Newspaper article The Evening Standard (London, England)

NHS Needs New Style of Leadership; an Inquiry by a Leading Think-Tank Claims Stable Management Is Crucial If Health Services Are to Perform Better

Newspaper article The Evening Standard (London, England)

NHS Needs New Style of Leadership; an Inquiry by a Leading Think-Tank Claims Stable Management Is Crucial If Health Services Are to Perform Better

Article excerpt

Byline: Sarah Richardson

A NINE-MONTH inquiry by a leading health think-tank has found that the NHS is in urgent need of a new style of leadership to overcome unprecedented financial pressures and adapt to future challenges.

The King's Fund's Commission on NHS Leadership and Management emphasises the crucial role general and clinical managers can play in delivering the productivity improvements and service transformation that the NHS requires.

The Commission finds high-quality, stable management to be key to highperforming health services. Yet across the NHS, the average chief executive spends just 700 days in a post.

In part, this reflects a culture where "heroic" leaders grapple with problems only from the top of the organisation, or are "parachuted in" to replace individual managers and "turn around" troubled NHS services. The report advocates a new type of "shared leadership" involving leaders at different levels of the workforce working collaboratively with all those involved in patient care to lead change and improve services, rather than only tackling problems inside specific institutions.

The commission examined evidence from UK and international health care and other sectors, finding that given its size and complexity, the NHS is undermanaged, but over-administered. While the coalition Government led by Prime Minister David Cameron has imposed a 45 per cent cut in NHS management posts and 33 per cent cut in administration costs, no assessment of the future needs of the NHS has been made.

A large cohort of NHS administrators has developed over time to respond to extensive and often duplicated requirements from multiple regulators and performance managers -- and an urgent assessment of the information demands placed on the NHS is needed.

The report also recommends that each NHS organisation should take responsibility for its own leadership development and quality of management, including dealing with failing managers. The work that has started to strengthen leadership and leadership development should be taken forward through the creation of an NHS Leadership Centre.

The report highlights the important contribution that doctors, nurses, allied health professionals (clinical leaders) and general managers (nonclinical leaders) can make to these improvements.

Professor Chris Ham is chair of the Commission on NHS Leadership and Management and chief executive of The King's Fund. He admits: "We know there is public support for reducing the number of NHS managers. But given the immense challenges facing the NHS, politicians of all parties must resist the temptation to denigrate the value of management in delivering excellent and efficient services.

"The priority for the future NHS must be to deliver the best care possible to those with chronic and long-term conditions. That needs a new style of NHS leader, as adept at building partnerships to deliver care across boundaries as they are at managing their own services."

The commission, which included Dame Jacqueline Docherty, chief executive of West Middlesex University Hospital NHS Trust, and Lord Tugendhat, chairman of Imperial College Healthcare NHS Trust, was clear in its belief that leaders make improvements in service and outcomes.

Among the international examples it considered was Intermountain Healthcare in Utah in the United States, which has achieved an enviable reputation for high-quality care at lower-thanaverage costs. Sustained efforts to improve care have yielded substantial results in part by developing advanced electronic clinical information systems used by skilled staff who have highly developed skills to analyse and improve care. …

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