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Landmark review into health leadership to be published today

A major review is set to be published today into health and social care leadership, including seven recommendations on how to give the possible care in wake of the effects of the pandemic.

The review has been led by General Sir Gordon Messenger and Dame Linda Pollard and will constitute the biggest health and social care leadership shake-up in a generation.

The review was informed by thousands of front-line staff, managers and leaders across the health sector, ultimately leading to the seven recommendations brought forth, which look to establish the right culture and training, in order to improve the skills and competency of the NHS from top to bottom.

The seven recommendations are:

  • Targeted interventions on collaborative leadership and a unified set of values across health and social care, including a new, national entry-level induction for all who join health and social care and a new, national mid-career programme for managers across health and social care.
  • Action to improve equality, diversity and inclusion (EDI), including embedding inclusive leadership practice as the responsibility of all leaders, committing to promoting equal opportunity and fairness standards, more stringently enforcing existing measures to improve equal opportunities and fairness, and enhancing CQC’s role in ensuring improvement in EDI outcomes.
  • Consistent management standards delivered through accredited training, including a single set of unified, core leadership and management standards for NHS managers, and a curriculum of training and development to meet these standards, with completion of this training made a prerequisite to advance to more senior roles.
  • A simplified, standard appraisal system for the NHS, including a more effective and consistent appraisal system, to reduce variation in how performance is managed and focus on how people have behaved not just what they have achieved.
  • A new career and talent management function for managers, including the creation of a new function at regional level to address a lack of clarity and structure in NHS management careers, providing clear routes to progression and promotion, and ensuring a strong pipeline of future talent.
  • More effective recruitment and development of Non-Executive Directors (NEDs) - NEDs play a vital role in providing scrutiny and assurance, and an expanded, specialist Non-Executive Talent and Appointments team will encourage a diverse pipeline of talent.
  • Encouraging top talent into challenged parts of the system, including a better package of support and incentives in place to enable the best leaders and managers to take on some of the most difficult roles, whereby roles in challenged areas are seen as the best jobs rather than the most feared jobs.

The report accepted the current and mostly unprecedented circumstances the workforce is facing, however it found that there was a lack of consistency and coordination and that a “institutional inadequacy” has developed over time, in the way that leadership is trained and valued.

Health and Social Care Secretary Sajid Javid said: “The NHS faces huge challenges as we recover from the pandemic, from tackling the Covid 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.”

The report did identify many examples of inspirational leadership in the face of adversity, but ultimately the review looks to attract great leaders to recruit them into the most challenged areas of the NHS via a package of support of incentives.

General Sir Gordon Messenger said: “I have always held our health and social care workforce in the highest regard, and my respect and admiration has only deepened through witnessing their selflessness, professionalism and resilience first-hand.

“A well-led, motivated, valued, collaborative, inclusive, resilient workforce is the key to better patient and public health outcomes, and must be a priority.

“The best organisations are those which invest in their people to unlock their potential, foster leadership and accountability at every level, with good leadership running through the entire workforce. This must be the goal and I believe our recommendations have the potential to transform health and social care leadership and management to that end.”

After the publication of the report later today, a delivery plan will follow containing a clear timeline detailing the implementation of the aforementioned recommendations.

More information about the report is available here.

NHE March/April 2024

NHE March/April 2024

A window into the past, present and future of healthcare leadership.

- Steve Gulati, University of Birmingham 

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