In order to meet its future needs, the NHS must invest in the development of new senior leaders, say Jan Sobieraj and Chris Hopson

The NHS faces a significant top leadership challenge. In his recent review into NHS leadership, for example, former Marks & Spencer boss Lord Rose said greater emphasis is now needed on the essential skills and development to support change, and that a key answer to our challenging environment is better leadership. 

‘There is concern that trusts and FTs are encountering real difficulties recruiting chief executives’

The role of the chief executive is clearly very demanding – as two senior, experienced, provider chief executives, Sir Robert Naylor and Sir Leonard Fenwick, have recently publicly attested. But the role is more important than ever, given the wide range of challenges the provider sector faces.

Recent research by the King’s Fund found the average tenure of an NHS provider chief executive is currently just two and a half years. More than 12 provider chief executives – 5 per cent of the total – announced their departure during the summer.

Jan Sobieraj

Jan Sobieraj

There is widespread concern trusts and foundation trusts are now encountering real difficulties recruiting at chief executive level – provider chairs, and the headhunters that support them, are reporting many shortlists only have only one or two appointable candidates. 

But we will only get the right senior leaders if we invest in their development; create a strong pipeline of good candidates; prepare aspirant chief executives for the weight and responsibility of the role; and then support newly appointed chief executives immediately after their appointment, when that weight and responsibility is likely to feel at its heaviest.

That is why Monitor, the NHS Trust Development Authority, the NHS Leadership Academy and NHS Providers have come together to design two high quality leadership programmes to meet these important needs.

Aspiring chief executives

As a first step, drawing on input from a range of existing provider chairs and chief executives, we have created a new 12 month development programme for aspiring chief executives. This will build a strong pool of candidates ready to take on the top job and ensure that those who complete the course are ready to take on these demanding roles.    

The programme will, through an open application and assessment process, identify an initial cohort of 14 aspirant chief executives. It will then equip these future chief executives with the necessary skills, knowledge, attitudes and behaviours for future success.

‘The programme will build a strong pool of candidates ready to take on the top job’

The programme will provide professional and personal development, education and ongoing support and, through an end of programme assessment, verify they are ready to take on the most senior role in a trust or foundation trust.

Chris Hopson

Chris Hopson

Patient care and staff engagement will be at the heart of the programme, together with an understanding of the realities of being an accountable officer.  At the end of the programme, participants will be able to demonstrate their readiness to be an effective chief executive. This demanding programme builds on the Leadership Academy’s other successful programmes such as Nye Bevan.

Crucially, the programme will be a blend of a number of different types of learning and experience including action learning sets; a real life, practical, stretch assignment; and the chance to learn from and be mentored by those with deep experience of these demanding roles.

The programme also seeks to enshrine a key finding of HSJ’s recent Future of NHS Leadership inquiry – that the focus should now be on integration and system leadership. The programme will therefore deliberately move beyond the idea that provider chief executives are just leaders of their individual provider institution. It will, instead, embody the principle that providers also need to be effective co-leaders of their local health and care systems. 

Support programme

We are close to finishing the design of a second programme, to support newly appointed chief executives in the first two years after their appointment.

‘Nothing could be more important than ensuring we develop and support the next generation of senior leaders’

Talking to aspirant chief executives, chairs and experienced chief executives over a series of events during the past 12 months, one key theme is the need to support new chief executives at this key point in their career.

The learning and support provided by the programme is planned to be deliberately tailored to meet each individual’s chief executive’s requirements.

We recognise that both programmes will only succeed if individual provider boards support them by:

  • encouraging aspiring chief executives to apply;
  • offering stretch assignments;
  • looking to the talent pool created for new chief executive appointments;
  • allowing experienced chief executives to mentor new colleagues; and
  • ensuring that all newly appointed chief executives take part in the programme aimed at supporting their needs.

Nothing could be more important than ensuring that we develop and support the next generation of the most senior leaders.

Working closely with the provider sector, we believe these programmes, and the partnership that created them, offer a real chance to address a growing leadership gap that threatens the sustainability of the NHS and must, therefore be closed.

We encourage all provider board members to contact us and find out more.

Jan Sobieraj is managing director of the NHS Leadership Academy and Chris Hopson is chief executive of NHS Providers

More details of the aspiring chief executive programme can be found on the NHS Leadership Academy website and details of the newly appointed chief executive programme will follow shortly.

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