Workforce key to tackling abusive leadership culture, warns HCSA

HCSA has today welcomed General Sir Gordon Messenger’s stark review of current poor NHS leadership but warned that the situation won’t change without action on staffing.

Sir Gordon’s independent report identified wide-ranging failings in hospital management, warning: “The sense of constant demands from above, including from politicians, creates an institutional instinct, particularly in the healthcare sector, to look upwards to furnish the needs of the hierarchy rather than downwards.”

It singled out the fear of speaking up on poor leadership, a lack of seriousness in combating inequality, in particular in terms of race and disability, and a lack of workforce data as key factors.

He also noted that hospital doctors are “often co-opted for management roles, particularly early in their consultant career, for which they often feel inadequately prepared in comparison with their clinical training.”

The report proposes new national leadership training and standards, urging greater time and resource to be channelled into delivering a cultural shift.

The government said it would implement the recommendations in full.

Responding to the report, HCSA President Dr Naru Narayanan said: “The landscape of bullying, discrimination and blame culture painted by this review come as little surprise to hospital doctors who find themselves at the sharp end of these destructive management behaviours.

“We welcome the long overdue acknowledgement that medical staff are often thrust into leadership positions with inadequate or no training, making it a case of sink or swim.

“But while we welcome all of its recommendations, there is a very real risk they will be cast adrift in a stressed NHS facing huge staff and resource shortages. There is an obvious reason why in the NHS the ‘urgent tends to eclipse the important’, as this report puts it.

“Yet again we find ourselves facing a situation which cries out for a fully costed workforce strategy to increase staffing levels and create the breathing space to ring in positive change. Yet again we ask: where is it?

“Without action on workforce, I fear that the current intolerable situation will continue no matter how fine the words and ambition.”