HSJ’s round-up of Wednesday’s must read stories and debate

Management speak

At the NHS Providers conference on Wednesday, Jeremy Hunt probably made his biggest policy intervention for more than a year, announcing a package of measures aimed at reshaping the NHS workforce.

New policies were abundant, but the top line was that Mr Hunt wonders whether introducing a general “manager class” for the NHS may have been a “historic mistake”. This was a strange line to take in a speech that also sought to confront the problem of morale in the workforce – but it was no slip of the tongue. Unusually for Mr Hunt, he read his speech from notes rather than from memory, which is his usual style. The message, and the wording, was deliberate.

Mr Hunt compared the level of clinical leadership at the highest levels of the service to other systems around the world and noted that the NHS has relatively few chiefs from clinical backgrounds. But confusingly, he also pledged to increase the number of graduate management trainees by a quarter.

HSJ editor Alastair McLellan suspected that the speech was a “a massive distraction exercise from the pressing issues of declining NHS finances and access that he can do little about” and that his call for more clinical managers was based on a “false premise”.

The health secretary also announced:

  • Health Education England will examine whether doctors will be able to choose clinical leadership as a specialism with a dedicated programme.
  • NHS graduate scheme places will be doubled to 200 in 2018, followed by a phased increase of 1,000 places a year.
  • A review of professional regulation by Faculty of Medical Leadership and Management to encourage nurses and doctors to move into leadership roles will be completed in 2017.
  • The NHS Leadership Academy will send 30 students a year to global universities to fast track their move into senior management.
  • The launch of an “NHS MBA” for senior professionals in September.

There was also a tough message for the conference’s host, NHS Providers chief executive Chris Hopson. On Tuesday, Mr Hopson suggested that the Five Year Forward View’s projections around demand and performance had turned out to be wrong, going on to argue that without more money the improvements in NHS performance seen over the decade to 2010 will be reversed.

Mr Hunt was not impressed: he said Mr Hopson was not right to argue that the NHS could not do all that was being asked of it without more money, just a year after saying the 2015 comprehensive spending review represented a good settlement for the service.

The Treasury’s investment, he said, was based on the consensus that the 5YFV was the right plan across the NHS national bodies, and groups such as NHS Providers.

The previous day, NHS Improvement boss Jim Mackey told the conference there could be a “door open” at the Treasury for capital funding requests, but said leaders need to build a “stronger case than we’ve got now”. Rationalising “enorormous” overhead costs will be a key part of that process.

He said: “The Treasury are actually being very patient and pragmatic so far… and giving us time to get our case together, but we haven’t got a year to do it, we’ve got months. And we need to make it very very hard for people to reject them.”