NHS to cut diversity and inclusion jobs in a dramatic management shakeup

Sunday, June 12, 2022

NHS has been told to cut diversity and inclusion jobs in a dramatic management shakeup

An eight-month official inquiry calls for major reforms of the leadership of the health service, as part of the war on ‘waste and wokery’

It comes as the health service battles to cope with record backlogs, with over 6.4 million people still on waiting lists.

As widely reported across the media this week the NHS has been told to cut “diversity and inclusion” jobs as a landmark report recommends and sets out plans for the biggest shake-up of management in a number of years.

This has resulted in comments of disappointment from both the NHS Confederation and the BMJ.

Meanwhile Sajid Javid , the Health Secretary had called for “urgent” action to improve the quality of leadership in the health service, as part of a war on “waste and wokery” amid record NHS spending.

On Wednesday, Javid said the country had been left with a “Blockbuster healthcare system in the age of Netflix,” as he urgently called for radical change to “dramatically” boost productivity in the health service. 

This inquiry warns of “institutional inadequacy” in the way the NHS is run and called for immediate changes to improve performance overall.

General Sir Gordon Messenger, a general who led the Royal Marines’ invasion of Iraq, had been asked by the Health Minister to personally lead this eight-month inquiry into the health and social care leadership across the UK.

His report warns of widespread failings, which have allowed “poor behaviours and attitudes such as discrimination, bullying and blame cultures” to go unchecked.

New management standards must be set improve equality

Sir Gordon explained that far more needed to be done to improve equality in the NHS and stop barriers to progress.

However he added that this meant equipping all leaders with the right skills, and doing away with the plethora of equality, diversity and inclusion roles which have sprung up in recent years.

The inquiry’s report calls for major reforms - including the right incentives to attract the top talent to the toughest jobs.

It says new management standards must be set, with mandatory training required for anyone advancing to senior roles.

Extra funding boost for health and social care

The review was commissioned as part of efforts to ensure that an extra £12 billion a year funding boost for health and social care, paid for by a 1.25 per cent National Insurance hike is used wisely.

Sajid Javid accepts recommendations

This week have read the full report, the Health Secretary has accepted the recommendations in full.

Mr Javid went on to say, “In my view, there are already too many working in roles focused solely on diversity and inclusion, and at a time when our constituents are facing real pressures around cost of living, we must spend every penny on patients’ priorities.”

“As this report sets out, it should be the responsibility of everyone to encourage fairness and equality of opportunity which is why we must reduce the number of these roles.”

Sajid Javid believes there are too many people working in roles focused solely on diversity and inclusion.

The findings come after warnings of an “astonishing” explosion in central bureaucracy in the NHS, with a doubling in the numbers working in NHS England and the Department of Health and Social Care in the last two years.

On Tuesday, Mr Javid likened plans to reform the health service to a shift from video rental to streaming services, saying the country has a “Blockbuster healthcare system in the age of Netflix.

Downing Street said Mr Javid told a Cabinet meeting on Tuesday that it was “no longer simply an option to stick to the status quo,” and the Government had set the NHS a target of “dramatically improving productivity.”

‘Institutional inadequacy’ in leadership

The eight-month review by Sir Gordon and Dame Linda Pollard, chairperson of Leeds Teaching Hospitals Trust, included meetings with over 1,000 front-line staff, managers and leaders across health and social care in the UK.

It found that “overall there was a lack of consistency and coordination – in particular that there has developed over time an ‘institutional inadequacy’ in the way that leadership and management is trained, developed and valued.”

The report “found evidence of poor behaviours and attitudes such as discrimination, bullying and blame cultures in certain parts of the health and social care system, with some staff in the NHS in particular not feeling comfortable to speak up”.

The report calls for immediate action to break down barriers to progress and create a fairer workplace.

Reaction to the inquiry was immediate from the NHS Confederation and the BMJ

Responding to General Sir Gordon Messenger and Dame Linda Pollard’s review of health and care leadership, Matthew Taylor chief executive of the NHS Confederation said: 
“This is an important report which demonstrates the vital role that NHS leaders and managers play in delivering high quality and efficient care.

Whilst there may be a view in some quarters that money spent on NHS managers is wasted, we know that high performing health systems require investment in effective management.

We need to move away from the damaging narrative that managers are somehow an unnecessary expense. Put simply, the NHS is not over-managed and never has been.

He went on to say, “The report recognises that the NHS is now operating in a new environment as we deliver more integrated care for patients.

This requires system leadership built on collaboration and means leaders can no longer work autonomously in their own organisations.

New skills and a systems-focused mindset will need to be hard-wired into those in leadership positions within the NHS and much of this is already in evidence across the service. “

“The report is also right to point out the gaps in support for NHS leaders and what more can be done to ensure we deliver a consistent approach to leadership development at all levels within the NHS.

And, in particular, how we support chief executives who take on highly challenging roles. NHS leaders are not football managers, and they shouldn’t be treated as such, taking on difficult jobs only to be sacked before they have had time to turn round performance.

We need to better support them and reward them for taking on tough roles. This new approach to leadership needs to be based on a culture of learning and improvement, with less emphasis on top-down performance management which has been a feature of recent years.”   

“The report rightly acknowledges that we have much still to do to create a more diverse leadership in the NHS, but we also need tangible action and changes to ensure this happens. We can’t hide from the fact that all too often staff from ethnic minority backgrounds are still not being provided with the support they need to progress to leadership roles. We need to move beyond admiring the problem and make concrete progress in addressing it.”

“Finally, we must acknowledge the limited focus in this report on supporting leaders in primary care and social care. The risk is that this looks like an after-thought and we would encourage the government and its arms-length bodies to not overlook these sectors.”

The bmj also reacted on its website to the report’s findings

The said that it is disappointing that Messenger’s review of NHS leadership and management largely overlooks general practice, apparently regarding clinical leadership by GPs as the main area for attention, rather than the whole gamut of primary care management expertise.

Strong primary care strengthens the NHS and is critical to pandemic recovery. But the sector is precarious and requires bespoke, co-designed leadership and management support, alongside a bevy of measures to recruit and retain clinical staff.

Messenger has missed an opportunity with general practice.

Eyes now turn to the Government’s response to the Fuller stocktake (which set out a vision) to provide answers about how desired wide scale change in primary care can be resourced, led, and managed.

The debate continues