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Under performing leaders will be managed out, says Streeting

Under performing leaders will be managed out, says Streeting
By Anna Colivicchi and Beth Gault
13 November 2024



The health secretary has pledged to ‘manage out’ underperforming leaders within the NHS as part of a new package of reforms.

These measures include a ‘zero tolerance’ policy for failure, whereby persistently failing senior managers will be replaced and those who do not make progress will be ineligible for pay increases.

Speaking about his reforms on the BBC’s Today Programme on 13 November, Mr Streeting said: ‘This is the guilty secret of the NHS, there are very senior managers who are paid on average £145,000 a year who are managed out, given a pay off in one trust and then reincarnate in another NHS trust.

He said while they might be the ‘rotten apples’ among some other outstanding leaders, it gives the rest of the profession ‘a bad name’ and is ‘unacceptable’.

‘We’ve got to manage those [leaders] out as well as investing in leadership and development training and crucially setting free the highest performers so we have less top down, less centralisation, less management by dictate from the centre,’ he added.

At an speech at the NHS Providers conference today, Mr Streeting also promised to cut long hospital waiting times back down to the NHS 18-week target via financial incentives and performance league tables.

Meanwhile, NHS England will carry out a review of hospital performance across the country, resulting in a league table that will be made public and regularly updated.

The Government is hoping that keeping hospitals to account financially will reduce waiting times for patients.

Mr Streeting said: ‘Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.

‘There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.

‘Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.

‘With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.’

NHS England chief executive Amanda Pritchard said: ‘While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.

‘The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients.’

The NHS Oversight Framework, which sets out how trusts and ICBs are best monitored, will be updated by the next financial year ‘to ensure performance is properly scrutinised’.

Under plans to be put forward for consultation in the coming weeks, NHS trusts could also be banned from using agencies to hire temporary entry level workers in band 2 and 3, such as healthcare assistants and domestic support workers. 

The consultation will also include a proposal to stop NHS staff resigning and then immediately offering their services back to the health service through a recruitment agency.

Last month a report from The King’s Fund found that health leaders focused too much on waiting times and financial performance, which diverts attention away from population health and long-term goals.

A version of this story was first published on our sister title Pulse.

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