Health Management and Policy Alert

Survey of NHS trust leaders on the financial reset

NHS Providers -
With the NHS looking to recover a predicted financial shortfall that reached nearly £7bn this year, trusts have been asked to drastically reduce running costs while improving performance against key targets. With the 10-year health plan due to be published in the coming months, nearly half of trust leaders (47%) surveyed warned they are scaling back services to deliver tough financial plans. Virtual wards, rehabilitation centres, talking therapies and diabetes services for young people are amongst services identified at risk.

• Briefing
• NHS Providers - news

Supporting system improvement: lessons from a peer learning programme

NHS Confederation -
System improvement can help deliver more holistic, place-based care that improves people’s health and expands beyond the NHS to include the voluntary sector, local government and other partners. It provides an opportunity to do things differently by working at scale, breaking down siloes, maximising resources and tackling issues that cannot be solved by individual organisations. This report explores the challenges facing those leading and delivering improvement across systems and discusses how peer learning can facilitate progress.

• Report
• NHS Confederation - publications

Bridging the gap: a guide to making health inequalities a strategic priority for NHS leaders

Royal College of Physicians -
This guidance provides actionable steps for tackling health inequity within health care delivery, emphasising the role clinicians and clinical leaders can play in addressing these longstanding disparities. It argues that tackling these disparities is essential to improving the nation’s health and reducing unnecessary pressures on health care services. It underscores that NHS leaders have a statutory, moral, and financial responsibility to prioritise this issue, and includes: practical actions; existing statutory duties and guidance; and barriers and enablers.

• Guidance
• Royal College of Physicians - news

Greater than the sum of its parts?: sharing board leadership between NHS trusts

NHS Confederation -
This report explores the learning from shared leadership models in provider trusts in England. Despite the absence of a national policy to support shared leadership arrangements, many regions, systems and organisations in England regard them as beneficial in addressing the challenges faced by the NHS provider sector. The reasons for this are explored in detail in this report. It also makes recommendations for those considering similar arrangements.

• Report
• NHS Confederation - publications

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