Flory: 'Loss of experience is greater than I’ve seen'
David Flory has said the current NHS reforms have prompted the greatest loss of management experience of any health service reorganisation he has seen in his career.
In an exclusive interview with HSJ, the NHS Trust Development Authority chief executive and former deputy chief executive of the NHS said the service was now struggling to find enough people with the “requisite capability” to run its most challenged hospitals.
The old system of primary care trusts and strategic health authorities was abolished on 1 April prompting many senior leaders to leave the NHS. The hospital sector has also seen a significant number of experienced chief executives and senior directors retire.
Mr Flory was talking about the leadership challenge faced by the service in the wake of the changes set in train by former health secretary Andrew Lansley.
He said: “I sat in my kitchen on Sunday reflecting on my last day as deputy chief exec at the Department of Health and looked through my contact book of the people who I regularly connect with.
“Forty-two per cent of them left last week, so the scale of the change and loss of experience is greater than I’ve seen in any reorganisation before.”
His view was backed by another very senior manager from the previous system.
Sir Neil McKay, who was senior responsible officer for human resources transition during the reforms and chief executive of NHS Midlands and East, told HSJ: “I think David is right. It’s not been easy to provide the depth of NHS talent in recent years and that has been exacerbated by the reforms. I think there are significant risks in terms of keeping the show on the road in the short term.”
He supported Mr Flory’s view that the loss of management experience extended to the hospital sector.
“We managed to make good appointments, but whereas in the past there would have been a deep pool of talent, that’s not always the case these days,” he said. “There might be some people who in the past might have aspired to these roles and are now thinking twice.”
Mr Flory said encouraging people to take up posts within struggling trusts would be key for his organisation.
“In the provider sector those jobs at a challenged provider are the toughest in the NHS by some way, and [there is] an increasing number of them, and they’re increasingly hard to fill,” he said. “And in that sector the evidence shows us we have not got enough people with all the requisite capability.
“We need to redefine what success in those jobs looks like,” he added. That would mean making it as rewarding to get an organisation “which has been in trouble for five years” out of trouble as it was to run “an internationally recognised world-class centre of excellence”, he suggested.
Jon Restell, of trade union Managers in Partnership, also lamented the leaking of talent from NHS during the reforms.
He wrote in a blog entry: “Talented and experienced leaders and managers have left the service over the last three years, forced out through redundancy, the dismal rhetoric of ministers and the endless uncertainty.
“Staff who have secured new jobs have done so in conditions that have been far from ideal. The HR transition programme did well in the circumstances, but there was too much to be done in the closing few months for everyone to feel they were treated properly.”
However, NHS England said the reorganisation had been a success. A spokeswoman said: “NHS England spends around 50 per cent less on running costs and has around 60 per cent fewer highly paid executives in comparison to the old system.”