The health service often “decapitates” senior leaders who take on difficult jobs when it should be supporting and promoting them, the chair of NHS Improvement has said.
Baroness Dido Harding was speaking at The King’s Fund leadership summit on Thursday.
She said a priority for NHSI under her and chief executive Ian Dalton would be putting more focus on the development and career paths of senior leaders, and on supporting them.
Asked whether she could be confident that trusts currently without substantive chief executives – including several of the biggest providers – would be able to make good appointments, she said she could not because NHSI had not tracked would be candidates elsewhere in the service.
She said: “One of the questions I asked when I joined [NHSI] was: where is the talent map?” This would be a list of the “dozen or half dozen or so leaders who are ready for a move”, she said. “Any of the large organisations I’ve worked for would have been able to give me that information.”
Baroness Harding was previously chief executive of TalkTalk and has worked in senior roles in retail.
She said she was “confident… there are some amazing leaders out there” and the NHS nationally needed to be “a bit more thoughtful about what long term career pathways look like”, and for promising individuals to “support them, identify them”.
She said she was concerned too many senior NHS leaders lost their job after taking on difficult jobs.
Baroness Harding said in other industries “the only way you get promoted is if you do some horrible jobs. That’s the way of earning your stripes. In the NHS the opposite has been true. If you do the hard jobs you are likely to be decapitated.”
She said in some cases senior managers who had struggled had in the past been “decapitated privately then a year later they pop up somewhere else”.
She said their problems were often not primarily the individuals’ fault, and NHS regulators should better ensure leaders are supported and put in appropriate roles, rather than punishing them. Baroness Harding said there were only a small number of cases where people had acted in a way, which meant they should not do a similar role in the service. She said an ongoing review of the fit and proper person test for NHS board members would be helpful in addressing the issue.
She said NHSI would be paying more attention to staffing in the NHS in several ways. With NHS England it is appointing a chief people officer to set out, collaborating with other agencies such as Health Education England, “what is our people strategy”. The organisation would be prioritising human resources as a profession, she said.
Simon Stevens on the NHS long term plan
Speaking at the same event, NHS England chief executive Simon Stevens highlighted several areas which should be covered in the forthcoming NHS long term plan.
- Put “rocket boosters” under existing work on integration.
- Address the “missing link” of workforce, including, as well as training more staff, the role of teams and the need to continue to recruit from overseas.
- Ensure sufficient funding for social care in the next few years, as a longer term funding solution may not be in place in time. This will enable hospitals to free up many beds by reducing the number of “super stranded” patients who stay for long periods, which will be a focus this winter, Mr Stevens said.
He also called again for strong government action on childhood obesity, including in relation to the role of social media.