Biggest shake-up in health and social care leadership in a generation to improve patient care
The Department of Health and Social Care has accepted “in full” the recommendations published in a landmark independent review this week which set out new plans to attract great leaders to the most challenged areas in the NHS into health and social care leadership.
The Health and Social Care Secretary Sajid Javid has welcomed the publication of an independent review of health and adult social care leadership, led by General Sir Gordon Messenger and Dame Linda Pollard – and, in what will be the biggest shake-up in health and social care leadership in a generation, is accepting all seven transformative recommendations they have put forward.
Strengthening leadership and embedding the best examples of management is vital in ensuring every pound of investment is well spent, with the government investing a record amount in health and care services over the next three years to tackle the COVID-19 backlog.
The review team met over a thousand passionate frontline staff, managers and leaders across health and social care to hear their views, which informed their recommendations for improving the skills of all leaders and managers and putting the right culture, training and incentives in place.
While it recognised the current pressures faced by the workforce and identified many examples of inspirational leadership, the review found overall there was a lack of consistency and coordination – in particular that there has developed over time an “institutional inadequacy” in the way that leadership and management is trained, developed and valued.
The report also sets out new plans to attract great leaders to the most challenged areas in the NHS, with a package of support and incentives to recruit the top talent into these positions. Through support networks, peer mentoring, training and development, this will ensure the government and the NHS can continue to tackle disparities across the country.
It also found evidence of poor behaviours and attitudes such as discrimination, bullying and blame cultures in certain parts of the health and social care system, with some staff in the NHS in particular not feeling comfortable to speak up.
The review identified a lack of equal opportunity for managers to access training and colleagues to progress in their careers, with those who have existing networks or contacts more likely to access these opportunities.
Health and Social Care Secretary Sajid Javid said: “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.”
General Sir Gordon Messenger added: “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.”
Aimed at ensuring the right leadership is in place at all levels, the recommendations seek to ensure services can deliver the best possible care, tackle the COVID-19 backlog and address the disparities the pandemic has exposed across the country.
These include an induction for new joiners to instil core values across health and social care, a mid-career programme for managers, stronger action on equality and diversity to ensure inclusive leadership at all levels, clear leadership and management standards for NHS managers with a standardised appraisal system, and greater incentives for top talent to move into leadership roles in areas facing the greatest challenges, to help combat disparities across the country.
NHS Chief Executive Amanda Pritchard said: “As this report recognises, leaders across the health service do a fantastic job in often very challenging circumstances, from designing and delivering the world-leading COVID-19 vaccination programme to delivering the elective recovery plan, and investing in developing our leaders must be a priority.
“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.
“Publication of the report will be followed by a delivery plan with clear timelines on implementing agreed recommendations.”
Care England, the largest and most diverse representative body for independent providers of adult social care, has also stated that it welcomed the review. Professor Martin Green OBE, Chief Executive of Care England, said that it presents “a window of opportunity” for greater collaboration between adult social care and the NHS.
Professor Green added: “We hope that this report will signal a new era of cross sector partnership through leadership and a greater parity of recognition, with equal esteem between health and social care sectors. The recommendations must be delivered across both health and social care. The disparity in Government treatment between the NHS and the care sector including funding and workforce training, development and leadership must be redressed to accomplish this.”
The review of health and social care leadership in England was announced in October 2021 and is the most far-reaching review of health and social care leadership in 40 years.
The review team was made up of representatives from the Department of Health and Social Care, NHS England, Health Education England, NHSX and social care leaders, as well as clinicians, managers and academics.
The review engaged with more than 1,000 stakeholders on over 400 different occasions including patients and users of social care services, GPs, allied health professionals, clinicians, managers, care workers, researchers, clinical fellows, chairs of previous reviews, NEDs, CEOs, chairs and MPs.
