The Messenger review of NHS leadership, announced by the health secretary in October, will examine the ‘pay and incentives’ offered to the service’s most senior figures.
It will also look into “effective systems for intervention and recovery in both providers and integrated care systems”, and ensuring there are “the right incentives for the best leaders and leadership teams to take on the most difficult leadership challenges”.
The review’s terms and conditions were published today, seven weeks after Sajid Javid announced it at the Conservative Party conference on 4 October. It was flagged as being the ”most far-reaching review” of NHS leadership since the seminal Griffiths reforms of the 1980s.
The T&Cs state the review will be delivered to the health secretary ”after four months and will be followed by a delivery plan with clear timelines on implementing agreed recommendations”.
The terms confirm the review will be led by General Sir Gordon Messenger, former vice chief of the defence staff. He will be supported by Leeds Teaching Hospital Trust chair Dame Linda Pollard.
General Messenger and Dame Linda also published an open letter to the service about the review.
They write that the review: ”will be conducting a comprehensive programme of engagement events, including site visits, webinar-style outreach, workshops and personal interviews, and aim to access as many viewpoints and diverse communities as we can.”
They add: ”we are mindful of the strain that you are working under, no more so than at present. 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.”
The review leaders state their: ”starting premise is that the NHS and social care are staffed by a hugely impressive, dedicated, well-motivated workforce which deserves a system and a culture where its full talent and experience can flourish and where the right skills can be applied to where they are needed most. We acknowledge that the excellent leadership and management currently evident across many parts of the system can be built upon to the benefit of all.”
General Messenger and Dame Linda say their work will be guided three factors: “the importance of collaborative, systems leadership”, ”shared vision and ownership at all levels within a system”, and ”the need to address the variation in our national provision of health and social care.”
Despite the delay in publishing the terms and conditions, they run to a little more than 200 words.
The review will look at:
- “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, including effective systems for intervention and recovery in both providers and [ICSs];
- How to help health and care leaders collaborate for more integrated care for citizens;
- Proposals for ensuring the right incentives for the best leaders and leadership teams to take on the most difficult leadership challenges;
- How to more rapidly foster and replicate the best of examples of leadership;
- How to support and improve the skills of all leaders and managers throughout their careers and encourage the best leaders within the system to rise;
- How to draw new expertise and talent into leadership roles in the health and care systems (including the NHS Management Graduate Trainee Scheme);
- How to ensure the right training, opportunities and support for clinicians to take on management roles throughout their careers;
- 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; [and]
- Driving up efficiency — to support leaders, managers, clinicians and wider staff, creating the space and time for them to focus as much time as possible on delivering for patients and care users.”
The review will not examine leadership in NHS England and other arm’s length bodies, as many senior NHS figures had requested.
In May, the DHSC provided evidence to the senior salaries review body pay had fallen by nearly 5 per cent in recent years. However, in July the government announced senior managers would not be among those who receive the 3 per cent pay rise announced for most NHS staff
The announcement of the Messenger review of NHS leadership was closely followed by a briefing to The Times (£), suggesting trust leaders would be sacked if they fail to reduce their elective backlog,
Speaking before the publication of the review T&Cs, NHS Providers chief executive Chris Hopson expressed concerns that the review could result in a ‘blame game” which would set up leaders ‘”to fail [against] unrealistic expectations.”