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Interesting to look at this King's Fund graph of the NHS workforce: http://www.kingsfund.org.uk/blog/2013/09/you-cant-get-staff-these-days-shifting-nhs-workforce

(I know what follows is correlation rather than causality, but bear with me.)

We have many more consultants and significantly fewer managers in the NHS since 2010. In light of this, consider how A&E and RTT performance has faltered in recent years - services that benefit from good operational management and attention to non-clinical detail. There are far fewer people doing the routine stuff that holds it all together. The role of managers is to ensure nurses and medics are supported by processes and resources that allow them to deliver fantastic care. Take out the managers and the clinicians either sacrifice care to manage process, or focus on care and process falls apart. A perverse result of the (understandable) post-Francis decision to prioritise resources on more clinicians at the expense of managers.

And hands up - I am an NHS manager, and I'm relatively proud of it (although not proud enough to post my name!)