Hancock: ‘we need to fire fewer chief executives’

The comments came after a speech Mr Hancock made about expanding the use of technology in the NHS.

Challenged on the risks taken by NHS leaders who embark on major service change or IT projects, Mr Hancock said he had told trust chief executives: “I want the NHS to get better and to do that we need to fire fewer people – it’s nearly always the case that if you want something to improve you come in and fire a few people. I think the opposite.”

He continued: “We need to give people the security that they can undertake big projects and that is going to lead to progress. There are, of course, huge pressures in leading NHS organisations and I think we need to be more cognisant of those, and more supportive of our leaders when they come under pressure – especially in the very public environment in which NHS leaders operate.”

Last month, the health secretary abandoned the regular Monday performance meetings instigated by his predecessor Jeremy Hunt. These meetings had led to the centre intervening at organisations whose performance was deemed to be below par. The highest profile example was the removal of Matthew Kershaw and Elizabeth McManus as chief executives of East Kent Hospitals University Foundation Trust, and North Middlesex University Hospital Trust respectively in September last 2017.

Two years earlier, Keith McNeil lost his job as chief executive of Cambridge University Hospitals Foundation Trust when the implementation of a new IT system plunged the organisation into the red. The trust was also heavily criticised by the Care Quality Commission who rated the trust inadequate for a variety of care failings.

Earlier in his speech to the Public Policy Projects group, the health secretary had said he wanted to give NHS leaders “more permission to fail” and added that “a lower fear of failure is one of the important cultural changes we need to drive through the health system.”

Mr Hancock continued: “The medical and pharmaceutical change processes are understandably very cautious because of the negative impact of getting it wrong could bring. That means our change culture in the NHS – and this is true of health systems around the world – is very, very cautious and that need not be so.”

He argued that the examples set by new technology businesses or lessons learned from high performance teams in Formula One and cycling showed a more “agile” approach to “continuous improvement” was possible.

“We need to bring that new culture to bear on the NHS”, he said.

The health secretary also cautioned against the use of “evidence” as a “blocker” to innovative projects and ideas.

“I want to see the evidence” is often what somebody says when what they mean is ‘no’. You have to be really careful, because we do want clinically evidence -based policy, but we want evidence based policies that can make progress”, he said.