After several scandals that revealed longstanding deficiencies and a continual churn of executive staff, a recent independent review of leadership in the National Health Service (NHS) has uncovered a lack of consistency and coordination as well as cases of discrimination within the system. As a result of the report, the British government announced what it called “the biggest shake-up in health and social care leadership in a generation.”
The findings in this report are stark: it shows examples of great leadership but also where we need to urgently improve.
Sajid Javid, the Health and Social Care Secretary
While the report, which is based on meetings with frontline staff, managers and leaders across the health and social care system, recognised the pressure experienced by the workforce and identified examples of inspirational leadership, it also demonstrated an “institutional inadequacy” in the way that leadership and management is trained, developed, and valued.
Specifically, the report found evidence of discriminatory behaviour, bullying and blame culture, with some staff expressing their discomfort about speaking up. It also identified a lack of equal opportunities for managers to access training and career progress, with those having existing networks more likely to get opportunities.
To counter these findings, the report sets out measures such as: induction for new joiners; a mid-career programme for managers; actions to increase equality and diversity; clear leadership and management standards for NHS managers, and greater incentives for top talent to move into leadership roles in areas facing the greatest challenges.
A well led, motivated, valued, collaborative, inclusive … workforce is the key to better patient and public health outcomes …
Leader of the review, Gordon Messenger
According to the government strengthening leadership will be an important component of the record amounts it is set to invest in health and care services over the next 3 years. Sajid Javid, the Health and Social Care Secretary, welcomed the report and is accepting all 7 of the recommendations it has put forward.
“The NHS faces huge challenges as we recover from the pandemic, from tackling the COVID-19 backlogs to addressing the widespread health disparities that exist across the country. The findings in this report are stark: it shows examples of great leadership but also where we need to urgently improve. We must only accept the highest standards in health and care – culture and leadership can be the difference between life and death. I fully support these recommendations for the biggest shake-up of leadership in decades. We must now urgently take them forward, to ensure we have the kind of leadership patients and staff deserve, right across the country,” Javid said.
The review was led by Gordon Messenger, former vice chief of the defence staff, and Linda Pollard, chair of Leeds Teaching Hospitals NHS Trust.
“A well led, motivated, valued, collaborative, inclusive, resilient workforce is the key to better patient and public health outcomes, and must be a priority,” said Messenger.