We need inspiration and system leadership, health leaders tell incoming NHS Improvement CEO

Senior health care figures say the incoming leader of the powerful new NHS Improvement regulator will need to give up on a top-down 'just do it' approach to managing performance, instead creating a sense of inspiration and a shared understanding of how the NHS can meet its current challenges. The new body needs a clear agenda that rises above 'short-term political imperatives' to bring stability and collaboration to health service trusts.

The chief executive of NHS Improvement needs to realise that a ‘heroic individual’ leadership model isn’t going to work - the system is too large, and too disjointed, for one person to lead single-handedly.

Nigel Edwards, Chief Executive, Nuffield Trust

The advice comes in What do leaders want from NHS Improvement?, a collection of opinion pieces published today by the Nuffield Trust health think-tank, and NHS Providers, the organisation representing NHS provider foundation trusts and trusts. Contributors include the chief executives of a range of NHS provider trusts, the former Health Secretary Stephen Dorrell, and representatives of patients and professionals.  

 In his contribution, Dorrell warned that the new organisation “will need to show quickly that its primary focus is genuine service improvement.” He added: “It is widely believed by both service users and professional staff that their interests have too often been the victim of a political fudge.”

Chief Executive of National Voices, Jeremy Taylor advised the new leader to “Insist on a really clear and simple mandate. Don’t be an empire builder. The more you have to do, the more likely it will either duplicate or get in the way of what others are doing.”

Angela Pedder, chief executive of the Royal Devon and Exeter NHS Foundation Trust, used her contribution to underline the need for the new organisation to work constructively with NHS England. “Until they, and we, are clear how that will work and how both bodies will work separately and together on system-wide management, the pace of improvement and change will be constrained. Since 2012, collectively we have offered commentary on why things do not work and the barriers to effective system change.  These blockages to change are something that everybody can describe, but thus far, a sophisticated game of ‘pass the parcel’ has been played.” 

Commenting on the collection, Nuffield Trust Chief Executive Nigel Edwards said:

“The absence of local system leadership continues to be a key issue. The chief executive of NHS Improvement needs to realise that a ‘heroic individual’ leadership model isn’t going to work - the system is too large, and too disjointed, for one person to lead single-handedly.

“It will be essential for the new leader to remain focused on the professionals and managers that can actually deliver change, rather than trying to convince and reassure central leaders in the Whitehall machine.”

Chris Hopson, chief executive of NHS Providers, said:

“The messages from some of our members featured in this publication are clear – the new chief executive of NHS Improvement needs to ‘do things differently’.  With leaders in the provider sector under real pressure and feeling they are on the end of an increasingly interventionist, 'squeeze harder' approach, provider leaders need reassurance that their concerns will be heard. 

“To ‘improve’ the NHS, the new CEO must understand that providers and commissioners will want to be inspired, and be part of a community of leadership that crosses organisational boundaries and has shared aims, values, and behaviours. “