- Culture of continuous improvement is vital to the future of the NHS
- More clinicians need to find their way to the boardroom
- Ethnic and gender imbalance at the top of trusts must be changed to ensure “diversity of thought”
The NHS must develop leaders who will foster a “learn not blame” culture, the health and social care secretary Matt Hancock said today.
Finding ways to “cement” this culture of continuous improvement is part of the long-term plan and is “vital to the future of the NHS”, Mr Hancock added.
“Mistakes will happen despite everyone’s best efforts. What matters is that we admit mistakes, we learn the right lessons and that we improve,” he said. “Nowhere is the learn not blame culture more important than in patient safety.”
Speaking at the King’s Fund annual conference, Mr Hancock called for a mindset shift among NHS leaders, going from a mentality where “there are certain errors that should never happen and that, therefore, it is wrong to make them,” to one that recognises “making mistakes is acceptable, it’s okay, everyone does it”.
Mr Hancock also said he welcomes a review published today by Sir Ron Kerr “into how we can empower NHS leaders to lead”. He did not address the report’s findings that bullying and discrimination are “prevalent and accepted” in NHS leadership. But he acknowledged “bad behaviour and failing to learn from mistakes” is unacceptable.
The health and social care secretary said he wants “more clinicians becoming chief executives, so we need a pipeline of talent from the frontline to the boardroom”. The service also needs “new people and new ideas from outside the system”, and he called for “more porous borders into the NHS”.
He said the NHS needs “more outsiders, more insiders, more training on the way up”, adding: “What matters is you get the best leaders.”
Mr Hancock also highlighted the urgency of developing the NHS’s leadership, saying one in 10 NHS chief executive posts is not permanently filled.
The health and social care secretary also used his speech to highlight the lack of ethnic and gender diversity in top roles. “If we look at racial equality, our leadership in the NHS looks spectacularly undiverse, uniform in fact,” he said. “More than half of all NHS trusts in England have no black or ethnic minority staff at the very senior management level.”
He also pointed to the imbalance in gender representation. He said three quarters of NHS staff are women but that falls to 40 per cent at board level.
“What we seek is diversity of thought,” he explained. “Diversity of thought is essential to the future of the NHS and it’s essential to making the best and the most intelligent use of the extra £20bn that we’re putting into the NHS.”
The speech also addressed technology, and the need for trust leaders to understand that improving technology is less about the technology itself and more about culture.
“We must have the right skills and capability in management and leadership,” he said. “Technology is no longer just another department but it’s at the core of how every good organisation works.”
He said chief executives need not “know everything about technology” but he does expect them “to have a CIO or CCIO on the board who does”.
Speech by Matt Hancock at King’s Fund annual conference
28 November 2018
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Hancock calls on NHS leaders to create 'learn not blame' culture