Exploring the importance of leadership training and development


By Skills for Health | 7 December 2023

The recent statement made by the Chief Executive of NHSE regarding the lack of training available for managers and the opportunities for future regulation, reflects many things and captures the ongoing and increasing interest in management development we are seeing across organisations in the sector. We believe that managers and leaders can only really play their part if they are skilled, competent, and continuously elevating the practice of management and leadership.


We were struck by the stark realism of Amanda Pritchard’s recent statement at the Commons Health and Social Care Committee that training and development of managers is inadequate and patchy. It was also interesting to note her commitment to prioritising the introduction of statutory regulation to generate improvements, and her reference to the recommendation from the Messenger Review for consistent management training delivered through accredited routes.

As the Sectors Skills Council for Health, having a relationship with NHS organisations spanning decades, we see managers grappling with overlapping, unparalleled challenges in many domains every day, challenges that require a reframing of management thinking. We see those challenges in polarity, often mired in a paradox, for example increasing capacity for elective care with inadequate staffing levels.

Let’s talk about management

At any level, regardless of experience and qualifications, management is hard. And it should be. The idea that being a good manager is something anyone can do is a flawed judgement on the skill, practice and character required.

Good management requires comprehensive formal and informal training and a willingness to engage in continuous learning. It requires an openness to change, vulnerability and courage, a good grasp of technical skills and competencies related to service delivery, empathy, compassion, a commitment to understanding what it takes for individuals and teams to thrive, and a purposeful approach to contributing to the management of those conditions.

Good management is, possibly, quite rare, and for equally good reasons. Nobody is infallible, and nor should we expect them to be. The demands placed on managers, the scope of competing ideas that surround the discipline, and the variable expectations of what successful management is and how to measure it, all serve to make a hard job, even harder.

And of course, in the NHS, the context within which we are asking managers to lead their teams is exponentially bounded in an ongoing, era-defining period of turmoil – an environment of ever-increasing complexity, disparate and stretched intra-organisational relationships, multi-cultural teams and a workforce crisis converging with the operational demands of improbable waiting list targets, having to do more with less, and respond to a deep and consistent uncertainty across the health and care system. All under increased regulatory scrutiny.

Management and Leadership –

A Perennial Issue

Flip through any of the many reviews conducted over the last few years and you will note the prominence of management and leadership imbued throughout. From the Kark Review of fit and proper persons, to the Messenger Review, which was clear in its call to action for a more consistent approach to leadership development at all levels within the NHS. And the most recent Hewitt Review that cited the need to ensure the right skills and capabilities are available to ICSs as both systems and national organisations navigate a period of challenge.

There is a clear disparity between support available to managers and leaders from a clinical leadership perspective, and managers needing to acquire broader management and leadership skills.

There are well established paths for clinical development in the form of recognised pathways for medical and dental, nursing and allied health professionals. These pathways provide a body of knowledge and a code of ethics which guide the actions of managers in a clinical setting. But what about those accidental non-clinical managers in Estates, Corporate, Catering roles, who find themselves leading teams with conflicting, complex needs? And just how does a clinical expert make the leap from leading clinically to leading organisationally? There are many critical skills that clinical experts bring to management and leadership, such as their solving complex problems based on tangible evidence. Where we have seen them struggle how to lead organisationally, instituting cultural programmes of change which are more focused on the behavioural aspects of managing and leading teams.

Where to begin?

The Messenger Review called for tangible actions towards recognising the value that needs to be placed on managers and leaders. So, where to begin?

1. A good starting point would be to identify those managers or leaders in your Trust or ICS who are managing well, and whose services are delivering good outcomes for patients. What do you notice that they are doing differently? How might this good practice be replicated more widely?

2. The next step would be to take a short, medium and long-term view of the management development needs within your organisation, avoiding the temptation to initiate quick fixes that do little to creating sustainable learning. What are your managers grappling with? What skills do they need now, tomorrow, and into the future? In our experience, some of the more fundamental and pressing challenges managers are facing now include:

a. How do I have those difficult conversations when conflict and confrontation arises?

b. How do I transition from being a member of the team to being a manager?

c. How do I manage the multi-cultural differences and preferences within my team?

3. Engage the support of an expert who can work alongside you to help bridge some of these immediate skills gaps and facilitate the transition to a more formal, nationally recognised development path for managers and leaders in health and social care.

What’s next?

We propose that management and leadership as a profession needs to be cemented into every aspect of the NHS Long Term Workforce Plan. There is also a longer-term planning and alignment piece to ensure that the way in which NHS organisations are measured is focused not only on operational targets but also on management development.

The NHS People Promise has a clear mandate: We want our culture to be positive, compassionate, and inclusive – and we all have our part to play. Managers and leaders can only really play their part

if they are skilled, competent, and continuously elevating the practice of management and leadership in health and social care. Plant the seeds, nurture them, and watch them grow.

How Skills for Health can help to elevate your management and leadership potential

Our experienced team of coaches and consultants are experts in leadership and organisational consultancy and can work with you to unpick your immediate and long-term management and leadership challenges, and tailor solutions to meet the unique needs of your organisation.

Ready to transform your leadership capabilities?

Find out more today.


Tam Whipp joins Skills for Health as a Technical Consultant 

Why the NHS Needs Workforce Planning More Than Ever 

Laura Schell appointed as Skills for Health Client Director 

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