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Great meeting on Tuesday where our group reviewed the Kings Fund Paper "The Future of Leadership & Management in the NHS-No More Heroes"  The review was commissioned in September 2010 and was intended as a "stock take" of current management & leadership in the NHS, to assess the requirements to deliver the financial and quality challenges faced by the NHS and to make some recommendations for developing and strengthening management & leadership.

The reviews’ starting point is a quote from Lord Tugendhat June 2010 that suggests caution “ the government want to maintain frontline services and free professionals who staff them to get on with their jobs but they must remember that doing that in a time of cuts requires skilful and careful managers – the fewer the resources, the greater the management challenge…..”

The report draws the following key conclusions:

• Leadership and management in the NHS should be celebrated and not undermined
• The NHS is over-administered but there is no substantive evidence of it being over-managed
• The government should rethink the 33% cuts in administration costs and 45% cuts in the number of managers and senior managers.
• Leaders should be given room to lead and not tied up in risk aversion
• The government should recognise that current proposals raise serious issues around governance, leadership and management.
• Leadership and management should span organisational boundaries of social care, voluntary sector organisations and local authority to engender better cooperation and integrated working.
• NHS organisations should “own” the need to develop managers and leaders

The report does establish a critical case for NHS leadership and management but for me fails to address the key point which is not the number of them or what development they do but the systematic failure to hold them to account for poor performance where it exists. It is not the number that we should get hooked on but the quality of how they lead others and manage the corporate functions and responsibilities of their organisations.