As managers lack faith in their leadership skills, training opportunities must be increased to ensure the reforms are a success, says Susan Hodgetts

It goes without saying that this is a unique period in the NHS and a time of significant, sweeping changes for health and care services.

One of the more worrying aspects of the healthcare system’s overhaul is the unprecedented demands it will place on NHS managers’ leadership skills and the unparalleled levels of responsibility that will be devolved to frontline staff. 

There is a real fear these new responsibilities will be challenging for many managers who have had to bear the brunt of the financial squeeze on training and development provision in recent years.

The truth of the matter is that some managers may just be not up to the job and the reforms could flounder if nothing is done to address the skills gap and help managers become the leaders they must be to run the new organisations.

Much has been said and written about the need for a more engaging style of leadership in the NHS. The King’s Fund report Leadership and Engagement for Improvement in the NHS made a compelling argument for a shift from traditional “heroic” leadership towards a more collaborative approach. It also made a strong case for giving frontline managers the opportunity to innovate and succeed by adopting a collaborative stance to reach across different sectors and organisations.

But is this being achieved when all the evidence points to an embattled, demoralised management team struggling with budget cuts, a lack of proper leadership training and development, and a severe dent in confidence? The latest research from the Institute of Healthcare Management found more than three quarters (78 per cent) of managers think patient care is at risk due to a lack of proper staff training and development. Some 87 per cent of those surveyed believe this training gap has resulted in low team morale while a further 87 per cent cite a lack of confidence in staff as a direct consequence, resulting in slipping standards and, ultimately, putting patients at risk.

Furthermore, a quarter (24 per cent) of managers feel they do not have access to the support they need to develop their leadership and management skills and a third (33 per cent) think their direct line manager does not have the skills and experience necessary to further develop them.

Almost six in 10 of those surveyed (58 per cent) have only had mandatory training in the past year despite the vast majority (69 per cent) calling for more leadership and management training to improve career and skill development in the NHS.

The reality is that at a time when managers must step out of their comfort zone, the budget cuts of recent years have created distracted, disaffected managers who have lost confidence in their leadership abilities.

Tools of the trade

It is vital frontline clinical and non-clinical managers have the leadership knowledge and skills to help drive the restructure and ensure its success.

But the key question is: just how can this be achieved? While there is no denying managers are far more likely to deliver a better quality of patient care and successfully meet financial targets and complex operational challenges through engagement with populations, patients, carers and staff, they need the tools of the trade in order to achieve this and work effectively across boundaries and services.

A robust training and development programme can equip managers with the skills needed to get the best out of people regardless of their level, management style or background, and ensure serious incidents such as at Mid Staffordshire Foundation Trust and Winterbourne View are avoided.

The IHM is committed to providing managers with continuous professional development to ensure the highest quality of leadership and the best level of care for patients. We are calling on the government to increase access to training and development so managers have the skills they need to embrace the changes and succeed in the new structure.

The Accredited Manager Programme is an 18 week university-accredited training programme to develop management and leadership skills, giving managers the tools of the trade and the confidence to lead teams and manage resources effectively as they face the complex challenges that lie ahead. It focuses on the key attributes today’s managers need to raise their game to meet the challenge of the NHS reforms head on; these include contextual leadership, managing stakeholders, risk management, communications and relationship management and reflection, to name a few.

These are exceptional times. They call for brave, inspirational, engaging, collaborative and inclusive leadership combined with commercial understanding and acumen.

Without the proper training and development in place, there is a very real threat the restructure of the NHS will fail and it will be patients that, ultimately, pay the price. Managers at all levels need to continue to develop, hone and stretch their leadership capabilities.                    

Susan Hodgetts is chief executive of the Institute of Healthcare Management.

Leading the way to reform