Review into NHS leadership will examine pay and incentives

The Messenger review into NHS leadership, announced by Sajid Javid last month, will look into the incentives offered to senior leaders, according to the terms of reference published earlier this week.

The review will cover leadership and management in both the NHS and social care.  The move to integrated care boards in April 2022, and the need for closer working between NHS organisations and local authorities, “provides an opportune moment to look at what more needs to be done to foster and replicate the best leadership and management, including in the most challenged areas,” the document says.

Among the issues the review will consider are:

• The drivers of performance and the standards expected of good leaders and leadership teams
• What further powers may be needed to drive real and sustained change
• How to help health and care leaders collaborate for more integrated care for citizens
• Whether the right pay and incentives are in place to foster good and excellent performance and recruit and retain the best leaders from start of career to retirement

It will also look at making sure training and support is in place for clinicians to take on management roles and at ways of driving up efficiency so that leaders have time to focus on “delivering for patients and care users”.

The terms of reference say that the review will report to the health and social care secretary after four months, and will be followed by a delivery plan “with clear timelines on implementing agreed recommendations”.

Avoiding ‘review fatigue’

To coincide with the publication of the terms of reference, General Sir Gordon Messenger, who is leading the review, and Dame Linda Pollard, who is supporting him, wrote an open letter to NHS and social care staff. The letter outlines their plans to consult staff through site visits, workshops, personal interviews and “webinar-style outreach” with the aim of accessing “as many viewpoints and diverse communities as we can.”

The letter also says that the pair are mindful of the strain staff are working under, adding: “Conscious of the potential for ‘review fatigue’, we will do all we can to avoid adding to that pressure during both the engagement and the implementation phases of our work.”

Their approach would be shaped by three factors, they wrote:

• The importance of collaborative, systems leadership at every level
• The impact of shared vision and ownership at all levels within a system, in order to empower decision-making and problem-solving appropriately, and to reinforce the sense of value across the workforce
• The need to address the variation in the national provision of health and social care