NHS cannot reform without better managers, research reveals

• Six in 10 (62%) NHS managers and leaders say they face significant management-related challenges which prevent them from doing their job effectively.
• More than half (56%) of leaders and managers in local authorities believe their organisation isn’t ensuring accountability for failure, with the vast majority (69%) reporting that critical management obstacles block them from doing their jobs.
• Report just days after Lord Darzi’s review of the NHS found that management capability in the health service is behind the stage it was at in 2011 and must be addressed if reforms are to succeed.

London - The Social Market Foundation, in partnership with the Chartered Management Institute (CMI), has today published a report highlighting the value that skilled management and leadership brings to the delivery of the UK’s vital public services.

Following on from Lord Darzi’s review findings that management capability in the NHS is still behind where it was in 2011 following a decade of constant restructuring and austerity, this report highlights the essential role of skilled management in driving change and delivering better outcomes for patients.

This report brings together the collective findings of three separate studies that examined the impact of leadership and management across the NHS, education, and local government. It  offers a clear diagnosis of the challenges within these public services and provides targeted recommendations for improvement.

Anthony Painter, Policy Director at CMI, commented on the report:

There’s no single fix for the deep-rooted challenges facing our public services. The  challenges are broad and deep as, in the case of the NHS, the Darzi Review emphasised. Increased investmentment, new technology, and careful organisational reform are absolutely critical. ,

For these to deliver transformation, we need  skilled managers to develop services that are more productive, better run, and better able to meet the needs of the public.

That’s why developing and deploying top-quality management is so critical. 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.

At its crux, alongside MRI scanners, new buildings and deploying leading edge technology, management skills represent an investment in delivering a service that meets the needs of the public.

Richard Hyde, Senior Researcher at Social Market Foundation, said:

There is near universal agreement that many of the UK’s most important public services are in dire need of improvement.

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.

To help bring these important drivers of public services success into a more prominent place in the debate over reform, our research has sought to champion the voices of transformational leaders and effective managers. We hope their experiences might inspire stronger and more consistent action from policymakers towards fostering more excellence in leadership and management across the public realm.

The report found that 62% of NHS managers face significant management-related challenges, including navigating complex internal processes, recruitment and retention difficulties, and excessive red tape.

Further findings in the health sector reveal a strong correlation between effective management practices and better healthcare outcomes. The authors recommend broadening the Care Quality Commission (CQC) inspections to include a detailed review of an organisation’s management practices, training and leadership pipelines in order to better understand where improvements are needed. It also calls for mandatory in-work management training for NHS managers. The report signals the need for skilled managers across local government  who are able to navigate the uncertainties around funding and recruitment challenges. One in five local authority leaders (20%) believe their senior leadership is ineffective, while two in five (40%) say their leadership fails to motivate staff effectively, or doesn’t attempt to do so at all.

The report also calls for the creation of a leadership academy and a 10-year workforce strategy, ensuring local authorities have the necessary tools and expertise to provide high-quality services to their communities.

In the education sector, the report outlines how improved leadership can tackle ongoing challenges related to staff morale, recruitment, and retention. It advocates for a revamp of leadership training programs, making them mandatory for all aspiring leaders in state-funded education. By prioritising leadership development, schools, colleges, and universities will be better positioned to meet these challenges head-on.

This research serves as a resource for those looking to better understand the significant difference that skilled managers can make in achieving services that are more productive, better run and, in turn, better equipped to meet the expectations of those they serve.