Recently, Sir Gordon Messenger, a retired senior Royal Marines officer who hails from Dundee, delivered an independent report to the Department of Health & Social Care. His brief was to examine the state of leadership and management in the health and social care sector in England.

He highlighted the positive difference that first-rate leadership can make in health and social care, with many outstanding examples contributing directly to better service. He also observed that the development of quality leadership and management was not adequately embedded or institutionalised throughout all health and care communities.

Sir Gordon made seven recommendations to improve the situation:

• Targeted interventions on collaborative leadership and organisational values, with a new, entry-level induction for all who join health and social care and a new, national mid-career programme for managers across health and social care.
• Positive equality, diversity and inclusion (EDI) action, including embedding inclusive leadership practice as the responsibility of all leaders, committing to promoting equal opportunity and fairness standards, and more stringently enforcing existing measures to improve equal opportunities and fairness.
• Consistent management standards delivered through accredited training, with a single set of unified, core leadership and management standards for managers, together with training and development bundles to meet these standards.
• A simplified, standard appraisal system for the NHS, with a more effective, consistent and behaviour-based appraisal system, designed to be of value to individuals and the system.
• A new career and talent management function for managers at regional level which oversees and provide structure to NHS management careers.
• More effective recruitment and development of non-executive directors, with the establishment of a specialist non-executive talent and appointments team.
• Encouraging top talent into challenged parts of the system by improving the existing package of support and incentives to enable the best leaders and managers to take on the most difficult roles.

Everyone is committed to ensuring that NHS Scotland’s £18 billion health budget (a significant percentage of the nation’s public spending) is deployed effectively. There are many initiatives already taking place in Scotland and this may present an excellent opportunity to piggy-back, as it were, on what seems to be a well-researched piece of work.

Given Scotland’s much smaller footprint and less complex NHS structure, the Scottish Government could take advantage of the report’s findings and assemble a small group of Scottish experts to review its recommendations speedily. It could then adopt those findings which are helpful in addressing Scotland’s particular needs, with a view to implementing the outcome urgently.

This would show determination to enhance the leadership, management, governance and efficiency of an organisation which plays such a key role in Scottish life.

Jointly authored by John Sturrock and Sir Ewan Brown, author of books on corporate governance, The Times, 2nd August 2022