A new report from the NHS Confederation outlines the views of new NHS bosses on the required changes to leadership needed to meet the goals set out in the NHS Long Term Plan.

The report revolves around the message to break down barriers and ensure collaborative work is prioritised as the NHS moves to build new partnerships and system working. To enable this, the report suggests, the NHS needs a new form of ‘leadership’ to go beyond ‘traditional boundaries’ and work in partnership at the local level.

The report follows the publication of the interim NHS People Plan, which includes commitments from NHS England/Improvement to develop a ‘leadership compact’ to foster a different approach to leadership development and supporting chief executives.

The nine NHS trust Chief Executives interviewed for the report regard their role as ‘a privilege’, bringing with it the chance to make real and positive changes for their local communities and staff.


Primary observations: 

  • Leaders support the need to move beyond working in isolation as leaders of single organisations to being part of a health economy.
  • Leaders recognise the need to have a dual responsibility for the performance of their local systems for the benefit of their local communities, as well as for their own organisations.
  • Talent management has not been a notable feature within the NHS in recent years, but this is starting to be addressed by NHS England/Improvement.
  • Leaders want to see a different approach to identifying and supporting leaders and recognise the need for proactive talent management to secure the next generation of leaders, with the right skills, mindsets and from diverse backgrounds.
  • Leaders want greater commitment and support when things go wrong to avoid chief executives being ousted without good reason and proper checks.
  • Leaders want an increased focus on creating an inclusive culture within organisations.

Chief Executive of NHS Confederation, Niall Dickson, said: “There is widespread support from the Chief Executives we interviewed on the need to foster a different approach to leadership development, diversity and supporting leaders.

“They now want to see this well-intentioned rhetoric followed through. They know that delivering cultural change and more sophisticated leadership behaviours throughout the system is challenging and will take time, but there is a strong view that nothing less will do.”

The full report can be read here.