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Javid promises urgent action as review reveals ‘bad behaviour’ by NHS management

Health Secretary Sajid Javid has pledged to take urgent action to overhaul the management of the health and social care sector after a major review found evidence of ‘bad behaviour’, including discrimination , bullying and blame cultures.

The review, led by former senior officer General Sir Gordon Messenger, concluded that there was an ‘institutional deficiency’ in the way leadership and management in the sector were trained, developed and valued. Mr Javid said the findings – which will be released in full later on Wednesday – were “stark” as he promised “the biggest leadership shake-up in decades”.

The report comes as the NHS is under pressure to ensure a cash injection of £12billion a year to deal with the backlog that has built up during the Covid pandemic is spent effectively. A press release from the Department of Health and Social Care ahead of full publication said that while the review recognized the pressures on the sector and identified many examples of inspirational leadership, overall it found “a lack of coherence and coordination”.

In particular, he said there has developed over time “an ‘institutional insufficiency’ in the way leadership and management are formed, developed and valued”. The statement added: ‘He also found evidence of poor behavior and attitudes such as discrimination, bullying and cultures of blame in parts of the health and care system, some NHS staff especially not feeling comfortable expressing themselves.

“He identified a lack of equal opportunity for managers to access training and colleagues to progress in their careers, with those with existing networks or contacts being more likely to access these opportunities.”

Mr Javid said he fully supported the report’s recommendations, saying it was essential that staff and patients had the leadership they deserved. He said: “The findings of this report are striking, they show examples of great leadership but also areas where we urgently need to improve.

“We must only accept the highest standards of health and care – culture and leadership can mean the difference between life and death. I fully support these recommendations for the biggest leadership overhaul in decades We now need to move them forward urgently, to ensure that we have the kind of leadership that patients and staff deserve, across the country.

Among the report’s recommendations are measures to improve equality, diversity and inclusion, the development of consistent management standards through accredited training, and clear pathways for progression and promotion to ensure a “strong pipeline of future talents. It also calls for support and incentives for the best leaders and managers to take on the toughest roles so they are seen as “the best jobs rather than the most dreaded jobs.”

Gen Messenger, a former deputy chief of defense staff who led the Royal Marines in the invasion of Iraq, said he believed the recommendations could transform leadership in the sector.

“A well-led, motivated, valued, collaborative, inclusive and resilient workforce is key to better patient and public health outcomes, and must be a priority,” he said. “That must be the goal and I believe our recommendations have the potential to transform the leadership and management of health care and social services to that end.”

The findings were welcomed by the acting chief executive of NHS providers, Saffron Cordery, who said the review had identified a “window of opportunity” for change. “Trusts commit to working together more effectively to develop and improve leadership, building on existing strong foundations, and local leaders must be fully engaged and involved in any change to ensure a successful and well-performing NHS,” said she declared.

Matthew Taylor, chief executive of the NHS Confederation, said the report identified the need to create more diverse leadership within the NHS. “We can’t hide the fact that too often ethnic minority staff still don’t get the support they need to move into leadership roles,” he said.

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