Jobseekers have ranked healthcare management among the most desirable careers. Louise Hunt finds out why

The NHS may never be able to dazzle prospective recruits with the promise of bright lights and fast living, but a recent survey suggests that the public perception of a career in health service management has come a long way from one of thumb twiddling and layers of bureaucracy.

The poll of 4,500 members of the public was taken to see where the health service sat in their estimation of desirable careers. Healthcare was ranked the third most popular sector overall, sandwiched between the creative and cultural industries and social care. The same question for management roles put the NHS in fifth place, above finance and retail.

The research was done in spring for the Health Learning and Skills Advice Line, which is jointly sponsored by NHS Careers and Skills for Health. Its remit is to provide tailored careers advice to NHS staff, including signposting people to the different routes for career progressions and training possibilities to get there.

Although there has not been a similar survey for comparison, Alan Simmons, a consultant for NHS Careers, believes it is indicative of the rise in popularity of public sector careers, with the NHS in particular offering a broader choice of roles.

"What is attractive is the perception of being able to make a difference," he says. "Anecdotally, there is a trend towards more people seeking careers in the public, rather than private sectors, for the job satisfaction in helping others. This is a relatively recent phenomenon."

Shareholders

Andrew McMylor is typical of the new type of graduate who prefers the NHS over other employers. He completed the NHS graduate management scheme in 2007 and is now public health and special projects manager for Richmond and Twickenham primary care trust, having risen through management posts in emergency planning and a stroke services review.

"Other sectors didn't appeal. They tend to be working for shareholders and I would rather work with the public as a shareholder. When I get up in the morning I like to think that I'm doing something positive," comments Andrew.

"It was the thought of being able to start off small and make a bigger difference. I am working in sexual health services with all walks of life at the moment and am starting to see results," he says.

His ultimate goal has always been to work in disaster management, a route that may take him out of the NHS. But he says his experience in public health is an excellent foundation. "I see it as part of my development. You can go as far as you want to go in the NHS, there are so many opportunities.

"I am looking forward to developing partnerships with the voluntary and independent sectors so that no matter what's wrong with you you will get access to services."

Mark Orchard, deputy director of finance, information and performance at Bournemouth and Poole PCT, went into NHS management 10 years ago for many of the same reasons. He had started out in a private practice accountancy firm, but became demotivated "because it was all about chasing the bottom line".

When he made the move to the NHS, he says, "I suddenly found myself in a position where I could contribute much wider by interacting with other staff and patients".

"It is much more rewarding than the private sector, being able to make a difference to the local community and influence the way healthcare is delivered. I am always surprised when I talk to people who live for the weekend. I thoroughly enjoy my work."

He, too, thinks perceptions of a career in NHS management are changing. "Ten years ago I remember colleagues in the private sector who knew that I liked to get things done, saying :'I can't believe you're going to work in the NHS. You're going to be sat there twiddling your thumbs all day, it's so bureaucratic.'"

Commercial skills

On the contrary, he believes the NHS now is a far more dynamic beast. "From what I can see the NHS is at the forefront of public services. It can be a political football at times, but that keeps it a very exciting area to work in."

Of course, it helps that the NHS is also able to offer management salaries that have been rising steadily to compete with the private sector, while at the same time offering the public sector benefits of more flexibility and that increasingly rare perk of a final salary pension scheme.

It is probably a melding of public sector ethos with commercial acumen that is making NHS management a more attractive career prospect, suggests Angela Carter, an occupational psychologist at Sheffield University and a former NHS manager. "There used to be no room for innovation, but now management is a much more commercial role, with more opportunities to generate and keep incomes, for example, with foundation trusts. It has become much more like private sector management," she says.

Indeed, this is attracting more people from the private sector, as the NHS needs their skills and experience, believes Angela. She says business management skills have been useful in helping trusts to meet the four-hour accident and emergency target or become foundation trusts, for example. "These skills weren't seen as important before, but the pressure on performance in the NHS has changed the perception of managers' role in achieving real business outcomes. And this makes NHS management more attractive to people with that background."

Ironically, one section of the workforce who may be overlooking NHS management opportunities are those already working in the NHS. "My gut feeling is that there are still many people working in the NHS who are not really aware of the opportunities they have got to become managers," says Ms Carter.

"A lot of people working in the NHS don't think laterally about their careers unless they are professionals with professional bodies to raise awareness of career frameworks and specialist courses. Whereas a lot of non-professionals, such as ancillary staff, have great management skills and would make good managers if they knew of the opportunities," she adds. "Maybe this is where the Health Learning and Skills Advice Line can help."

Movers and shakers

Top 10 most desirable sectors for careers in management

1 Creative and cultural

2 Broadcast, film and video industries

3 Sport, recreation and health and fitness

4 Hospitality, leisure, travel

and tourism

5 Healthcare

6 Policing and law enforcement

7 Social care

8 Retail

9 Financial services

10 Central government

Source: OnePoll, for NHS Careers and Skills for Health

www.learndirect-advice.co.uk/campaigns/nhs