Strengthening NHS management and leadership : priorities for reform

Good management is key to the NHS’s ability to provide high-quality services and to maximise the impact of its resources in the face of growing demand for care. However, in recent years, the importance of good management has been somewhat forgotten in the policy debate at the expense of a focus on leadership.As part of the Health Foundation’s research on management in the health service, we interviewed NHS managers and leaders in England to understand the challenges they face, what works well and what could be done differently. In this long read, we set out some of the insights from these interviews, focusing mainly on the role and practice of managers, and how they are trained and supported.This coincides with government commissioning a review of leadership in health and social care in England, led by Sir Gordon Messenger, which is expected to report to the Secretary of State for Health and Social Care at the end of March. Here, we conclude with a series of recommendations for the Messenger review to consider, focused around the need to: better support providers and systems to tackle variation in management practice; improve access to training and development opportunities; ensure training equips managers and leaders with the skills they need today; tackle the reporting burden facing managers, and ensure the role of managers and leaders is better understood and valued. Arguing that we should better value NHS managers and leaders, and increase the support available to them, might not be the most politically popular case. But it is the right thing to do, and indeed will be essential if the NHS is to improve the quality and efficiency of its services as it recovers from the COVID-19 pandemic