Frank message in Whitehall report card: must try harder

The capability review of the Department of Health, undertaken on behalf of the Cabinet Office, is a dissection of the DoH's shortcomings which makes queasy reading for any squeamish mandarins (see 'Nicholson: let local managers drive health service reforms').

Of the review's three segments, leadership and strategy are exposed as woefully below standard, with only delivery judged to be more or less in the right place.

The problems are exposed in brutal language. On leadership it concludes: 'The department has not yet set out a clearly articulated vision for the future of health and social care and how to get there.'

Arguably even more damning is the need for 'greater clarity about its role as a Department of State'. In other words, 'tell us what you are for'.

The DoH's ability to 'set direction' was rated as a serious concern - the bottom score - while the ability to 'ignite passion, pace and drive' was ranked as an 'urgent development area'.

NHS staff would recognise many of the criticisms - rushed changes undermining morale, short-term decision making, poorly managed departmental changes, poor policy integration, poor understanding of the impact of policies on the front line, poor use of data, too many initiatives, inability to learn from experience, and much more.

And small details are enlightening; the fact that three people signed off the DoH's response to a report highlighting poor leadership has caused much merriment in Whitehall circles.

But despite this presentational slip-up the DoH's new leadership team may well find the report a useful tool in driving through internal change. It demonstrates why they are demanding robust performance standards, adherence to the new culture of engaging with stakeholders and each other, and a focus on the long-term strategy not the short-term headline. Managers throughout the organisation will need to grasp the meaning of accountability, or face the consequences.

And the report has one final benefit. It can be used to warn off any minister with a bright idea for more upheaval.