Daily Insight: Messenger received

What was billed as the biggest review of NHS leadership since the 1980s has recommended a single set of “core leadership and management standards” for managers.

General Sir Gordon Messenger and Dame Linda Pollard say an “institutional inadequacy” has formed in the way leadership and management is trained and developed in the health service.

The report has produced seven recommendations (see our full story), which have all been accepted in full by the health and social care secretary Sajid Javid, who said they must be taken forward “urgently”.

The recommendations do not include any registration system for NHS managers, despite calls from some over many years for more regulation of the roles, nor appear to include specific reform of the “fit and proper person” test, which has been discredited and under review.

When asked by HSJ ahead of the report’s publication about the impact historic underfunding has had on NHS management quality, General Sir Gordon said good leadership did not have to be “an enormously resource intensive function”.

“All I would say is good leadership and great managerial skills among clinicians and non-clinicians is not necessarily an enormously resource intensive function, and one can get a great deal from approaching it the right way.”

Also in an interview with HSJ, Mr Javid said the health system must find ways to attract talented leaders into areas which are struggling.

He said: “One of [the report’s recommendations] is what I’d call breaking the cycle of poor performance, which is about encouraging top talent into the most challenged parts of the system with better support.

“We’ve got to give them incentives, whether it’s regional or other parts of the system, to move into that, and give them better support packages…

“That can vary from anything from looking at their pay packages and making sure there’s enough flexibility and variability in there, but also recognition I think is an important part of that, and support for them.”

There was some disagreement in the immediate wake of the report’s publication, with Sir Gordon saying Mr Javid’s claim that the number of NHS roles dedicated to promoting equality and diversity should be cut is incorrect and not what the review recommended.

To clarify his position, he told HSJ: “The report does not recommend the reduction of equality, diversity and inclusion professionals.

“What it does say though, is that if one successfully inculcates EDI to every leadership’s responsibilities then that becomes an accepted, instinctive, understood part of being a leader and a manager at every level then the requirement for dedicated EDI professionals should reduce over time.”