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Trusts to be judged on ‘leadership and culture’, government warns

Published on: 16 Feb 2022

NHS England and the Care Quality Commission will put more emphasis on trusts’ ‘leadership and culture’ in their oversight and regulation, the government has revealed.

It comes after ministers responded to the health and social care committee’s report, published last June, on workforce burnout and the impact of resilience in both the NHS and social care.

Among its 18 recommendations, the committee urged NHSE to review the role of targets across the NHS that seek to balance the “operational grip” given to senior managers against risks of inadvertently creating a culture that “deprioritises” care of patients and staff.

Health and social care secretary Sajid Javid responded that NHSE’s work to develop a new description of the behaviours expected of leaders represented the “foundation” of a new approach.

He said: “Leadership and culture will be at the core of how NHS leader’s [sic] performance is measured, and this will be reflected in the accountability of the NHS oversight framework and Care Quality Commission well-led framework.

“We recognise that healthcare settings can become stressful and pressurised, sometimes impacting negatively on a minority of staff.

“We therefore agree that there should be careful consideration in the setting and management of targets, ensuring that such performance measures support quality care but not at the expense of staff wellbeing.

“That is why, as part of the [NHS] long-term plan, NHSE have led the clinical review of standards for urgent and emergency care to ensure that the right set of measures are used to evaluate and manage UEC services.”

Mr Javid also said the government had worked with NHSE to agree a “suite of measures”, including workforce measures around staff retention and wellbeing, and that will be used to monitor the implementation of the long-term plan.

He added: “We are building our implementation model around systems which will bring together all parts of the health and social care sector within local geographies to ensure that local plans and delivery is aligned to local needs and priorities.”

The government also said:

  • Both the workforce race equality standard, and the workforce disability equality standard, should be included in the “balanced basket of indicators” for integrated care systems;
  • Health Education England has been commissioned to undertake a “refresh” of framework 15 to understand “future drivers of supply and demand” for health and social care workforces; and
  • A system workforce improvement model is being developed to ensure future workforce in ICSs are “reflecting the equality, diversity and inclusion priorities” of NHSE