This thesis contains an account of research into the competencies used by leaders of innovative change in health service organisations. A competency is defined as a\ud capability that enables an individual to be effective in a task or a role. Leadership is defined as a process of influencing others to agree what needs to be done, and\ud how it can be done, and assisting efforts to achieve the agreed aims. Innovative changes are changes that involve novelty to the organisation or group to which they are introduced.\ud \ud A qualitative approach was taken to the research. Interviews were carried out with forty executives and clinicians in UK and Australian health service organisations,who had been identified as effective in leading change. The interviews followed a Behavioural Event approach, based on the critical incident method, and the\ud recordings and transcripts were subjected to a grounded analysis to derive descriptions of behaviours and competencies.\ud \ud Eleven competencies were identified from the interviews, including the ability to make sense of complex social systems, and the ability to work well in collaboration\ud with others. The eleven competencies were used in combination in a range of leadership styles that were participative, collaborative, persuasive, transactional,\ud pragmatic, personable and managerial. The majority of interviewees described bringing about effective change using styles that were not visionary - and therefore\ud that did not employ what is often regarded as a central element of the leadership of change, and of transformational leadership, that of an appealing vision of the future. No significant differences in the competencies employed were found between UK and Australian interviewees in comparable roles.\ud \u
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