The NHS needs to take a different and proactive approach to talent management by providing the next generation of leaders with more opportunities to work across different organisations and allowing them to learn from their mistakes, say trust chiefs in a report* published today by the NHS Confederation.
The report outlines the views of new nine NHS chief executives across England on the changes in leadership approach and culture that they think will be needed if the NHS is to meet the ambitions of the Long Term Plan.
Central to this is the need to break down barriers and work collaboratively as the NHS moves to greater partnership and system working. But this requires leaders who can reach out beyond traditional boundaries and work with a range of local partners.
The interim NHS People Plan included commitments from NHS England/Improvement to develop a ‘leadership compact’ to foster a different approach to leadership development and support for trust chief executives.
There is widespread support for these intentions among chief executives, the feedback reveals, but they want to see want to the rhetoric mirrored in the actions they see from leaders across the system.
The chief executives interviewed for the report regard their role as a privilege, bringing with it the chance to make real and positive changes for their local communities and staff. That is despite the operational pressures they and their staff increasingly face.
They make several observations about the future of leadership in the NHS. They support the need to move beyond working in isolation as leaders of single organisations to being part of a health economy.
To that end, many have taken on wider roles as system leaders and they recognise the need to have a dual responsibility for the performance of their local systems for the benefit of their local communities, as well as for their own organisations.
But talent management hasn’t been prominent within the NHS in recent years, although this is starting to be addressed by NHS England/Improvement. And the interviewees want to see a different approach to identifying and supporting leaders.
They recognise the need for proactive talent management to secure the next generation of leaders, with the right skills and attitudes, and from diverse backgrounds.
This should include providing opportunities for leaders to work across different organisations, and allowing them to learn from their mistakes when things go wrong.
The interviewees want to see a commitment to ensuring that chief executives aren’t forced out when they are doing a difficult and challenging job.
They also want to see more progress on developing inclusive cultures and organisations, because they recognise how this is strongly linked to better outcomes for patients and staff.
NHS Confederation chief executive Niall Dickson commented: “It is clear from this report that we can look forward to the prospect of new players and new attitudes as the health service responds to the prospect of a decade of transformation.
“Central to this will be the role of local leadership and the culture it engenders. We are all familiar with, and support, the rhetoric which says the NHS Long Term Plan will not be delivered by central diktat, centralisation, and control but instead by letting local systems lead the way.”
The chief executives interviewed recognised the need to foster a different approach to leadership development, diversity and supporting leaders, he said.
“They now want to see this well-intentioned rhetoric followed through. They know that delivering cultural change and more sophisticated leadership behaviours throughout the system is challenging and will take time, but there is a strong view that nothing less will do.”
The nine chief executives were the first cohort in an NHS Confederation and NHS Employers programme of learning and support for ‘first time’ provider chief executives. Thirty-four leaders have taken part so far.
* The best job in the world? NHS Confederation, 2019.