Future of NHS Leadership inquiry: Download the full report

Download the report

Leadership in the NHS is an endlessly debated topic – but discussions rarely go beyond the expression of bland platitudes and well-worn truisms. Only very occasionally do these debates produce actionable conclusions with lasting impact on the management of the NHS. 

This report is an attempt to go beyond that uninspiring conversation, to provide real insight into the challenges faced by current and future NHS leaders, and to make some concrete recommendations on how they may be overcome.

Thirty years ago Roy Griffiths produced his landmark report containing the defining phrase that “if Florence Nightingale were carrying her lamp through the corridors of the NHS today she would almost certainly be searching for the people in charge”.

It was, precisely, the right diagnosis for the time. It led to the introduction of general management in the NHS – a form of leadership which replaced the “consensus management” that had arrived with the 1974 reorganisation of
the NHS. 

Consensus had failed because it effectively gave a veto to any member of the team and too often produced, in Sir Roy’s words, “lowest common denominator decisions”, if any decision at all.

Today’s debate on healthcare leadership, nationally and internationally, is all about integration and system leadership – perhaps
a reinvention of consensus management, but this time between organisations rather than within them.