New support and targets for managers

The review of management and leadership, by former vice chief of the Defence Staff Gordon Messenger and Leeds Teaching Hospitals NHS Trust chair Linda Pollard, recognised the pressures faced by the services and acknowledged many examples of inspirational management. However, the government-commissioned review also found a lack of consistency and co-ordination, and poor behaviours, such as bullying, discrimination and blame cultures. Managers who had existing networks or contacts were more likely to receive training to progress their careers, it said.

The report, Leadership for a collaborative and inclusive future, made seven recommendations. It said there should be:

• Targeted interventions, including a unified set of values across health and social care, a national entry-level induction and a mid-career training programme for managers
• Improvements in equality, diversity and inclusion, including the more stringent enforcement of existing equal opportunities measures
• Accredited training to deliver consistent management standards, with the completion of a core curriculum made a prerequisite for advancing to more senior roles in the NHS
• Simplified appraisal in the NHS with a standard system ensuring appraisal is consistent throughout the NHS and the focus is on behaviour as well as achievements
• A career and talent management function at regional level, which would provide clear routes to NHS management progression and deliver a pipeline of future talent
• More effective recruitment and development of non-executive directors
• Support and incentives to encourage top managers into challenged areas. This should include providing holistic support, allowing time for improvement, and developing realistic improvement plans, which should set out funding for digital, estates and equipment. Talented individuals should be hired at very senior manager level using flexibility in terms and conditions, and could include relocation support for staff moving to rural and coastal areas, where unwarranted variations tend to be greatest.

A delivery plan with a timeline on implementing the recommendations is due to follow.

Health secretary Sajid Javid accepted the report’s recommendations in full, saying it amounted to the biggest shake-up of health and social care leadership in a generation. He added: ‘We must only accept the highest standards in health and care – culture and leadership can be the difference between life and death.

‘We must now urgently take [the recommendations] forward, to ensure we have the kind of leadership patients and staff deserve, right across the country.’

NHS chief executive Amanda Pritchard also welcomed the report. ‘As this report recognises, leaders across the health service do a fantastic job in often very challenging circumstances,’ she said.

‘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 to help teams deliver the best care possible for patients.’

Danny Mortimer, chief executive of NHS Employers and deputy chief executive of the NHS Confederation, said: ‘Our members very much appreciated the engaging, thoughtful and authentic way in which Sir Gordon and Dame Linda undertook their review. They sought to understand the challenging reality rather than the misleading rhetoric about the roles that those in leadership positions in social care and health undertake.

‘Their recommendations are important and highlight the further work that is required to support leaders in social care and primary care,’ he added.