A new report has emphasised that NHS reform cannot go ahead without improving management processes, after statistics indicated that most NHS managers are hamstrung by complex internal systems and excessive red tape.
The research comes from the Social Market Foundation in collaboration with the Chartered Management Institute, who have launched a call for reforms to how the Care Quality Commission assesses the management structure of organisations and how NHS England accredits its managers.
Previous research from the pair has shown that more than a quarter (27%) of NHS managers and leaders deem the senior leadership in their organisation ‘ineffective’ at facilitating success.
This latest report suggests that almost two-thirds (62%) of NHS managers face significant management-related challenges which stop them from doing their job. The publication also features four case study examples of effective management in action at:
- Tameside and Glossop Integrated Care NHS Foundation Trust
- Leeds Teaching Hospitals NHS Trust
- The Oakwood Surgery
- North Staffordshire Combined Healthcare NHS Trust
NHS reform
In order to meet its various compounding pressures, the report’s authors highlight that management quality will need to improve.
To do this, they propose including a broader range of analysis when the CQC is determining whether an organisation is ‘well-led’. The amount/quality of management and leadership training should also be investigated, with the CQC actively supporting organisations who need to improve.
All newly appointed managers should be compelled to complete accredited management training at each stage. The report emphasises that this would not have to be through academic qualifications but through a new excellence framework developed and implemented by NHSE. This would be to outline the minimum competence requirements for NHS managers.
The piloting of NHS workplace democracy in underperforming trusts is also encouraged.
This all comes just after the publication of the Darzi Review, which concluded that management capability is still behind where it was 13 years ago.
Successive failures
The report threads through management in the NHS, local government and education. “There is near universal agreement that many of the UK’s most important public services are in dire need of improvement,” said Richard Hyde, senior researcher at the SMF, on the report.
He added: “But the success of any initiatives the government brings forward for reforming the NHS, our schools and colleges, or local government will likely fall short of their goals unless the quality of the leadership and management across those services is brought up to the levels of the best in each of them.
“Despite the issues of public sector leadership and management getting their moment in the sun from time to time, successive governments have not taken them seriously enough.”
Anthony Painter, policy director at the CMI, said that while more investment, new technology and refined reforms are “absolutely critical”, transformation can be brought about by skilled managers developing services that are more productive, better run, and better equipped to meet demand.
“That’s why developing and deploying top-quality management is so critical,” he said.
“Management skills alone won’t be the salvation of struggling, underfunded public services, but they represent a relatively low-cost, high-impact investment that can unlock real, lasting improvements alongside investment and reform.”
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