Today the NHS publishes its latest waiting list figures. While numbers are trending down they remain far too high, and much higher than pre-pandemic levels. Although this is just one dataset, the pace of change in the NHS being too slow is a familiar story. Could learning from business leaders turn the tide and bring improvements here and elsewhere in healthcare delivery?
As we push to modernise the NHS, the Health Secretary Wes Streeting has argued that centralisation has ‘infantilised’ NHS leaders and stifled the frontline, while health policy experts have questioned how we bring a diversity of thought and experience to breathe life into old systems. To help answer that question, new research by UCL’s Global Business School for Health analysed the views of business leaders on how to reform management in the NHS.
More than eight in ten business leaders across Britain believe that NHS senior management teams should bring in talent from the private sector. The same proportion said the skills their sector develops should be mirrored across the health service.
Half specifically identified a lack of focus on driving innovation and managing change as the defining skill gap in NHS leadership. When asked about specific areas of NHS management, nearly half of business leaders believe the NHS has poor financial controls in place, and seven in ten lack confidence in how the NHS currently manages its finances.
Among those running larger businesses, with a turnover above £50 million, nearly two-thirds want far more rigorous cost-benefit analysis applied before major resource decisions are made. With the NHS spending upwards of £200bn of public money each year, NHS leaders each have multi-million-pound budgets to oversee in high-pressure environments – something which should be ingrained in training from the start.
The government and the health sector is alive to the changes that the NHS needs to make. Politicians demand that the NHS be faster to adopt new technology, more rigorous about where money goes, and to deliver change and reform at greater scale and greater pace. Looking at this recent research, it is arguable that boosting private sector experience, to complement the wealth of knowledge of a career in clinical settings, could significantly benefit the NHS.
There is work to do to encourage this, and it is a long-term plan that will not happen overnight. Using a sample of England’s ten largest NHS trusts, our research found that just 8% of senior leaders have any private sector experience. It is not that the NHS has a dearth of talent, but often the NHS does not prepare its future leaders with the skills to run million-pound balance sheets and navigate hundreds, often thousands, of employees working round the clock.
At the same time, the Government’s 10-Year Health Plan is asking those same leaders to deliver one of the most complex organisational transformations in the NHS’s history. However, too often, clinicians are left without the leadership tools to succeed in post. There is an argument that NHS trusts need to be far more deliberate about the blend of experience in their senior teams, and far more honest about where the gaps are.
Doctors, nurses, allied health professionals, and healthcare managers should have funded, structured opportunities to develop management and leadership skills early in their careers. The private sector does not wait until someone reaches a senior post before developing their leadership capability. Given the scale of what the 10-Year Plan is asking, the NHS cannot afford to either. As healthcare becomes increasingly patient-centred, the leaders best placed to drive innovation are those who combine clinical understanding with the management tools to act on it.
The waiting list figures published today are a snapshot. But they will again prompt questions about why, after years of reform promises, the pace of change remains so slow. The government’s 10-Year Plan is the most serious attempt in a generation to answer that question. It will not succeed without leaders who have the experience and support to deliver it.
UCL Global Business School for Health commissioned a poll of 500 UK business leaders to understand their views on what the NHS can learn from the world of business. Data was collected by Stack Data Strategy in July 2025, and focused on business leaders in medium and large organisations across the UK. Read the full Health Insight Report ‘What can NHS leaders learn from the corporate world?’
