Hancock to target NHS’s ‘very, very old school management’ culture

The new health and social care secretary, who took over from Jeremy Hunt earlier this month, made the comments at his first appearance in front of the parliamentary health and social care committee yesterday – and elaborated on his plans for a major cultural shake-up.

The former culture secretary, who has already caused controversy by his backing of “disruptive” new technologies, set out his immediate priorities, which included “accelerating” contingency planning for a no-deal Brexit and the stockpiling of drugs, as reported by HSJ yesterday evening.

He also confirmed that the proposed new NHS England chair, the name of which is understood to be awaiting clearance from the prime minister, will not begin before facing a parliamentary pre-hearing appointment after the summer recess. Sir Malcolm Grant steps down from the role in October.

Fleshing out his longer term thinking, he spoke of his desire to “look for culture changes, rather than a revolution in structures, which I’m not interested in”.

He said: “I am looking for…a change in the culture in the way the NHS works in a number of different ways. Firstly, a culture of greater respect among the workforce.

“I found it extraordinary looking at how a highly motivated, highly intelligent workforce has to cope with these structures and sometimes very, very old school management, which make it far less pleasant than it should be to work in the NHS.

“The NHS ought to be the best place to work in the world. It’s got these amazing values… But often, the ways of working, old school practices, get in the way of it being such a brilliant employer.”

The comments follow culture being a key part of his first speech earlier this month, when he said it was time to “back managers to manage in a dynamic and modern way” and break down the tribal barriers between clinicians and managers. He said workforce, technology and prevention were his three early priorities.

The new secretary did, however, indicate that he might be less interventionist than Mr Hunt was in pushing for the sacking of chief executives of struggling trusts, as happened ahead of last winter.

Asked about how he would deal with providers in special measures, he said: “One thing I have… seen so far is often going into special measures leads to new leadership.

“Sometimes that is absolutely necessary. However, new leadership is no panacea and it does not automatically solve the problem. You need not only that stick, but a big carrot and an arm around the trust to help them out of special measures.”

On development of the long term plan, he said NHS England was putting “together as we speak a skeleton outline, which is the big picture of the items which need to be hit”.

“These will feed into key decisions in October and likely November publication of the long term plan,” he added.