Comment / Welcome recognition

Let’s stop the manager bashing – transformational change calls for the combined skills of both clinicians and managers

The King’s Fund report on leadership and management – subtitled No more heroes – makes for interesting and refreshing reading. The result of a specially established commission that conducted a nine-month inquiry, the report highlights the urgent need for a new style of leadership to overcome unprecedented financial pressures and to adapt to future challenges. We need to move away from the model of heroic leadership to one that understands the concept of shared leadership and followership. (To understand ‘followership’, check out the video on ‘how to start a movement’ on learning forum TED’s website www.ted.com).

Perhaps the refreshing bit is the commission’s conviction that good-quality, stable management is key to high-performing health services. King’s Fund chief executive Chris Ham’s call for politicians of all parties to ‘resist the temptation to denigrate the value of management in delivering excellent and efficient services’ will be music to managers’ ears. 

It is all too easy in difficult times for the sport of ‘manager bashing’ to become a popular pastime. But this does little to encourage finance professionals to put their heads above the parapet and tackle the difficult challenges facing them. Better informed commentators know that management has an important contribution to make. As the HFMA has said before and the King’s Fund report acknowledges, the division created in some quarters between front line and back office is simply unhelpful.

It may make for easy political point scoring, but equating anything other than ‘front line’ staff as waste is an insult to much of the work undertaken by managers and administrators in support of improving patient care and ensuring good governance and accountability. The delivery of high-quality services and optimum value for money requires a partnership. For example, the use of service line or patient level cost data to identify opportunities for pathway improvement will not be done by clinicians or managers alone. Across the board, the transformational change we need will only be delivered by marrying the vision and skills of both clinical and managerial staff. 

We need to ensure support and encouragement for finance staff to step forward and take difficult roles, so it is refreshing to see the King’s Fund promoting a fairer view of management’s contribution.

The commission also identifies that, for its size, the NHS is under-managed but over-administered and that cuts of 45% of management posts and 33% administration costs have been imposed with no assessment of future needs. It is clear to those working in the service that there are many areas of overlap between performance management and regulatory bodies and in some cases bureaucratic requirements that add little or no value to care. We can only hope the reforms will allow for some streamlining of these requirements to ensure less time is spent filling in forms. 

That said, we must all ensure we have done all we can to minimise transactional processes and maximise the amount of time spent really adding value to patient care.

A different type of leadership is required in the future, so we need to exploit any opportunity to develop our skills in this respect.

The HFMA ‘Take control’ programme offers ways for individuals to take stock of their skills and abilities to create a personal development plan. If you’ve not done so, you may want to explore how the HFMA can help you become one of the leaders of the future.