NHS staff boost will be wasted without better management

• A new report from the SMF and the CMI finds that the NHS has a quality and quantity problem when it comes to management.
• According to a new Opinium poll, the majority (62%) of NHS managers and leaders say they face significant management-related challenges which prevent them from doing their job effectively.
• Over one in four NHS managers and leaders (27%) believe senior leadership in their healthcare organisations are ineffective.
• The study finds a demonstrable, positive link between good management practices and the quality of healthcare and recommends several new initiatives for politicians, policymakers and the NHS to deliver better for patients.

 

London - A new landmark study from the Social Market Foundation (SMF) in partnership with the Chartered Management Institute (CMI) — A picture of health? Examining the state of leadership and management in healthcare — has revealed that better leadership within the NHS can lead to improved patient care.

The report published today explores the role that skilled management can play in enabling the service to reform and evolve and finds the NHS has a quality and quantity problem when it comes to management.

According to an Opinium poll of 1,000  public sector leaders and managers — commissioned exclusively for the report — the majority of NHS managers (62%) say they face significant management-related challenges which prevent them from doing their job effectively. These issues included complex internal processes, an inability to recruit and retain great staff, red tape, and poor organisational cultures.

In the same survey, over one in four NHS managers and leaders (27%) believe senior leadership in their healthcare organisations are ineffective, and one in three (32%) leaders were “poor” at motivating staff.

Compared to the wider economy, the research highlights that the NHS appears to be under-managed, with analysis revealing that the number of managers in the UK workforce, as a whole, is 6.5 percentage points higher than in the English NHS workforce.

With data from the Care Quality Commission indicating that around a quarter of hospital trusts need considerable improvement, the study found a demonstrable, positive link between high quality management practices and the quality of healthcare.

One study found that 43% of hospitals scoring above average in management practices achieved “high quality” outcomes, compared to 14% of those below average. This positive relationship was found across all the key domains of management practice (operations, monitoring, targets, and human resources).

The research also highlights how two trusts have improved outcomes by prioritising good management. At the Leeds Teaching Hospitals Trust, one of the largest acute hospital trusts in the UK, a new CEO moved the trust from the bottom 20% of NHS employers to the top 20% in just three years. Similarly, at the Tameside and Glossop Integrated Care NHS Foundation Trust, a new leader reformed middle management to achieve a “good” rating across safety, effectiveness, responsiveness, and care, up from critical levels seven years earlier.

In responding to these management challenges, the Chartered Management Institute and Social Market Foundation have set out new recommendations for politicians, policymakers and the NHS to deliver better for patients. These include broadening Care Quality Commission inspections to include a detailed review of an organisation's management practices, training, and leadership pipelines. Including these metrics in inspections is key to understanding where improvements are needed. The report also recommends establishing a set of benchmarks for judging good leadership and management and mandating in-work leadership and management training requirements across the NHS and primary care for managers and leaders.

Richard Hyde, senior researcher at the SMF said:

Management and leadership are too often neglected by politicians discussing the health service. As well as talking about the money they’ll put in and the number of clinical staff they’ll deliver, leaders should pay more attention to how the service is managed and led.  Without good management, money and clinical staffing will still be wasted and patients will be let down.

This is a public service that costs more than £120 billion a year and is the country’s biggest employer. Making sure it’s well led and well managed should be an absolute priority - patients and taxpayers deserve nothing less.

If we want a world-class health service, make sure it has world-class management.  Fortunately, the health service provides many good examples of how good management can deliver better care, as this report sets out.”

In response to the report launch, the Chartered Management Institute’s Policy Director, Anthony Painter, said:

For the ambitious newly-released NHS workforce plan to succeed, there will need to be a lock step focus on improving the quality of management so that it can rise to the challenge of the acute demands and deep stresses facing our health care services.”

In truth, across the UK, leadership and management skills are not taken seriously enough as a driver of improved healthcare. NHS managers are often portrayed as a burden to the service. This couldn’t be further from the truth. Poorly managed health services cost lives and waste money while, as this report clearly demonstrates, good and outstanding managers in the NHS make a critical difference to our health.

We hope this work with the Social Market Foundation galvanises the critical reform needed to support NHS leaders, frontline staff, and patients who rely so heavily on this treasured service.”