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NHS staff must be better helped, guided and assessed in their performance and delivery

The former boss of M&S has called on the government to allow NHS change to settle down, if it wants to improve management and leadership in the service.

Lord Rose, who was invited by the health secretary last year to review leadership in the NHS, called for a shared vision across the service and its staff must be better helped, guided and assessed in their performance and delivery.

He says a few simple things could make a huge difference. The review suggests that a more centralised effort is needed on training, and middle managers need support to keep their confidence and focus.

It says: “At the start of their NHS career, everyone should have adequate training; in mid-career they should have adequate support and clear pathways to progression as managers; and top leaders should have the appropriate support and experience to enable them to make correct decisions.”

The review says successive governments have failed to tackle the growing administrative, bureaucratic and regulatory burden on NHS professionals and it is “fast becoming insupportable”.

He concludes that the level and pace of change in the NHS remains unsustainably high, placing significant, often competing demands on all levels of its leadership and management.

Rose says the data demands of regulators and oversight bodies must be reviewed; these can then be rationalised and harmonised in order to produce consistent, clear and simple reporting that does not distract staff from patient care.

The review also says core management competencies and behaviours should be set, taught and embedded at each management level.

A mechanism should be established for providing on-going career support for all those in a management role allowing individuals to increasingly take charge and identify their own development needs.

The release of Rose’s review was delayed amid suggestions that the health secretary did not agree with all the findings. He has however taken immediate action on a couple of recommendations – agreeing to merge Monitor and the Trust Development Authority, and moving responsibility for NHS Leadership Academy from NHS England to Health Education England.

Commenting on the review, Rob Webster, chief executive of the NHS Confederation, said: “Lord Rose’s report on leadership in the NHS, commissioned back in February 2014, reflects some of the pressures our members are facing against a backdrop of unprecedented challenge. We know we have great people at all levels in health and care showing effective leadership in tough circumstances and under intense scrutiny. We also know this is not the case everywhere.

“In healthcare we make difficult decisions every day and we must always be guided by our values, which should be consciously stated and shape our recruitment, selection and development processes.

“The Five Year Forward View gives us real hope and an opportunity to deliver a new leadership approach between national organisations and the frontline NHS, built on a culture defined by our values and a focus on working in partnership to deliver the care patients need and want. We need to ensure that politicians, regulators and the media are helping to create the right environment within which great NHS leadership can flourish.”

Sir Simon Stevens, the head of NHS England, was less than flattering about Lord Rose’s conclusions, when being quoted in The Telegraph.

He said: “It is about the support and public service backing NHS leaders get for the incredibly good jobs they do. I don’t think that denigrating the role of the NHS managers contributes to that.

“These are incredibly complex jobs. The complexity of leading improvement of the National Health Service more than rivals that of selling underwear.”

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