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NHS Leadership set for Big Changes Following 9 Month Review

strikes

Health Secretary, Sajid Javid has pledged an overhaul of health and social care leadership in England after a review found evidence of “institutional inadequacy” in how managers are trained and valued, with Mr Javid describing the findings of the review as “stark”.

NHS Management

The review, conducted by General Sir Gordon Messenger and Dame Linda Pollard, will be published later today and marks the largest review of NHS management since the Griffiths report on NHS management in 1983. The review tells of a need for a transformation of leadership, with Messenger commenting that “a well-led, motivated, valued, collaborative, inclusive, resilient workforce is the key to better patient and public health outcomes, and must be a priority.”

Speaking to her NHS colleagues, Dame Linda Pollard who chairs the Leeds Teaching Hospitals Trust, said: “Today’s report is about empowering you to be the best version of yourselves – to work to the best of your abilities, have the tools to develop your careers and support each other and to create an equal opportunities workplace of which we can all be proud.”

NHS of 2048

Javid reportedly explained to MPs that “the NHS is absolutely fantastic, we all rely on it, but much of how it’s set up is still very much 1948. We need to be thinking about 2048, and how we get from here to the needs of the British population when it comes to health in 2048.” Ahead of the publication of the full report, the Department of Health and Social Care stated that, while the report did highlight some instances of inspirational leadership, the report largely found “a lack of consistency and co-ordination.”

Health Secretary Sajid Javid promises NHS shake-up
Health Secretary Sajid Javid

The recommendations of the review are said to include:

  1. Targeted interventions on collaborative leadership including new entry level and mid-career programmes.
  2. Action to improve equality, diversity and inclusion and embed inclusive leadership practice.
  3. Consistent management standards through accredited and unified training.
  4. A simplified appraisal system including both how people have behaved not just what they have achieved.
  5. A new career and talent management function for managers.
  6. more effective recruitment and development of Non-Executive Directors.
  7. Encouraging top talent into challenged parts of the system.

Responding to the findings of the review, Amanda Pritchard, the Chief Executive of the NHS said: “as this report recognises, leaders across the health service do a fantastic job in often very challenging circumstances. The NHS is a learning organisation – we welcome this report and are determined to do all we can to ensure our leaders get the support they need.”

However, the Health Secretary reportedly spoke to cabinet colleagues of an anachronistic healthcare system, describing the NHS as a “Blockbuster healthcare system in the age of Netflix”.

Commenting on the Government’s reaction to the review, Shadow health secretary Wes Streeting said “I think it’s slightly absurd that 12 years into a government, we have government ministers who talk in the biggest generalities without plans to deliver anything.”

Saffron Cordery, Interim Chief Executive of NHS Providers said: “Trust leaders will welcome this constructive report… Trusts are committed to working more closely and effectively together to develop and improve leadership, building on existing strong foundations, and local leaders must be fully engaged and involved in any changes to ensure a successful, high-achieving NHS.”

Welcoming the report, Matthew Taylor, Chief Executive of the NHS Confederation said: “This important report demonstrates the vital role that NHS leadership and management plays in delivering high quality and efficient care. It rightly recognises the new operating environment which means we require system leadership built on collaboration – this can no longer just be about leaders working autonomously within their own organisations.”

Final Thought

While it is hard to disagree with the findings of the review that patient care would benefit from a well-led and motivated NHS, how this level of institutional change will be achieved is an entirely different issue, and not an easy fix. Motivating talented managers to take on the tougher roles in the NHS will be tough, particularly at a time when the NHS is already suffering a workforce crisis with chronic staff shortages that the Government has so far failed to fill.

As well as answering some questions, the review also raises further difficult questions – if the issues highlighted by the review are so pervasive and institutionalised, why had they not been recognised and addressed by the Government at any time over the last 12 years? While the pandemic has certainly increased strain on the NHS, these issues are not a product of the past two years.

Moreover, while they were not mentioned in the Department of Health and Social Care press release, the report notes that the NHS has been put under significant pressure by politicians. This raises the question of the extent to which these failures the result of the pressures put on the NHS by politicians, whether by underfunding or micromanagement.

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