Health Management and Policy Alert

System Leadership in the NHS: learning from the North East and Yorkshire Region

NHS Confederation - 
The North East and Yorkshire region has developed a distinctive approach to system leadership based on the regional director working closely with chief executives of the four integrated care boards in the region, known as the 4+1 arrangement. This report describes the approach and demonstrates how how all parts of the health system are changing – NHS England, integrated care systems, places, and providers. It also aims to show that a focus on purpose, governance, structure, and incentives needs to be backed by an equal focus on effective relationships.

• Report

Strengthening clinical leadership and management: lessons from our research in the UK and USA

The Health Foundation - 

This long read looks at what the NHS will gain from strengthening clinical leadership and management, the challenges involved in doing so and how they might be overcome. It draws on 30 interviews carried out with hospital-based clinician leaders and managers in the UK and the US in 2022–23 and relevant academic studies. The US interviewees are based in clinically-led academic medical centres, while the UK interviewees work in large teaching and district general hospital-based NHS trusts that have sought to strengthen their clinical leadership and management.

• Long read
• Alternative format

The management mission: how better leaders improve public services

Social Market Foundation -
This report brings together the highlights of detailed studies into the value of leadership and management in the UK’s health care, education system, and local government. It concludes that investing in managers both current and future, will ensure they have the basic set of skills required to navigate stretched budgets, but also the tools needed to manage the change that comes via new technologies, changing demographics and evolving demands of the workforce.

• Report
• Social Market Foundation - publications

Just about managing: the role of effective management and leadership in improving NHS performance and productivity

Policy Exchange - 

This report – based upon more than forty interviews and the findings of FOI requests to every trust and integrated care board in England – considers the role that management and leadership can play in enhancing NHS performance and productivity. It argues that a greater focus on the competencies, permissions and placement of management is required, noting that a weak and anecdotal evidence base has often defined the public debate. The report sets out sixteen recommendations to improve NHS management, including a reduction to vertical, tiers of NHS management, including the abolishment of NHS England and (re)merging its functions with Department of Health and Social Care (but for a delivery function to exist in the form of an NHS management board).

• Report
• More detail

 

10 actions the government can take to improve NHS working conditions

The King's Fund -

The workforce crisis is at the heart of many of the challenges facing the NHS in England. This briefing outlines early actions the government can take to enable NHS staff and leaders to deliver the highest possible quality of care in the coming months.

• Briefing
• The King's Fund - publications

Assessing the well-led key question for NHS trusts

Care Quality Commission -
This guidance outlines how the Care Quality Commission will assess the well-led key question to support NHS trusts to understand what good leadership looks like.

• Guidance
• Care Quality Commission - news

The King’s Fund submission to the Health and Social Care Committee inquiry on NHS leadership, performance and patient safety

The King's Fund -
This submission focuses on: how leadership intersects with the NHS’s productivity challenge; the evidence for associations between leadership and productivity; and what national leaders and politicians should do with this insight.

• Report
• The King's Fund - publications

Supporting SAS doctor development at East London NHS Foundation Trust

NHS Employers - 

Specialty and specialist (SAS) doctors at East London NHS Foundation Trust (ELFT) wanted to develop their leadership skills and in particular their involvement in quality improvement work. ELFT held a quality improvement training day tailored to the SAS workforce to support development and encourage sign up to its improvement leader’s programme.

• Case study

Systems for change: a whole-system approach

NHS Confederation -
This infographic outlines ten common approaches that leaders can take to develop effective system working.

• NHS Confederation - publications

NHS England fit and proper person test framework for board members

NHS England -
This framework was produced in response to recommendations made by Tom Kark KC in his 2019 review of the FPPT (the Kark Review). This also takes into account the requirements of the Care Quality Commission in relation to directors being fit and proper for their roles.

• Framework
• NHS England - publications