/HB boards, as well as demonstrating that those professions are valued 43 and considered able to contribute to service redesign and improvements. The results of this study found that 19% of the Trusts/HBs who responded do not currently have a Chief AHP or equivalent role, and 80% of those did not envisage creating one within the next 6 months. Regarding job titles for AHP leads, in 2018 it was reported that there were 41 job titles across 43 job descriptions for the most senior AHP lead 44 ; meaning that largely no ‘readily identifiable ‘go-to’ AHP leader’ existed within the NHS, as there is for other professions such as nursing. The current study identified 50 different job titles for equivalents of chief AHP roles, indicating that standardisation of this title is still an issue.

A lack of visible role models within senior leadership contributes to a reduced sense of identity and leaves AHPs without a readily identifiable leader as exists for other professions (eg, the director of nursing). 43 45 The absence of professions with smaller workforces in these roles creates a continuing problem with culture and a perception that leadership opportunities are not open to them 45 46 which in turn contributes to the absence itself. Leader inclusion is shown to be effective in facilitating an inclusive work environment, increasing positive employee attitudes and enhancing performance. 33

A further complication is the lack of clarity regarding which professions are classified as AHPs. There are significant differences between the four nations of the UK, with some professions only having been recently added to the list. Even within England, some Trusts will include more than the 14 professions recognised by NHS England, 6 such as psychologists, psychotherapists, biomedical scientists and social workers. 44 This is also true internationally, with the USA and Australia including a wider range of professions. 47 Furthermore, the term ‘therapies’ is often used as a synonym for AHPs which creates yet more confusion. 48 49 As there is no universally accepted definition for the allied health professions, this impacts further on the sense of identity of AHPs, in particular, those from the professions with smaller workforces, and also the understanding of their roles and the contribution they can make within healthcare systems.

Another possible barrier for the smaller AHP professions being appointed to senior leadership positions is that those in these professions are less likely to have received leadership training during their career than the AHP professions with larger workforces, who, in turn, are less likely to have received training than nurses or medics. 45 This is partly because as a collection of diverse professions, AHPs work in a variety of different settings and have less defined career pathways when compared with medical and nursing professions. 14 46 A degree of serendipity has been reported in the career paths of those who have reached senior leadership positions, with knowledge having been acquired in ‘unstructured opportunities’ 45 due to a lack of developmental leadership roles being available for AHPs. 14

As a result, AHPs (particularly those from professions with smaller workforces) can feel inadequately prepared or qualified for leadership positions 38 50 with a lack of a clear structure to support leadership development. 51 With the different career structures come significant variations in opportunities to develop leadership and management skills. 31 For example, AHPs are usually employed in direct patient care roles, with fewer opportunities to progress into non-clinical areas. 38 While in the current study occupational therapists occupied nearly a quarter of the chief AHP (or equivalent) roles, Eva and Morgan 42 found occupational therapists across Europe spent their time on direct and indirect patient care activities, with limited ability to participate in leadership activities, and this will be true for other AHP groups. Traditional AHP career pathways tend to focus on the development of clinical skills, research or specialisation which may ‘reduce opportunities for operational and strategic leadership’. 14

AHPs can find fewer career progression opportunities open to them; a recent NHS report noted that access to developmental leadership roles tends to be restricted to nursing or medical professions. 14 Further, some posts are open to applicants from certain professions only, either excluding some AHP groups or not being open to AHPs at all. 28 44 When chief AHP posts are open to AHPs, some Trusts have reported issues with not being able to appoint candidates due to gaps in their skills, knowledge and experience. 14 Wylie and Gallagher 52 found that AHPs who had received leadership training exhibited more transformational behaviours than those who had received none, meaning that they are more likely to possess the skills needed to contribute to healthcare planning and service delivery. Overall, it is recognised that leadership development within the NHS is ‘uncoordinated and inconsistent’. 45 For AHPs, it has been recommended that leadership roles should be promoted as part of (rather than alternatives to) clinical progression and that training opportunities should be available for AHPs earlier in their careers, even in preregistration education. 14 22 This would provide reassurance to AHPs that moving into leadership positions would not be a threat to their values or clinical credibility 36 46 as these moves would be established and normalised steps in their career pathways, just as they now are for professions such as nursing. The NHS now provides opportunities open to AHPs to develop their leadership skills. 53 54

Results found that 86% of those in Chief AHP (or equivalent) roles did not have a position on the Trust/HBs executive board. Of the nine chief AHPs (or equivalent) roles who had both an AHP background and a position on the Trust executive board, six were from Welsh HBs, which is due to the requirement in Wales to include an officer responsible for therapies and health sciences on executive boards. 30 This shows that a change in NHS policy regarding which positions must be included on the board does have a positive impact on the inclusion of AHP leadership positions. Reducing constraints on AHPs to develop and demonstrate their senior leadership potential. 31

As there are few chief AHPs (or equivalent) roles with a place on a Trust/HB executive board, responsibility for AHPs generally lies with the director of nursing or chief nurse. 20 However, those from a nursing background may be unable to adequately represent AHPs at the executive board level, partly due to the extent of the nursing agenda, 44 and partly because they are unlikely to have an in-depth understanding of the scope of practice for each of the of professions classified as AHPs. This is also due to the diversity across various AHPs and the marked differences between them. The chief AHP role can provide the necessary knowledge, reduce the fragmentation, and bring the workforce together, 28 but this would be even more effective if all the Chief AHPs had a place at the executive board level.

NHS England has raised the profile of AHPs in recent years, ensuring that the term ‘AHP’ has a position and purpose within the clinical workforce of the NHS. However, as all the allied health professions are not represented in the most senior roles, it introduces the risk that the term ‘AHP’ will become synonymous with the professions with the largest workforces.

This study is the first to map the state of NHS AHP strategic leadership in the UK; identifying inequity in the AHP professions represented in this role, non-standardisation of a title for chief AHPs and a lack of representation of Chief AHPs on Trust/HBs executive board. Changes are needed to enable AHPs to achieve ‘impactful, inclusive leadership’ which is identified as crucial to improve the contribution of AHPs to healthcare. 1

Recommendations

To establish AHP leaders within Trusts/HBs, a standardised job title for the person leading AHPs within a Trust/HB (i.e., chief AHP) is required.

A change in policy to stipulate a place for the chief AHP on Trust/HB executive boards, as currently exists in Wales, is required. This would bring AHPs in line with nurses and medical practitioners.

An exploration of the barriers preventing all AHP professions from being represented in the chief AHP role is needed. With the aim of ensuring a wider representation of the AHP professions in chief AHP roles.

The most senior AHP positions should be open to all the allied health professions, as should training and development opportunities, and early career pathways.

Ethics statements

Patient consent for publication.

Not applicable.

Ethics approval

Ethical approval was not required for this study as it was based on Freedom of Information requests. However, this study followed the research governance procedures outlined by Staffordshire University and it received necessary approvals, as per university policy.

  • NHS England
  • Griffiths M
  • Elwell-Sutton T ,
  • Iacobucci G
  • Welsh Therapies Advisory Committee
  • Nidirect government services
  • Scottish Government
  • Health & Care Professions Council HCPC
  • Nursing and Midwifery Council
  • Allied Health Solutions
  • NHS Improvement
  • Cockburn L ,
  • Devine N , et al
  • McGowan E ,
  • Elliott N ,
  • Gregoire MB ,
  • Health Education England
  • Chatalalsingh C ,
  • Travaglia J ,
  • Department of Health & Social Care
  • National Health Service Wales
  • Faculty of Medical Leadership and Management
  • Randel AE ,
  • Chung BG , et al
  • Great Britain
  • Chockalingam N ,
  • Eddison N ,
  • Messenger G
  • Institute of Health & Social Care Management
  • The Association of Schools Advancing Health Professions
  • Australian Government Department of Health and Aged Care
  • Butler-Henderson K ,
  • Newstead T , et al
  • Footer CB ,
  • Tsegaye HS ,
  • Yitnagashaw TA , et al
  • Gallagher HL
  • NHS Leadership Academy

Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

  • Data supplement 1

Twitter @nachic

Contributors NE conceived the original idea for the study. AH and NC contributed to the further development of the aim and developed the methods. All authors contributed equally to developing the FOI questions, data collection and manuscript preparation. NC is responsible for the overall content as the guarantor.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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