Now that the dust has settled since the Messenger review was delivered in early June, it’s worth taking time to consider what is needed to ensure effective (and efficient) delivery and what the plan, that will need to follow swiftly, should major on.
The seven recommendations are certainly welcome, though not surprising, but are they far reaching enough? Social care leadership is mentioned as important by the review, but an afterthought in terms of action needed. The recent White Paper, ‘People at the Heart of Care’ will hopefully go some way to addressing this.
What is now needed to deliver real benefit from the review is an inclusive approach to sector wide co-operation; more focus on the priority leadership areas; and a recruitment plan for talent.
Quality leadership and management is vital to ensure the successful delivery of our health and social care service. Leaders set the tone and standards that support the delivery of care and role model behaviours for others to follow. If they demonstrate care and compassion in their organisations, others will do the same.
As with every other distributed business, investment, development and support is needed to ensure the leaders of tomorrow are ready to step up, and that they are equipped to do the job. 40% of NHS CEOS are due to retire in the next five years, so a succession plan is needed right now to replace them. Upskilling people at scale for all these roles must be a priority.
For Messenger’s recommendations to really make their mark, there are three crucial areas for implementation:
Firstly, this must be worked on together. Sector-wide cooperation is essential and needs to be given real teeth to be effective. People Boards and ICBs, CPOs need to have real power and accountability to drive improvement and be able to measure the effectiveness of what is put in place.
Secondly, Messenger is a good jumping off point, but more work needs to be done on the priority leadership areas. For example, while recognising primary and social care, there isn’t a clear way forward for leadership in these sectors. Other areas of the review are quite specific. While the review wasn’t designed to have all the answers, the priority leadership areas need to be identified and detailed tactical plans agreed. One option could be to scale solutions that have been proven to work. For example, the Bevan programme that KPMG supports for the NHS aspiring executives has over 1300 graduates and won several major awards.
And thirdly, a recruitment plan for talent today and tomorrow. Four of Messenger’s recommendations fall into this area, and it’s surely one of the most crucial pillars on which to develop healthcare’s future leaders. Again, more work needs to be done. This could be a universal leadership development offer to all frontline staff to give them the core skills to create inclusive teams, delivered at ICS level to both health and care staff. A greater focus on celebrating success and spending more time sharing those stories and replicating them. Finally, it takes time to change cultures, and so leaders and leadership teams need to be given the recognition that it takes years - not months - for real, measurable change. These three actions, underpinned by strategic workforce planning to make sure that there are the right numbers, the right capacity of staff for now and the future, is key to make the recommendations real and clarify how this will be delivered, making the sector a more attractive place to work and develop careers.
Underpinning it all is inclusion. The report emphasises the need to be more inclusive but is light on solutions. Fostering a more inclusive approach will be the key to unlocking talent and improve patient outcomes for all. We’ve seen through our own experience how making a real difference in IDE positively impacts both our own organisation and our clients.
The bottom line is that all this needs investment, collegiate thinking and real system working. And that is the challenge. Improvements to leadership and management won’t happen overnight but real action is essential to ensure future NHS leaders continue to be supported and set up for success.