New approach to leadership development, diversity and supporting CEOs required – new NHS Confederation report

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A report published today by the NHS Confederation outlines the views of new NHS chief executives on the changes in leadership approach and culture that they believe will be required if the NHS is to meet the ambitions of the Long Term Plan.


At the heart of this is the need to break down barriers and work collaboratively as the NHS moves to greater partnership and system working. This in turn will require a new kind of leadership – those who can reach out beyond traditional boundaries and work effectively with a range of local partners.


The report follows the publication of the interim NHS People Plan, which includes commitments from NHS England/Improvement to develop a ‘leadership compact’ to foster a different approach to leadership development and supporting chief executives.


There is widespread support for these intentions and chief executives want to see this well-intentioned rhetoric mirrored in the actions they see from leaders across the system.

The nine NHS trust chief executives interviewed for the report regard their role as a privilege, bringing with it the chance to make real and positive changes for their local communities and staff. That is despite the operational pressures they and their staff increasingly face.


They make a number of observations about the future of leadership in the NHS, including:


  • - They support the need to move beyond working in isolation as leaders of single organisations to being part of a health economy. Many have taken on wider roles as system leaders and they recognise the need to have a dual responsibility for the performance of their local systems for the benefit of their local communities, as well as of course for their own organisations.

  • - Talent management has not been a notable feature within the NHS in recent years, but this is starting to be addressed by NHS England/Improvement. The chief executives want to see a different approach to identifying and supporting leaders and recognise the need for proactive talent management to secure the next generation of leaders, with the right skills, mind-sets and from diverse backgrounds. This should include providing opportunities for leaders to work across different organisations.

  • - They want to see more support when things go wrong and a commitment to make sure that chief executives are not forced out when they are doing a difficult and challenging job – with leaders given the opportunity to learn from their mistakes.
  • These chief executives also want to see more progress on developing inclusive cultures and organisations – they recognise the strong link that exists between inclusive and diverse working environments and better outcomes for patients and staff.

NHS Confederation Chief Executive Niall Dickson said: “It is clear from this report that we can look forward to the prospect of new players and new attitudes as the health service responds to the prospect of a decade of transformation.

“Central to this will be the role of local leadership and the culture it engenders. We are all familiar with and support the rhetoric which says the NHS Long Term Plan will not be delivered by central diktat, centralisation and control and that instead by letting local systems lead the way.

“There is widespread support from the chief executives we interviewed on the need to foster a different approach to leadership development, diversity and supporting leaders. They now want to see this well-intentioned rhetoric followed through. They know that delivering cultural change and more sophisticated leadership behaviours throughout the system is challenging and will take time, but there is a strong view that nothing less will do.”

The nine chief executives were the first cohort in an NHS Confederation and NHS Employers programme of learning and support for ‘first time’ provider chief executives. Thirty-four leaders have been part of the programme so far.


The nine chief executives are: Sam Allen, Sussex Partnership NHS Foundation Trust; Cara Charles-Barks, Salisbury NHS Foundation Trust; Dr Navina Evans, East London NHS Foundation Trust; Dr Richard Jenkins, Barnsley Hospital NHS Foundation Trust; Deborah Lee, Gloucestershire Hospitals NHS Foundation Trust; Steve McManus, Royal Berkshire NHS Foundation Trust; Sara Munro, Leeds and York Partnership NHS Trust; Suzanne Tracey, Royal Devon and Exeter NHS Foundation Trust and Northern Devon Healthcare NHS Trust; Alex Whitfield, Hampshire Hospitals NHS Foundation Trust.

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