Press release: New management is no magic bullet for turning around failing hospitals
19 Dec 2002
The NHS Confederation today warned against a simplistic approach to tackling failure in the NHS. The call comes as the Government announces names of franchisees from the private and public sector and those hospitals to be franchised.
Nigel Edwards, Policy Director for the NHS Confederation said: "You have got to get the diagnosis right before you start treatment. New management - whether from the public or private sector - is important but is no magic bullet. We need a more sophisticated approach which understands why organisations fail, recognises the early warning signs, and provides more effective support."
These concerns are highlighted in a new report entitled "Turning Around Failing Hospitals" published by the Confederation today. The report examines evidence from the NHS about the reasons why hospitals fail, the approaches to turnaround, and whether simply changing the management team is enough to drive up performance.
The report highlights three areas where we need a more sophisticated approach to turning around failing NHS trusts.
1. Identifying why organisations fail
A better understanding of the causes of failure is essential to avoid simplistic solutions. The report demonstrates that poor management was not always the sole reason for declining performance. Other reasons identified were:
- Difficulty in addressing long standing issues such as the viability of clinical services or incomplete mergers
- Problems in the relationship between clinicians and managers;
- Senior management time being absorbed by major projects such as PFIs or mergers.
Turnaround strategies need to be tailored to adapt to differing circumstances - a "one-size fits all" approach will not provide workable, long-term solutions.
2. Developing early warning systems
Many of those surveyed in the report stated that intervention came too late, despite early warning signs that the hospital was struggling. The report suggests that greater priority should be given to preventative action.
3. Moving beyond heroic leadership models
Many turnaround strategies currently rely on changing the senior management team. But simply parachuting in a new Chief Executive is not sufficient where problems are deeper and more systematic. In these cases much more radical reforms are required to prevent recurrent failure. Managers - whether they are from the public or private sector - need much more freedom to concentrate on creating change and delivering on the targets that really matter to patients.
Nigel Edwards said, "The way in which we measure performance in the NHS often does not diagnose why a hospital is failing. Where management is not up to scratch, it is right that new leadership is considered. But the real task for the NHS is not waiting until hospitals are in a spiral of decline, but putting more effort into the prevention of failure".
ENDS
Notes for editors
- The NHS Confederation represents the organisations that make up the NHS. Our members include the majority of NHS trusts, primary care trusts and health authorities in England; trusts, health authorities and local health groups in Wales; trusts and NHS boards in Scotland; and health and social services trusts and boards in Northern Ireland.
Contact details
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