NHS Confederation responds to Messenger review of NHS leadership

Matthew Taylor responds to General Sir Gordon Messenger and Dame Linda Pollard’s review of health and care leadership.

8 June 2022

Responding to General Sir Gordon Messenger and Dame Linda Pollard’s review of health and care leadership, Matthew Taylor chief executive of the NHS Confederation said: 
“This is an important report which demonstrates the vital role that NHS leaders and managers play in delivering high quality and efficient care. Whilst there may be a view in some quarters that money spent on NHS managers is wasted, we know that high performing health systems require investment in effective management. We need to move away from the damaging narrative that managers are somehow an unnecessary expense. Put simply, the NHS is not over-managed and never has been.

“The report recognises that the NHS is now operating in a new environment as we deliver more integrated care for patients. This requires system leadership built on collaboration and means leaders can no longer work autonomously in their own organisations. New skills and a systems-focused mindset will need to be hard-wired into those in leadership positions within the NHS and much of this is already in evidence across the service. 

“The report is also right to point out the gaps in support for NHS leaders and what more can be done to ensure we deliver a consistent approach to leadership development at all levels within the NHS. And, in particular, how we support chief executives who take on highly challenging roles. NHS leaders are not football managers, and they shouldn’t be treated as such, taking on difficult jobs only to be sacked before they have had time to turn round performance. We need to better support them and reward them for taking on tough roles. This new approach to leadership needs to be based on a culture of learning and improvement, with less emphasis on top-down performance management which has been a feature of recent years.   

“The report rightly acknowledges that we have much still to do to create a more diverse leadership in the NHS, but we also need tangible action and changes to ensure this happens. We can’t hide from the fact that all too often staff from ethnic minority backgrounds are still not being provided with the support they need to progress to leadership roles. We need to move beyond admiring the problem and make concrete progress in addressing it.

“Finally, we must acknowledge the limited focus in this report on supporting leaders in primary care and social care. The risk is that this looks like an after-thought and we would encourage the government and its arms-length bodies to not overlook these sectors.”