Beyond Western Leadership: The Potential of Ubuntu and Confucian Leadership in NHS Echocardiography Services.

Transthoracic echocardiography services are overwhelmed by long waiting lists, limited career progression, high attrition rates, and a shortage of future trainees. Unfortunately, leaders focus on throughput and performance targets while neglecting human factors, which drives healthcare scientists into the independent sector to perform similar roles for considerably higher salaries. Leadership theory in general, and NHS leadership efforts, are Western-centric. This perspective paper aims to broaden the leader-follower paradigm to include non-Western leadership styles - Ubuntu and Confucianism - to redirect leadership values towards changes necessary to improve service provision. Ubuntu is an ancient Indigenous African concept that emphasises "humanness" and interconnectedness, while Confucianism is an ancient Chinese philosophy that emphasises benevolence and social harmony through hierarchical structures. Such principles could fuel transparent, involving and creative decision-making processes that will likely engage staff and cultivate commitment and shared responsibility. Moreover, by establishing a clear career structure from band three to nine and dedicating resources to training, departments would combat the low "career ceiling", create career development opportunities and improve trainee success and quality. This paper advocates for a decolonised, pluralistic leadership model that combines Western principles with Ubuntu and Confucian philosophies in the leadership of echocardiography services within the NHS. Such leadership could enhance staff morale and well-being, promote upskilling, improve training regimes and help reduce high attrition rates. These improvements are vital to prevent workforce shortages, address waiting list issues, and ensure patient safety.