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Some managers get no training or support, warns Pritchard

Published on: 16 Nov 2023

Training and development of managers is inadequate and patchy, the NHS England chief executive has warned, arguing that introducing statutory regulation would improve it.

Amanda Pritchard told MPs on the Commons health and social care committee the NHS needed to “bake in” an expectation of ongoing training and development in order to improve management and leadership, and attract talent.

She said training for senior medics moving into management was inadequate, and non-medical leaders and managers “may not get any support at all”.

She added: “Part of what we need to link between the work that [General Sir] Gordon Messenger described in his review, and the potential for regulation, I think, is recognising that if we are going to get the calibre of leaders that we need in the NHS, then that investment in their education, as well as the standard setting, as well as the accountability, is crucial.

“I would very much like to see this work prioritised.”

Ms Pritchard, speaking on Tuesday, said there was better funding and protection for training and development for clinical professionals, partly because it was required by regulatory frameworks.

She repeated her view that, following the Lucy Letby murders scandal in Chester, it was “right to look again” at introducing formalised regulation of NHS managers. 

Ms Letby was convicted in August of murdering seven babies and attempting to murder six more at The Countess of Chester hospital, and a public inquiry into it is under way.

The NHSE chief highlighted work in progress – and following General Sir Gordon Messenger’s review of NHS leadership in October 2021 – to improve standards, as well as to block unfit directors

But she said leadership training funding was not protected or ringfenced, and acknowledged it may be at risk under current tight budgets.

She added: “We should have high expectations of our leaders, but I think if we are going to have high expectations we have to bake in an expectation that there will be ongoing training, there will be ongoing development, that it will be high quality, that it will be assessed, and that it will give people the skills that they need to do these jobs.

“Because these are big jobs we are asking of people.”

She said: “Within the resources that I have at my disposal, we are making sure that we continue to prioritise the implementation of the Messenger review but I would like to see that go further.” She said she thought it was likely the Letby inquiry would come to similar conclusions.

It comes as the Labour party announced it would set up a “College of Clinical Leadership”, run as a charity and developed out of the existing Faculty of Medical Leadership and Management.

Shadow health and social care secretary Wes Streeting said if he is in government he will “introduce a system of regulation and, crucially, training, to promote excellent leadership and to protect patients when things go wrong. I am clear that this must include disbarring those found guilty of serious misconduct. Our aim in all of this is to foster first-rate leadership across the service”.