Findings from the Institute for Public Policy Research think tank on the NHS workforce, published today, also found staff were “desperate” for managers to do the “managing” so that staff could focus on “caring”.
The IPPR analysis found there has been a “sustained mismatch” in the growth of managers compared to other staff groups, while the number of managers in hospitals and community settings had actively fallen since 2010.
It said quantifying the necessary number of managers was difficult, but that “we suggest this decade has seen the emergence of 10,000 missing managers”.
The report from the left-leaning think tank adds: “That is not to suggest that 10,000 more managers would be enough to solve the current shortage, but would rather undo some of the damage done by policies since around 2010.”
The researchers appear to have reached the figure by comparing the fall in managers in acute and community providers over that period, to the rate of growth in clinical staff.
The report said the NHS is “one of the most undermanaged health systems in the world,” adding: “Any comparable business would struggle to maintain productivity and effectiveness with the same management deficit.”
It also warns of a “triple threat” in increased demand on services, staff sickness and low pay that could worsen the NHS’s workforce crisis.
Jon Restell, chief executive of the Managers in Partnership trade union, told HSJ the report “highlights the scale of undermanagement in the NHS” and that this has “come at a cost for patient care”.
He said: “Despite the government’s politically charged and disrespectful rhetoric, NHS managers do their job to keep clinical colleagues on the frontline, treating patients and away from paperwork…
“With evidence like this, ministers should stop portraying managers as the enemy and begin to engage in sensible discussions about the strong link between management and clinical capacity, and how both the role and the numbers of managers support good patient care.
“The long-awaited workforce plan provides the perfect opportunity to do just that.”
IPPR’s report proposes a 10-point plan to solve the workforce crisis in England, which includes:
- Recruiting more and better managers to increase capacity to “adopt, adapt and spread innovation and new technology”;
- Creating a “return to health” scheme that matches people with long-term health conditions who wish to return to work; and
- Introducing a “comply or explain” right to flexible working that increases support for women returning to work following maternity leave.
Chris Thomas, head of the IPPR’s commission on health and prosperity, said there was “no one quick fix” to solve the NHS’s workforce crisis, but that more managers are “crucial to freeing up the time of doctors, nurses and other professions doing the caring”.
He added: “If nothing is done soon, demand will continue to outstrip capacity and England will only get sicker, and as a result poorer. We urgently need an ambitious, modern and sustainable workforce strategy.”
HSJ last month asked Labour leader Keir Starmer whether he thought more NHS managers were needed as well as clinical staff, but he did not answer the question.
The IPPR report also found that, while the NHS workforce grew by 1 per cent on average per year, between 2010 and 2019, patient need has outstripped supply.
The number of outpatient appointments has risen by nearly 4 per cent on average each year, and diagnostic tests by 5 per cent. At the same time, doctors have had less time to deal directly with patients, and the number of managers in frontline and community settings has fallen amid growing demand, according to the report.
Health and care workers were also more likely to leave, compared with other professionals, and research found staff had a long-term sickness rate of 7.8 per 1,000, which was higher than workers in construction, manufacturing and other sectors.
It also comes as real-terms pay has fallen over the last decade, leading to trusts struggling to recruit and retain staff.
A Department of Health and Social Care spokeswoman said: “We know that if we are to build a stronger, healthier NHS for the long-term with patients at its centre, it is vital to have the workforce to support it.
“There are record numbers of staff working in the NHS to care for patients and cut waiting lists, with over 53,600 more people compared to a year ago – including over 5,400 more doctors and 12,900 more nurses.
“We want to build on this progress and will soon publish a workforce plan focused on recruiting and retaining more staff so we can make the NHS the best place to work.”