This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at http://www.theguardian.com/healthcare-network/2015/dec/04/ailing-nhs-leadership-needs-urgent-treatment

The article has changed 2 times. There is an RSS feed of changes available.

Version 0 Version 1
Ailing NHS leadership needs urgent treatment Ailing NHS leadership needs urgent treatment
(about 2 hours later)
There are too few NHS staff willing to take on the toughest leadership roles, and too few of those that do survive. Successive reviews have exposed the failures in NHS leadership development, but progress in addressing them is a long way from matching the scale of the problem.There are too few NHS staff willing to take on the toughest leadership roles, and too few of those that do survive. Successive reviews have exposed the failures in NHS leadership development, but progress in addressing them is a long way from matching the scale of the problem.
The review of NHS leadership by former Marks & Spencer executive chairman Lord Rose, published in June, pinpointed one of the central difficulties facing the health service – the organisation is committed to a vast range of changes but does not have sufficient management and leadership capability to deliver them.The review of NHS leadership by former Marks & Spencer executive chairman Lord Rose, published in June, pinpointed one of the central difficulties facing the health service – the organisation is committed to a vast range of changes but does not have sufficient management and leadership capability to deliver them.
The Rose review was followed within weeks by Ed Smith’s review of centrally-funded leadership and improvement work. Smith, who has been appointed chairman of NHS Improvement, praised the quality of NHS Leadership Academy programmes, but his assessment of leadership work across the system was coruscating. He concluded the current approach is “remote, fragmented and unclear” and “difficult to access and navigate”.The Rose review was followed within weeks by Ed Smith’s review of centrally-funded leadership and improvement work. Smith, who has been appointed chairman of NHS Improvement, praised the quality of NHS Leadership Academy programmes, but his assessment of leadership work across the system was coruscating. He concluded the current approach is “remote, fragmented and unclear” and “difficult to access and navigate”.
Work intended to support clinical leadership came in for particular criticism, not least the fact that few people understood the improvement roles of clinical senates, strategic clinical networks and academic health science networks.Work intended to support clinical leadership came in for particular criticism, not least the fact that few people understood the improvement roles of clinical senates, strategic clinical networks and academic health science networks.
The Smith review called for all the national organisations to pull together to deliver leadership and improvement development which met the needs of the Five Year Forward View, and which would in turn link up with the programmes in individual organisations.The Smith review called for all the national organisations to pull together to deliver leadership and improvement development which met the needs of the Five Year Forward View, and which would in turn link up with the programmes in individual organisations.
Monitor – soon to merge with the NHS Trust Development Authority to form NHS Improvement – has always taken a tough line on leadership; whenever a foundation trust gets into difficulty Monitor looks at the quality of the board and the executive officers. Now NHS Improvement will be responsible for talent management across the NHS, which means it will eventually have to pass judgment on its own protégés.Monitor – soon to merge with the NHS Trust Development Authority to form NHS Improvement – has always taken a tough line on leadership; whenever a foundation trust gets into difficulty Monitor looks at the quality of the board and the executive officers. Now NHS Improvement will be responsible for talent management across the NHS, which means it will eventually have to pass judgment on its own protégés.
The working group pulled together from across the national bodies to lead an overhaul of leadership development is urgently identifying vacancies in crucial board-level posts in providers and commissioners and trying to find the talent to fill them. Its next priority will be to map where vacancies are likely to arise in the next six months, which will no doubt include places where it thinks the current leadership is not up to the task. In parallel it will identify people who are “ready now” and keen to take on these challenging roles, as well as people who could be ready soon with some development and support.The working group pulled together from across the national bodies to lead an overhaul of leadership development is urgently identifying vacancies in crucial board-level posts in providers and commissioners and trying to find the talent to fill them. Its next priority will be to map where vacancies are likely to arise in the next six months, which will no doubt include places where it thinks the current leadership is not up to the task. In parallel it will identify people who are “ready now” and keen to take on these challenging roles, as well as people who could be ready soon with some development and support.
This work is a tactical quick-fix rather a long-term strategy, and NHS Improvement knows that in 2016 it will need to go much further – mapping out development routes that go all the way from graduate training to boards. It is a gargantuan task; judging by the present vacancy rate and attrition in the top jobs it will take several years to develop a sufficient supply of senior staff who are not only appointable but can survive more than two or three years.This work is a tactical quick-fix rather a long-term strategy, and NHS Improvement knows that in 2016 it will need to go much further – mapping out development routes that go all the way from graduate training to boards. It is a gargantuan task; judging by the present vacancy rate and attrition in the top jobs it will take several years to develop a sufficient supply of senior staff who are not only appointable but can survive more than two or three years.
Lord Rose recommended that senior managers should participate in accredited courses to ensure consistent experience and training. One of the first outcomes of the new talent drive is that Monitor, the NHS Trust Development Authority, NHS Leadership Academy and NHS Providers have launched a year-long accredited development programme for “aspiring chief executives”, delivering training which they claim will be world class. The first group begins this month, and at the end of the programme they will be assessed for suitability for the top post. The initial group will be small – just 14 participants. If it succeeds it will be expanded in subsequent years, and incorporate other executive roles.Lord Rose recommended that senior managers should participate in accredited courses to ensure consistent experience and training. One of the first outcomes of the new talent drive is that Monitor, the NHS Trust Development Authority, NHS Leadership Academy and NHS Providers have launched a year-long accredited development programme for “aspiring chief executives”, delivering training which they claim will be world class. The first group begins this month, and at the end of the programme they will be assessed for suitability for the top post. The initial group will be small – just 14 participants. If it succeeds it will be expanded in subsequent years, and incorporate other executive roles.
The aspiring chief executives programme has three key strands: reshaping care systems to meet patient needs; engaging staff; and fulfilling the role of accountable officer for the organisation, with responsibilities such as money, governance and risk management. Mentoring by chief executives will be an important ingredient.The aspiring chief executives programme has three key strands: reshaping care systems to meet patient needs; engaging staff; and fulfilling the role of accountable officer for the organisation, with responsibilities such as money, governance and risk management. Mentoring by chief executives will be an important ingredient.
It stresses the importance of system leadership – encouraging future executives to see themselves as one of a group of leaders of the local health economy rather than just the head of their own organisation. The inspection and regulation regimes have yet to catch up with system leadership, but there is movement.It stresses the importance of system leadership – encouraging future executives to see themselves as one of a group of leaders of the local health economy rather than just the head of their own organisation. The inspection and regulation regimes have yet to catch up with system leadership, but there is movement.
The same organisations are working on a programme to support new chief executives for their first two years in post. A key message from serving chief executives has been how unprepared they felt when they took up the role. This programme will provide both professional and personal support, shaped around the local challenges.The same organisations are working on a programme to support new chief executives for their first two years in post. A key message from serving chief executives has been how unprepared they felt when they took up the role. This programme will provide both professional and personal support, shaped around the local challenges.
Beyond the national organisations there are many leadership programmes which deliver the quality, if not the quantity, the NHS needs, involving providers, deaneries, charities, think tanks and others.Beyond the national organisations there are many leadership programmes which deliver the quality, if not the quantity, the NHS needs, involving providers, deaneries, charities, think tanks and others.
One of the best is the King’s Fund’s five-week top manager programme, aimed at health and social care leaders from the public, private and third sectors, which has been running for 30 years.One of the best is the King’s Fund’s five-week top manager programme, aimed at health and social care leaders from the public, private and third sectors, which has been running for 30 years.
Related: End the macho culture keeping women from the top of NHS
Bursaries and scholarships are there for a lucky few; for example, the Florence Nightingale Foundation enables nurses and midwives to study in the UK and abroad to prepare for the most senior roles.Bursaries and scholarships are there for a lucky few; for example, the Florence Nightingale Foundation enables nurses and midwives to study in the UK and abroad to prepare for the most senior roles.
But despite many examples of outstanding leadership training for both managers and clinicians, the need vastly outstrips supply. NHS Improvement is faced with leading a talent drive that has to reach into every NHS body if the health service is to deliver the scale of reforms envisaged in the Five Year Forward View.But despite many examples of outstanding leadership training for both managers and clinicians, the need vastly outstrips supply. NHS Improvement is faced with leading a talent drive that has to reach into every NHS body if the health service is to deliver the scale of reforms envisaged in the Five Year Forward View.
There needs to be the same sense of urgency around developing and keeping good leaders as there is around sorting out the money.There needs to be the same sense of urgency around developing and keeping good leaders as there is around sorting out the money.
Join our network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.Join our network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.