Three quarters of the most senior NHS leaders are “not creating strong work climates”, according to an analysis seen by HSJ.

The detailed assessment of around 900 participants in the NHS Top Leaders programme says overall they are “high on over-confidence” and suffer from “an absence of attention to detail and completion of tasks”.

They are “not necessarily understanding their own limitations” and do not tend to listen to others, analysis by Hay Group consultants for the National Leadership Council says.

It says 75 per cent are “not creating strong work climates”.

However, their numeracy skills are slightly better than the “management/professional/graduate norm” and their verbal reasoning abilities are well above average.

The work was carried out last May to help senior leaders diagnose their strengths and areas for improvement.

As of last September, the programme had invested £2.69m over 18 months on providing “top leaders” with tailored career plans involving on-the-job support, secondments, placements, coaching, networking and mentoring.

The analysis also measures how far NHS top leaders are creating a climate that encourages risk taking, minimal bureaucracy, improvement, autonomy and “congeniality”.

It then provides a benchmark for the standard they should ideally be hitting in these areas. This has shown significant gaps between their present standards and the benchmark.

The biggest gap, at 38 per cent, concerns the extent to which they are creating a climate that provides colleagues with “clarity”. However, the diagnosis suggests senior leaders themselves are equally unclear about their own work.

Manchester Business School head of health policy and management Naomi Chambers said the lack of clarity occurred partly because the NHS tended to recruit leaders who needed “everything spelt out” and were not good at “making do with what they’ve got”.

She added: “More than ever, the NHS is incredibly centrally led” and that people were modelling their behaviours in response to NHS chief executive Sir David Nicholson’s style.

The top leaders also feel their performance is not rewarded as much as it should be. In addition, they are 22 per cent behind where they should ideally be in “minimising bureaucracy”.

Levels of “congeniality” created by their leadership styles are 25 per cent below the ideal standard while autonomy and innovation are behind by 14 per cent and 26 per cent respectively.

The analysis was obtained by HSJ following a Freedom of Information request battle with the Department of Health.