Robust leadership delivers effective care

There has been much discussion in recent months about changes within, and the future of, the NHS. During these debates, high levels of patient care have been lauded as the ultimate aim. However, in order to achieve this during these turbulent times it is imperative that the NHS is led by strong managers who are able to raise their game to unprecedented levels.

They are being asked to take on a wider variety of tasks and to achieve more stretching targets with less and less support and resources. In many cases, even their own jobs are under threat. This has big implications for the way that managers approach their role and for the skills they will need going forward. Ensuring they are supported with professional training will be imperative if the reforms are to succeed.

The need for strong management
The Chartered Management Institute (CMI) has worked with a range of employers and individuals in the NHS on the link between good management and leadership, and patient outcomes. The results, which are supported by the findings of government sponsored research (Assuring the Quality of NHS Senior Managers research report by PriceWaterhouseCoopers (February 2010)) show that improving leadership and management skills, including good employee engagement, leads to better staff performance, which in turn leads to more satisfied patients and better communication so that mistakes are avoided. In other words, good leadership and management practice means better outcomes for patients.

What’s more, improving leadership and management skills ultimately saves the NHS money as problems and mistakes are avoided and efficiencies gained. For example, the NHS Institute for Innovation and Improvement estimates that its work has potentially saved the NHS £6bn over the last few years. For this reason alone, all NHS managers, whether clinical or non-clinical, should have the opportunity to develop and professionalise their leadership and management skills. By doing so, they will be better equipped to deliver the ambitious reforms being introduced by the government and ensure that patients’ needs are met. A major new report into the state of leadership and management in the NHS, published in May by The King’s Fund’s Commission on NHS Leadership and Management looked at the effect of ‘arbitrary’ cuts to NHS management and supported this view. The report concluded that plans to cut managers and leaders in the health sector will lead to financial failure instead of improved patient care.

The importance of qualifications
Managers and leaders are much more than bureaucrats there to tick boxes; they are essential to drive change, identify opportunities and set a vision of where the NHS is going – more important than ever under the current reforms. The fact that managers and leaders do not work on the front line can also help give them the objectivity needed to make vital decisions that directly impact those who are ‘on the ground’.
The Government says it wants to make ‘the NHS work for patients, not bureaucrats’. They’re right to have this as an aim, but the fact is that managers and leaders have a vital role to play in nursing the NHS back to health. Only by having managers who meet a professional and consistent set of skills standards up and down the country, will we have leaders who can make a difference, and help the NHS perform successfully.

Encouraging take-up of professional management qualifications in the health service is an important step in this process. Yet research by CMI, which represents 3,000 health sector managers across the UK, shows that just 37 per cent of healthcare managers believe they have had sufficient training. It’s a worry when there are a variety of qualifications already in existence which can be easily applied to the healthcare environment to equip managers with the skills they need and help to justify their position within the health service. Ultimately, every manager and leader ought to have access to the best available learning materials so that the right skills are developed and patient-centred care becomes a reality.

If the planned refocusing of NHS resources is to be successful, it is vital that we have a health service where leadership and management standards are consistent, no matter what part of the country a patient is in or whether the people they come across are clinical or general managers. CMI’s research found that some three-quarters of healthcare managers think they should be judged by an agreed set of professional standards. So there is clearly a thirst for standardisation within the NHS and with King’s Fund report rightly making it clear that the priority for the future NHS is to deliver the best possible patient care, staff will be better engaged in an NHS where all managers are trained and developed to national professional standards. Under plans for a more devolved health service, managers and leaders will enjoy greater autonomy, but with this comes a responsibility to exercise autonomy properly and effectively.

The national leadership academy
A key step that was announced in June by Andrew Lansley to mark the 63rd birthday of the NHS is the plan to establish a new National Leadership Academy for NHS staff.  Under his proposals, the Academy will provide the uniform high standard of leadership and management that the NHS needs to survive and succeed at this time of radical change in the health sector.

The launch of the National Leadership Academy is great news for the future of the NHS as it is an opportunity to address the confusion that comes from too many organisations having responsibility for developing skills. By introducing a co-ordinated approach, the Health Secretary has given voice to the importance of building skills and performance against one set of professional standards and ensuring that all staff can be recognised equally for their management skills.







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