Articles / Leadership Now Programme: NHS Development and Ready Now Guide
Development, Training & CoachingExplore NHS Ready Now programme for senior BAME leaders, compassionate leadership initiatives and present-focused leadership development in healthcare.
Written by Laura Bouttell • Mon 5th January 2026
The NHS Leadership Academy's Ready Now programme addresses urgent need for diverse senior leadership by developing Black, Asian, and minority ethnic (BAME) leaders to progress into executive positions, recognising that representation at senior levels currently lags substantially behind workforce demographics where BAME staff comprise 21.4% of NHS employees but hold only 6.7% of very senior manager positions. This leadership development gap reflects broader challenges NHS faces: accelerating leadership capability development to meet immediate service pressures, cultivating compassionate leadership responding to workforce wellbeing crises, and building inclusive cultures where talent from all backgrounds can flourish.
The concept of "now" in NHS leadership development reflects multiple imperatives: immediate action required to address health inequalities, workforce sustainability, and service transformation; present-moment awareness central to compassionate leadership; and urgent need to diversify senior leadership. Various NHS programmes embody this NOW focus—from Ready Now's targeted support for senior BAME leaders, through Compassionate Leadership frameworks emphasising present attention and authentic connection, to rapid leadership development responding to crisis demands demonstrated during COVID-19 pandemic.
This guide examines NOW-focused leadership development in NHS contexts: the Ready Now programme structure and outcomes, compassionate leadership principles and practices, immediate-impact leadership capabilities responding to current healthcare challenges, inclusive leadership development addressing representation gaps, and practical strategies for developing leadership presence and effectiveness now rather than deferring development until circumstances seem ideal.
The NHS Leadership Academy's Ready Now programme provides intensive development for senior BAME leaders positioned for progression to executive positions including director and board-level roles. The programme addresses persistent underrepresentation at senior NHS leadership levels through targeted intervention combining skills development, coaching, peer networks, and organisational culture change advocacy.
Ready Now operates as cohort-based development programme typically spanning 6-12 months, bringing together senior BAME leaders from across NHS organisations for shared learning experiences. The programme structure integrates multiple developmental modalities: residential learning workshops providing intensive skill-building and relationship development; one-to-one executive coaching addressing individual leadership challenges and career aspirations; action learning sets enabling peer consultation on real organisational problems; and networking events creating connections across organisations and sectors.
The curriculum addresses competencies particularly relevant for executive roles: strategic thinking and planning, financial acumen and commercial awareness, board-level governance, stakeholder engagement and political navigation, leading cultural transformation, and executive presence. These capabilities build on participants' existing operational leadership expertise whilst developing strategic perspectives essential for senior positions.
Coaching proves particularly valuable component of Ready Now, providing confidential space for participants to explore career aspirations, develop strategies for navigating organisational politics, address imposter syndrome or confidence barriers, examine experiences of discrimination affecting progression, and clarify personal values informing leadership approach. Coaches bring understanding of NHS contexts alongside expertise in executive development and often lived experience of barriers underrepresented leaders face.
Action learning sets create peer support networks that frequently persist long after programme completion. Participants bring genuine leadership challenges from their organisations—implementing transformation initiatives, managing underperformance, navigating restructuring, building diverse teams—receiving consultation from peers who understand NHS contexts whilst offering fresh perspectives. This peer learning builds problem-solving capability whilst reducing isolation that senior leaders often experience.
Ready Now targets senior BAME leaders currently in roles typically Band 8c, 8d, or equivalent (assistant director, deputy director, senior operational or professional roles) with clear potential and aspiration for executive positions. Applicants typically demonstrate substantial leadership track record, strategic thinking capability, organisational impact, and commitment to championing diversity and inclusion.
Selection processes assess both individual readiness for executive progression and organisational commitment to supporting participants' development and advancement. Ideal candidates possess combination of proven operational excellence, strategic perspective, personal resilience, political acumen, and authentic commitment to inclusive leadership extending beyond their own career progression to advancing opportunities for others.
Organisations nominating participants should demonstrate commitment to creating conditions enabling progression—through succession planning addressing diversity, tackling discrimination and bias in recruitment and promotion, flexible working arrangements supporting diverse needs, and senior sponsorship of high-potential BAME talent. Programme impact depends partly on organisational readiness to recognise and promote developed talent rather than merely training individuals who subsequently find progression blocked.
Programme evaluation demonstrates measurable career progression impacts: participants report increased confidence in executive capabilities, expanded professional networks including potential sponsors and mentors, enhanced strategic thinking and board-level competencies, and clearer career strategies. Many participants progress to executive roles within 12-24 months of completion, though individual timelines vary based on opportunities and organisational contexts.
Beyond individual career advancement, Ready Now aims to influence organisational cultures and systems perpetuating inequality. Participants often become active champions for diversity and inclusion within their organisations, challenging discriminatory practices, advocating for equitable policies, mentoring other underrepresented staff, and using their growing influence to open opportunities for others. This multiplier effect extends programme impact beyond immediate cohort to broader workforce.
The programme builds collective capacity for change by creating community of senior BAME leaders who maintain connections, share intelligence about opportunities, support each other through challenges, and collectively advocate for systemic changes addressing barriers to progression. This network effect proves valuable both for individual participants finding allies and counsel, and for organisations seeking to recruit diverse senior talent through recommendations within this community.
Compassionate leadership represents core strand of contemporary NHS leadership development, emphasising leaders' attentiveness to staff needs, intelligent response to suffering, and creation of cultures enabling people to flourish. This leadership approach proves particularly relevant amidst workforce wellbeing crises, where staff burnout, moral injury, and attrition threaten service sustainability.
The King's Fund and NHS Leadership Academy framework identifies four elements characterising compassionate leadership:
Attending involves paying attention to people—their experiences, concerns, suggestions, and wellbeing. Compassionate leaders create time and space for genuine listening rather than rushing conversations, demonstrate curiosity about others' perspectives, notice when people struggle, and signal genuine interest in staff as whole human beings rather than merely functional resources. In healthcare's task-focused, time-pressured environments, this attending proves challenging but essential—staff who feel genuinely seen and heard by leaders develop commitment, resilience, and willingness to extend themselves.
Understanding requires moving beyond surface observations to deeper comprehension of others' experiences, motivations, and contexts. Compassionate leaders seek to understand why people behave as they do, what pressures or constraints shape their actions, what matters most to them, and how their life circumstances affect work performance. This understanding enables empathetic response rather than judgment, sees difficulties as problems to solve rather than character flaws to criticise, and informs supportive interventions addressing root causes rather than symptoms.
Empathising involves emotionally connecting with others' experiences, feeling with rather than merely observing from distance. Compassionate leaders allow themselves to be moved by staff struggles, patient suffering, or collective challenges rather than maintaining detached professional persona. This emotional resonance doesn't mean becoming overwhelmed or losing boundaries—rather, it involves authentic human connection that validates others' feelings and demonstrates genuine care. In healthcare's emotionally demanding environments, leaders who model healthy emotional engagement rather than stoic suppression help create cultures where staff feel permitted to acknowledge emotional impacts whilst developing resilience.
Helping translates attention, understanding, and empathy into supportive action addressing people's needs. Compassionate leaders don't merely sympathise—they actively seek to improve situations, remove obstacles, provide resources, advocate for staff interests, and create conditions enabling flourishing. This help might involve practical support (flexible working arrangements, additional resources, workload redistribution), developmental assistance (coaching, training, stretch assignments), or systemic interventions (policy changes, cultural initiatives, structural reforms) addressing underlying problems.
Translating compassionate leadership principles into practice requires both individual behavioural change and organisational culture transformation. Several practical approaches support implementation:
Leader rounding and visibility ensures leaders maintain regular contact with frontline staff rather than becoming isolated in executive suites. Compassionate leaders schedule regular walkabouts through clinical areas, staff rooms, and support departments, engaging in informal conversations, observing conditions firsthand, and demonstrating accessibility. These encounters build relationships enabling genuine dialogue whilst keeping leaders grounded in operational realities.
Reflective practice and supervision supports leaders developing compassion for themselves alongside staff. Healthcare leadership's emotional demands create risks of burnout, compassion fatigue, and vicarious trauma. Supervision provides space for processing difficult experiences, examining emotional reactions, maintaining perspective, and sustaining wellbeing. Leaders who tend their own needs model self-care for staff whilst maintaining capacity for compassionate engagement.
Inclusive decision-making processes demonstrate respect for staff expertise and experience. Compassionate leaders involve frontline workers in decisions affecting their practice, genuinely listen to concerns about proposed changes, incorporate staff wisdom into planning, and explain decision rationale transparently when staff input cannot be accommodated. This participative approach builds ownership whilst recognising staff as intelligent professionals rather than merely policy implementation resources.
Wellbeing initiatives and support services translate compassionate concern into practical assistance. Organisations led compassionately invest in psychological support services, ensure manageable workloads, provide flexible working arrangements supporting work-life balance, celebrate successes and appreciate contributions, and create cultures where admitting struggle and seeking help are normalised rather than stigmatised.
Effective leadership development cannot wait for ideal circumstances—pressures NHS faces demand capable leaders operating effectively in present conditions whilst building capacity for future challenges. Several principles support NOW-focused leadership development:
Mindful leadership practices cultivate present-moment awareness essential for effective decision-making, authentic relationships, and stress resilience. Leaders who develop capacity for present attention notice subtle cues about staff morale, patient experiences, and organisational dynamics that distracted leaders miss. This noticing enables early intervention before problems escalate, more nuanced understanding of situations informing better decisions, and authentic presence in interactions that builds trust and connection.
Mindfulness practices—meditation, breathing exercises, body scans, mindful walking—train attentional capacities whilst reducing stress reactivity. Regular practice develops ability to pause before reacting, choose responses rather than habitually pattern-follow, tolerate uncertainty without premature closure, and maintain equanimity amidst pressure. These capabilities prove valuable for healthcare leaders navigating constant change, competing demands, and emotionally charged situations.
Present-focused leadership contrasts with common patterns of dwelling on past problems or anxiously anticipating future difficulties, neither of which enables effective action in current moment. Whilst learning from history and planning for future remain important, leaders who become trapped in past regrets or future worries miss opportunities for immediate positive impact. NOW-focused leadership asks: "What does this situation require of me right now? What constructive action can I take immediately?"
Leadership presence—the quality of being fully present, authentic, and centered whilst engaging others—proves essential for executive effectiveness. Presence involves congruence between internal experience and external expression, confidence without arrogance, calm authority that puts others at ease, and genuine interest in others that invites openness. These qualities cannot be faked or performed superficially—they emerge from internal work developing self-awareness, clarifying values, managing ego needs, and cultivating genuine care for mission and people.
Developing presence requires multiple practices: honest self-examination identifying gaps between aspirational and actual behaviour; seeking feedback on how others experience your leadership; working with coaches or mentors to address blind spots; experimenting with different approaches and noticing impacts; and committing to alignment between values and actions even when inconvenient. This work proves ongoing rather than one-time achievement—presence deepens through sustained attention and practice.
Executive capability development addresses competencies distinguishing effective senior leaders: strategic thinking that sees patterns and anticipates implications, systems understanding that grasps how components interconnect, political acumen that navigates competing interests, financial literacy that informs resource stewardship, board-level governance knowledge, stakeholder engagement skill, and change leadership capability. These competencies can be developed through targeted learning, but require application in increasingly responsible roles to truly embed.
Crisis contexts including COVID-19 pandemic demonstrated that leadership capability can develop rapidly when circumstances demand and support systems enable accelerated learning. Rapid development approaches include:
Stretch assignments that thrust capable individuals into more senior roles with support rather than waiting until they feel fully prepared. Healthcare's operational pressures create numerous opportunities for temporary leadership responsibilities—covering vacancies, leading improvement projects, representing services in forums—that develop capability through doing rather than merely studying.
Intensive coaching and mentoring accelerates learning by providing structured reflection, tailored guidance, political navigation support, and confidence-building for leaders assuming new responsibilities. Short-term intensive coaching around specific transitions or challenges often proves more impactful than lower-intensity longer-term arrangements.
Peer learning cohorts bring together leaders facing similar challenges for mutual consultation, creating efficiency through shared learning rather than everyone solving problems individually. Cohorts develop quickly because participants bring immediate real-world challenges rather than theoretical exercises.
Just-in-time learning provides targeted capability building precisely when needed—leadership training for those just promoted, strategic planning workshops for leaders developing annual plans, financial literacy sessions for new budget holders. This timing maximises relevance and immediate application rather than learning concepts that may or may not prove useful later.
Inclusive leadership development recognises that traditional pathways often inadvertently favour dominant groups whilst creating barriers for women, BAME staff, LGBTQ+ professionals, disabled leaders, and others facing discrimination or exclusion. Creating equitable opportunities requires intentional design addressing these barriers.
Research consistently identifies multiple barriers affecting underrepresented groups' leadership progression:
Bias in selection and promotion manifests through subtle preferences for leaders who "look like leaders" (often meaning conforming to dominant group norms), valuing confidence over competence (favouring those socialised toward self-promotion), informal networks determining opportunities (excluding those lacking connections), and assessment criteria reflecting dominant culture norms rather than genuine leadership requirements.
Lack of role models and sponsors means underrepresented staff see few people like themselves in senior positions, creating questions about whether progression is possible, lacking mentors who understand specific challenges they face, and missing sponsors willing to use influence to advocate for their advancement.
Work-life balance challenges disproportionately affect women, particularly those with caring responsibilities, disabled staff managing health conditions, and others whose life circumstances require flexibility that traditional leadership roles often don't accommodate. Expectation of constant availability, long hours cultures, and inflexible working patterns exclude talented individuals unable to conform to these norms.
Microaggressions and discrimination create hostile or unwelcoming environments where underrepresented staff expend energy managing others' biases rather than focusing on leadership development, face questioning of their competence or credentials that peers don't experience, and must choose between assimilating to dominant culture or risking being seen as "not fitting."
Addressing these barriers requires systemic interventions alongside individual development:
Transparent pathways and criteria ensure everyone understands progression requirements rather than relying on informal knowledge, assess candidates against objective competencies rather than subjective "fit," and monitor demographic patterns in selection outcomes identifying where bias may operate.
Sponsorship programmes deliberately connect high-potential underrepresented staff with senior leaders willing to actively advocate for their progression, make introductions, recommend for opportunities, and provide political guidance. Sponsors go beyond mentoring's advisory function to actively use influence on protégés' behalf.
Flexible working and job-crafting accommodate diverse needs through remote work options, flexible hours, compressed weeks, job shares, and other arrangements enabling talented individuals to contribute without conforming to traditional patterns. Leadership roles can often be designed more flexibly than assumed whilst maintaining effectiveness.
Inclusive cultures and zero-tolerance policies establish clear expectations that discrimination, harassment, and microaggressions are unacceptable, investigate complaints seriously, hold perpetrators accountable regardless of seniority, and create psychological safety for raising concerns without fear of retaliation.
Targeted development programmes like Ready Now provide intensive support for underrepresented groups, addressing specific challenges they face, building confidence and capability, creating peer networks, and accelerating progression.
The NHS Leadership Academy's Ready Now programme provides intensive leadership development for senior BAME (Black, Asian, and minority ethnic) leaders preparing for executive positions including director and board-level roles. The 6-12 month programme combines residential workshops, executive coaching, action learning sets, and networking events, addressing competencies like strategic thinking, financial acumen, board governance, stakeholder engagement, and executive presence. The programme aims to address underrepresentation at senior NHS leadership levels where BAME staff hold only 6.7% of very senior manager positions despite comprising 21.4% of the overall workforce.
Ready Now targets senior BAME leaders currently in roles typically Band 8c, 8d, or equivalent (assistant director, deputy director, senior operational or professional roles) with clear potential and aspiration for executive positions. Applicants should demonstrate substantial leadership track record, strategic thinking capability, organisational impact, and commitment to championing diversity and inclusion. Organisations nominating participants should demonstrate commitment to supporting progression through succession planning, addressing bias in recruitment and promotion, and creating conditions enabling advancement. Selection assesses both individual readiness and organisational commitment.
Compassionate leadership in healthcare emphasises leaders' attentiveness to staff needs, intelligent response to suffering, and creation of cultures enabling people to flourish. The King's Fund framework identifies four elements: attending (paying genuine attention to people), understanding (comprehending others' experiences and contexts), empathising (emotionally connecting with others' experiences), and helping (taking supportive action addressing needs). Compassionate leadership proves particularly relevant amidst workforce wellbeing crises, where staff burnout and moral injury threaten service sustainability. Research demonstrates compassionate leadership associates with higher staff engagement, improved retention, and better patient outcomes.
Developing leadership presence requires honest self-examination identifying gaps between aspirational and actual behaviour; seeking feedback on how others experience your leadership; working with coaches or mentors addressing blind spots; and committing to alignment between values and actions. Mindfulness practices cultivate present-moment awareness essential for authentic engagement. Stretch assignments provide opportunities to practice leadership in increasingly responsible roles with support. Intensive coaching around specific transitions or challenges accelerates learning. Present-focused leadership asks: "What does this situation require of me right now?" rather than dwelling on past problems or future anxieties.
Research identifies multiple barriers: bias in selection and promotion favouring those who "look like leaders" or conform to dominant group norms; lack of role models and sponsors meaning fewer people like themselves in senior positions; microaggressions and discrimination creating hostile environments; informal networks determining opportunities excluding those lacking connections; and assessment criteria reflecting dominant culture rather than genuine leadership requirements. Addressing these barriers requires systemic interventions including transparent pathways, sponsorship programmes, flexible working arrangements, inclusive cultures with zero-tolerance policies for discrimination, and targeted development programmes like Ready Now.
Mindful leadership practices cultivate present-moment awareness essential for effective decision-making, authentic relationships, and stress resilience. Leaders who develop present attention notice subtle cues about staff morale and organisational dynamics that distracted leaders miss, enabling early intervention before problems escalate. Mindfulness training develops ability to pause before reacting, choose responses rather than habitually following patterns, tolerate uncertainty without premature closure, and maintain equanimity amidst pressure. These capabilities prove valuable for healthcare leaders navigating constant change, competing demands, and emotionally charged situations whilst reducing stress reactivity and burnout risk.
COVID-19 pandemic demonstrated leadership capability can develop rapidly when circumstances demand and support systems enable accelerated learning. Rapid development approaches include stretch assignments providing more senior responsibilities with support; intensive coaching and mentoring around specific transitions or challenges; peer learning cohorts for mutual consultation; and just-in-time learning providing targeted capability building precisely when needed. While deep expertise requires time and experience, foundational leadership capabilities can develop quickly through deliberate practice, structured reflection, and application in increasingly responsible roles. The key involves balancing challenge with support rather than waiting until feeling fully prepared.
NHS leadership development increasingly recognises that capability building cannot wait for ideal circumstances—urgent service pressures, workforce challenges, and transformation imperatives demand leaders who can operate effectively in present conditions whilst developing capacity for future challenges. The Ready Now programme exemplifies this immediacy, addressing underrepresentation at senior levels through intensive development preparing BAME leaders for executive progression now rather than through slow incremental advancement.
Compassionate leadership frameworks emphasise present-moment awareness and authentic connection, recognising that effectiveness requires full presence rather than distracted partial attention. Mindful leadership practices cultivate capacities for noticing, pausing, choosing response, and maintaining equanimity that enable thoughtful action amidst chaos. These NOW-focused approaches prove particularly valuable in healthcare's volatile, complex, ambiguous environments where leaders face constant change and competing demands.
For individual leaders, embracing NOW-focused development means refusing to defer capability building until circumstances seem ideal, seeking stretch assignments that accelerate learning through doing, cultivating present-moment awareness through mindfulness practice, and taking constructive action on immediate challenges rather than waiting for perfect solutions. It means developing executive presence through alignment between values and actions, building authentic relationships through genuine attention to others, and championing inclusive cultures where diverse talent can flourish.
The concept of leadership NOW challenges common patterns of dwelling on past problems or anxiously anticipating future difficulties, neither of which enables effective action in the current moment. While learning from history and planning for the future remain important, leaders who become trapped in past regrets or future worries miss opportunities for immediate positive impact. The most valuable question becomes: "What does this situation require of me right now, and what constructive action can I take immediately?"
For organisations, creating conditions for NOW-focused leadership development requires removing barriers to progression for underrepresented talent, providing intensive development opportunities like Ready Now alongside broader leadership programmes, championing compassionate leadership as performance expectation rather than optional nicety, creating psychological safety for taking leadership risks, and recognising that rapid capability development proves possible when properly supported.
NHS workforce and patient needs demand capable, compassionate, inclusive leadership operating effectively now whilst building capacity for evolving challenges. By embracing NOW-focused development—through programmes like Ready Now, compassionate leadership practices, mindful presence, and inclusive cultures—healthcare leaders accelerate their growth whilst contributing to the urgent transformation healthcare systems require.
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