Sajid Javid Health Secretary called these findings’stark’, and admitted that there are parts of the NHS leadership that need to improve. His comments included that “culture and leadership could make the difference between life or death.”
Sajid Javid has ordered the biggest shake up of NHS management in a generation after a major review led by a former military chief found leadership in the health service was ‘institutionally inadequate’.
The health secretary, who has vowed to stamp out ‘waste or wokery’ in the NHS and social care, has accepted the recommendations of the report led by General Sir Gordon Messenger in full.
Sir Gordon, who led the Royal Marines’ invasion of Iraq, met over a thousand health service workers as part of a review into how the health service and social care sector is managed.
The Messenger Report found ‘evidence of poor behaviours and attitudes such as discrimination, bullying and blame cultures’ in certain parts of the NHS and social care system that has left some staff ‘not feeling comfortable to speak up’.
According to the report, managers are not afforded equal access to training and advancement opportunities. Staff with connections or networks will be more likely to get these opportunities.
This report noted, “Strengthening Leadership and embedding best practices of Management is crucial in ensuring that every penny of investment is well invested”.
It follows concern that a £12billion a year funding boost – raised through a 1.25 per cent National Insurance hike – will be swallowed by management salaries.
Last night’s findings were accepted by Mr Javid who warned that leadership and culture can make all the difference between life or death.
He pledged to follow the seven recommendations of the report, including an induction program for new employees, plans to increase the number of independent advisers, and the sending out the most qualified NHS managers to the worst-performing trusts.
As part of an evaluation of leadership in health and social services, General Sir Gordon Messenger met with over 1000 health workers to discuss the Royal Marines invasion of Iraq. A review panel including Dame Linda Pollard chair of Leeds Teaching Hospital found that there was a lack of coordination and consistency in the way leaders and managers were trained.
Topping 6.36million are now waiting in England for routine hospital treatment. NHS data shows one in nine people were in the queue for elective operations such as hip and knee replacements and cataracts surgery by March — up from 6.18m in February
HM Treasury data shows the NHS received £100.4billion in 2010/11 and its budget had grown steadily until 2019. In 2020, the NHS was given £129.7billion of core funding for its usual services, which was topped up with an extra £18billion to help with the pressures from the pandemic. For 2021/22 the Treasury said the health service is set to receive £136.1billion pounds of core funding, as well as £3billion to help with the Covid recovery
Who is GORDON MESSSENGER?
Sir Gordon Messenger was the general responsible for leading the Royal Marines’ invasion in Iraq.
Sir Gordon (59), retired in 2019 from Royal Marines and was appointed head of operations last year for Government’s Covid program.
He commanded the Royal Marines unit during the invasion of Iraq 2003, his distinguished military career.
He served also as British commander at Helmand during the conflict in Afghanistan, 2008-2009.
Ministers had asked Sir Gordon last year to assist them in identifying ways to “develop leadership skills.” [needed]To reduce record NHS wait lists, this decade in both social care and healthcare will see significant improvements.
Sir Gordon Messenger (pictured) was requested to eradicate ‘wastefulness’ from the health system and ensure that every pound spent is well-spent.
Sir Gordon, who was previously second in command for the British Armed Forces. Together, they worked to make management more effective, to attract talented leaders and to provide value for the money.
According to one recommendation, the NHS should “embed inclusive leader practice as the responsibility for all leaders”.
The review found that ‘overall there was a lack of consistency and coordination – in particular that there has developed over time an “institutional inadequacy” in the way that leadership and management is trained, developed and valued.’
Workers should have clear paths to promotion and improvement. The best leaders and managers will receive more encouragement to help them take on the most difficult jobs.
Sir Gordon and Lady Linda called for “more effective recruitment of non-executive director’ and “improvement in the development of independent advisors” who “play an essential role in providing oversight and assurance.”
Javid replied to the review saying that the NHS will face huge challenges in recovering from the pandemic. These include tackling Covid backlogs and addressing health disparities throughout the country.
“The report’s findings are shocking. It shows great examples of leadership, but it also highlights areas where we must improve. Accepting the best standards of health and care is essential. Culture and leadership are key to ensuring that we live and die with dignity.
I fully endorse these suggestions for the greatest shake-up in leadership in many decades. They must be urgently implemented to assure that we have the right leadership for patients and staff across the country.
Sir Gordon claimed that he regards NHS staff and other social workers with ‘the greatest regard’. His respect was only deepened by witnessing first-hand their generosity, professionalism, and resilience.
He added: ‘A well-led, motivated, valued, collaborative, inclusive, resilient workforce is the key to better patient and public health outcomes, and must be a priority.
The most successful organisations invest in their employees to unleash their potential and foster leadership and accountability at all levels. Good leadership runs through every member of the workforce. This is the ultimate goal. I think our recommendations will help to change the way health care and social service leadership and management.
Sir Gordon retired as a Royal Marines officer in 2019, and was promoted to head of operations in the government’s Covid community testing programme.
He served a distinguished military career and commanded a Royal Marines unit in the 2003 invasion. He was also the British commander for Helmand from 2008 to 2009.
However, the release of this report coincides with NHS Providers’ warning today that the NHS has a long way to go in addressing backlogs.
It stated that the NHS is working more efficiently to provide care for more patients. The number of patients who require mental health and cancer services, as well as diagnostic testing, has increased than it did before Covid.
NHS Providers warned there was a “long road ahead” to address the NHS backlog. Results from its survey of 106 trust leaders — representing half of the sector — revealed 92 per cent believe workforce shortages are the main barrier stopping activity levels from increasing
Two-thirds of hospital bosses said they were ‘confident’ or ‘very confident’ that they could operate on all patients who have been waiting longer than one year by March 2025 — the deadline set by Mr Javid in the NHS recovery plan, which was unveiled in February. Only one-third of hospital bosses said that they were able to meet their targets this year. These include ending wait times exceeding two years by July 2022. A half of trusts say they cannot reduce wait times for mental healthcare services.
Many people still wait too long for their healthcare, as’some targets are taking longer to deliver that expected,’ NHS Providers reported.
Results from its survey of 106 trust leaders — representing half of the sector — revealed 92 per cent believe workforce shortages are the main barrier stopping activity levels from increasing.
Nearly nine out of ten respondents said that problems in discharging medically-fit patients safely and promptly was the biggest barrier.
Two-thirds said they were ‘confident’ or ‘very confident’ that they could operate on all patients who have been waiting longer than one year by March 2025 — the deadline set by Mr Javid in the NHS recovery plan, which was unveiled in February.
But only one third of those surveyed said they would be able meet the targets set for them this year. They include ending waits that have been two years by July 2022.
The majority of trusts believe that they cannot reduce the long waiting times for mental health services.
Eight out of 10 hospital leaders said that rising demand is preventing them from reaching their goals.
95% of the respondents said that this year’s financial request will prove to be difficult or extremely challenging.
According to NHS Providers, “Trust leaders face tightened financial pressures as well as several operational and administrative pressures. They are also trying to resolve care backlogs.”
The NHS and social care are already getting an extra £36billion over the next three years, raised through a controversial 1.25 per cent national insurance rise, to recover from the pandemic.
And health bosses announced last month that the health service would be allocated an extra £1.5billion to cope with rises in inflation.
NHS Providers however stated that there were still questions over the effectiveness of cash injections to improve its “financial health”.
Saffron Cordery, interim chief executive of NHS Providers, said: ‘No one should doubt the determination of trust leaders to increase activity and bear down on waiting lists.
They understand the distress and disruption caused by treatment delays.
They also understand the importance of using every penny of public money efficiently and innovating to provide better care and efficiency savings.
NHS England data on A&E performance in April shows a record 24,138 people were forced to wait 12 hours or more to be treated, three times longer than the NHS target and the worst figure on record
According to April’s ambulance statistics, wait times for paramedics have fallen compared with March. However they are higher than almost all the other months since records were started. Responding to Category 2 calls such as strokes and epilepsy took ambulances an average 51 minutes 22 seconds. It was nine minutes and 41 second faster than the one-month prior
The Covid backlog for England’s cancer care in England will continue to grow by five additional years, according to a top cancer charity. Graph shows: The number of patients fewer than expected to receive first cancer treatment since the start of the pandemic (red line) and how long it will take to reduce to zero if treatments continue at the current pace (dotted red line), increase 5 per cent on pre-pandemic levels (dotted green line) or increase 10 per cent on pre-pandemic levels (dotted blue line)
NHS England has a goal to treat 85 percent of all cancer patients who are referred by their doctor within two months. However, in November 2021 the most recent available data shows that only 67.5 percent of those patients were treated in this timeframe. The problem has been present since before the Covid pandemic. However, disruptions to the services due to the virus have only exacerbated it.
“This year’s challenges are too big for trusts to ignore, and this report proves that. It also provides a reminder of the reality that trusts must face as they strive to achieve their goals.
Ms Cordery said trusts are making ‘real progress’ in increasing activity levels.
However, she said that it was time for them to admit what is going on. There are many obstacles, including persistent severe pressures on emergency and urgent care, Covid threat, worker shortages, delayed discharges and stretched social services.
“Understandably everyone wishes to see normalcy restored after the pandemic. Trusts do everything possible to help alleviate current stressors and to meet future requirements.
“It is a great challenge. That was their challenge. It will be a long process.
After Monday’s initial health announcement, these reports are now available. Mr Javid revealed patients will have faster access to the world’s newest drugs on the NHS thanks to a £340million scheme.
People with rare diseases and conditions, like Alzheimer’s or Motor Neurone Disease, can have hope through the Innovative Medicines Fund (IMF).
The cash will allow doctors to invest in promising treatment options as more evidence becomes available about their value and effectiveness.
The National Institute for Health and Care Excellence, or Nice, had previously to thoroughly appraise any new medications before they could routinely be used. This often delayed their rollout for many years.
Today, Mr. Javid compared today’s NHS to Blockbuster, a now-defunct rental movie company in an age dominated TV streaming.
He called for large scale changes to ensure that people get what they want, and stressed the need to not merely maintain the status quo.
The Health Secretary stated that some systems and structures were not designed for the new age and called for an innovation in tech.
His comments, and his Blockbuster analogy caused confusion as to what he actually meant. However, there is no additional money being used to support the NHS or boost its performance.
In March, the waiting list at the health system hit 6.4million despite receiving cash injections. This figure represents the highest ever recorded since 2007 when records started. The number is predicted to rise until March 2024.
There were 306,000 patients waiting for more than a year for their operation, up two per cent on one month earlier, and 16,796 were seeking treatment for more than two years, down slightly.
Javid promised to reduce wait times of one year or more to zero by 2025 using the 1.25 percent increase in National Insurance that took effect last month.
Separate data on A&E performance in April shows a record 24,138 people were forced to wait 12 hours or more to be treated, three times longer than the NHS target and the worst figure on record.
Seven out of ten patients received care within the first four hours following their arrival at an ‘absolutely crowded’ emergency department. It is slightly higher than last month but still significantly lower than the previous record. Access to urgent care is a serious problem, according to medics.
According to Ambulance statistics, April’s waits were lower than March’s, but they are higher than almost all the other months since records began. Experts say that even though waiting times have decreased by a little, patients are still facing frightening waits.