Commentary: trust chiefs are like football managers

There has been volatility at the top of many trusts. Rather like football managers, it appears some chief executives are not given time to impose their management style on their organisations and start to deliver results.

‘Should Monitor and the NHS Trust Development Authority should hold their nerve for a little longer?’

The median length of appointment is 24 months, with a significant falling off in years three and four.

In contrast, where chief executives are able to establish themselves, they can remain in post for considerable lengths of time. The survey shows nearly 10 per cent have been in their current position for more than a decade, with many of the trusts they lead being well regarded and high performing.

Room for improvement

This raises the question of whether trust boards, Monitor and the NHS Trust Development Authority should hold their nerve for a little longer before making leadership changes.

‘There is further scope for the NHS to promote equality and diversity in its upper echelons’

Despite the call for increased clinical leadership of healthcare organisations, most trust chief executives still come from a general management background − only 21 per cent come from nursing and just 8 per cent have a background in medicine.

However, given the typical tenure for many chief executives, it is perhaps not surprising that there are relatively few senior doctors contemplating this career change.

Finally, there are 53 women in the top positions − just over a third of the total. Although this is probably a historical high point, there is further scope for the NHS to promote equality and diversity in its upper echelons to secure the most effective leaders for the future.

Peter Edwards is senior partner at Capsticks