The UK government has promised “the biggest shake-up in health and social care leadership in a generation” as it published a review that criticised “institutional inadequacy” in the way the NHS trained, developed and valued managers.
The review by retired general Sir Gordon Messenger also found evidence of poor behavior and attitudes among staff “such as discrimination, bullying and blame cultures in certain parts of the health and social care system”.
Some employees in the NHS, in particular, did not feel comfortable speaking up about their concerns, according to the report, which was produced jointly with Dame Linda Pollard, chair of Leeds Teaching Hospitals Trust.
The report was commissioned last year by health secretary Sajid Javid as part of a drive to demonstrate the health service would secure maximum value from an additional £36bn raised from a controversial rise in national insurance contributions.
Javid said the NHS faced huge challenges in recovering from the pandemic, from tackling treatment backlogs to addressing widespread health disparities across the country.
“The findings in this report are stark, it shows examples of great leadership but also where we need to urgently improve,” he said, as he promised “the biggest shake-up of leadership in decades.”
The litany of failings identified in the report included “a lack of equal opportunity for managers to access training and colleagues to progress in their careers.”
The health department said strengthening leadership and embedding the best examples of management were “vital in ensuring every pound of investment is well spent, with the government investing a record amount in health and care services over the next three years to tackle the Covid backlog.”
The report set out plans to attract strong leaders to the most demanding areas in the NHS, with a package of support and incentives designed to ensure “roles in challenged areas are seen as the best jobs rather than the most feared jobs”, it said.
Matthew Taylor, Chief Executive of the NHS Confederation said the report had acknowledged that much more needed to be done to create a more diverse leadership in the NHS. “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,” he said.
Earlier, Javid, and NHS England chief executive Amanda Pritchard, had given evidence to the Commons health select committee on the workforce crisis facing the NHS.
Pritchard said the health service was “carrying about 100,000 vacancies at the moment”. Although there had been “a significant increase in numbers [of new hires] over the last couple of years . . . it’s not enough.”
Javid acknowledged that meeting a target to deliver 6,000 more GPs during the current parliament was “going to be incredibly tough”. However the NHS had recruited 18,000 other members of primary care teams, and was on track to meet a commitment of 26,000 of these additional roles.
The government came under fire this year for refusing to accept an amendment to health legislation that would have required publication every two years of an independent assessment of the NHS’ workforce needs.
Javid said the NHS was working on a 15-year strategy for the workforce which would include such numbers and which he had asked NHS leaders to deliver by the end of the year.