Wednesday 8 June 2022 12:07 AM Sajid Javid unveils biggest shake-up of NHS management in 40 years trends now

Sajid Javid has ordered the biggest shake up of NHS management in a generation after a major review led by a former military chief found leadership in the health service was 'institutionally inadequate'.

The health secretary, who has vowed to stamp out 'waste or wokery' in the NHS and social care, has accepted the recommendations of the report led by General Sir Gordon Messenger in full.

Sir Gordon, who led the Royal Marines' invasion of Iraq, met over a thousand health service workers as part of a review into how the health service and social care sector is managed.

The Messenger Report found 'evidence of poor behaviours and attitudes such as discrimination, bullying and blame cultures' in certain parts of the NHS and social care system that has left some staff 'not feeling comfortable to speak up'.

A 'lack of equal opportunities' among managers to access training to progress their careers means staff with networks or contacts are 'more likely to access these opportunities', the report said. 

It also noted that 'strengthening leadership and embedding the best examples of management is vital in ensuring every pound of investment is well spent'.

It follows concern that a £12billion a year funding boost - raised through a 1.25 per cent National Insurance hike - will be swallowed by management salaries. 

Mr Javid, accepting the findings last night, warned that rotten 'culture and leadership can be the difference between life and death'. 

He has promised to implement the report's seven recommendations, which include an induction for all new staff, plans to hire more independent advisers and sending the best NHS managers to worst-performing trusts. 

Sir Gordon, formerly second in command of the British Armed Forces, worked with Dame Linda Pollard, chair of the Leeds Teaching Hospitals NHS Trust to find ways of improving management standards, make jobs more attractive to talented bosses and delivering value for money.

One recommendation says the NHS should 'embed inclusive leadership practice as the responsibility of all leaders'.

The review found that 'overall there was a lack of consistency and coordination – in particular that there has developed over time an "institutional inadequacy" in the way that leadership and management is trained, developed and valued.' 

There should be 'clear routes' to workers on how they can improve and be promoted, while more support and incentives will be offered to the 'best leaders and managers' to encourage them to take on the 'most difficult roles'.

Sir Gordon and Dame Linda also called for 'more effective recruitment and development of non-executive directors', or independent advisers, who 'play a vital role in providing scrutiny and assurance'. 

Responding to the review, Mr Javid said: 'The NHS faces huge challenges as we recover from the pandemic, from tackling the Covid backlogs to addressing the widespread health disparities that exist across the country. 

'The findings in this report are stark, it shows examples of great leadership but also where we need to urgently improve. We must only accept the highest standards in health and care - culture and leadership can be the difference between life and death.

'I fully support these recommendations for the biggest shake-up of leadership in decades. We must now urgently take them forward, to ensure we have the kind of leadership patients and staff deserve, right across the country.'

Sir Gordon said he holds NHS and social care workers in 'the highest regard' and his respect has 'only deepened through witnessing their selflessness, professionalism and resilience first-hand'.

He added: 'A well-led, motivated, valued, collaborative, inclusive, resilient workforce is the key to better patient and public health outcomes, and must be a priority.

'The best organisations are those which invest in their people to unlock their potential, foster leadership and accountability at every level, with good leadership running through the entire workforce. This must be the goal and I believe our recommendations have the potential to transform health and social care leadership and management to that end.'

Sir Gordon retired from the Royal Marines in 2019 and, despite having no background in healthcare, was made head of operations for the Government's community testing Covid programme last year. 

During a distinguished military career, he commanded a unit of the Royal Marines during the 2003 invasion of Iraq. He also served as British commander in Helmand province from 2008 to 2009 during the war in Afghanistan. 

But the publication of the report comes as NHS Providers today issued a warning that there is a 'long road ahead' to tackle NHS backlogs.

It warned that NHS staff are working 'flat out' caring for more patients, with the number of people requiring mental health, cancer services and diagnostic tests higher than pre-Covid levels.