NHS shake up won't work, say managers

A survey of interim managers in the NHS defends their role and argues that in the wider public sector in general there is a need for senior team members with specific skills
Interim managers have issued their own warning about the future of the NHS. Photo: Getty

Two-thirds of the UK's NHS interim managers say that the government's change to the NHS will not improve services and three-quarters also think GP-led commissioning will not save costs, according to a new survey [http://www.interimpartners.com/news/top-nhs-interim-managers-warn-against-government-plans/] of senior short-term managers in the health service.

Steve Melber, senior consultant in healthcare at recruitment firm Interim Partners, which commissioned the survey, says senior interim managers working in the NHS understand "where efficiencies are made and where corners cannot be cut without seriously compromising service delivery".

The survey follows similar warnings from doctors' leaders about the potential damage that could be caused by the government's radical shake-up of NHS management.

It is also part of a growing defence of the use of short-term senior managers in the public sector. Paul Botting, managing partner at recruitment firm Odgers Interim, who chairs the Interim Management Association, says that the scale of public sector reform being proposed by the government will call for interim management skills.

"Now more than ever, as the public sector embarks on a new phase of transformation, it is in need of strong, senior resources that have very specific skills," he comments.

"In some instances, there simply isn't anyone within the existing framework that has the necessary skills. The roles interim managers perform require unique and extensive experience at board level or similar. Interim managers and executives are deployed for a finite period to undertake a specific role and are not required to be part of a permanent workforce. The role is often around departmental transformation, re-structuring or change."

In October, a National Audit Office report said that while central government departments are now spending slightly less on management consultants and interim managers, they are still not getting value for money. The central government watchdog's report said spending on external consultants by 17 Whitehall departments had fallen from £904m in 2006-07 to £789m in 2009-10.

Botting points out that an interim manager does not work in the same way as a permanent employee. "Therefore, taking a day rate and multiplying it by 365 is really not a true indication of an annual income. It's always important to weigh up results or 'value' versus cost when reviewing expenditure and considerations such as 'all inclusive' costs are also important," he adds. "The reality is that interim managers often negate high long-term costs/overheads."

Improvement projects

Ian Gray has more than 17 years' experience of delivering major turnaround and improvement projects in both the private and public sectors. In 2008, Gray worked at two NHS Trust Hospitals – Mayday University Hospital and Epsom and St Helier University Hospitals NHS Trust – where he was responsible for changing their respective financial situations through the introduction of smarter processes.

At Mayday the predicted £9m deficit was eliminated and at Epsom and St Helier University Hospital, the deficit was reduced by £6m in just a year.

Fiona Tordoff, who, like Gray, works via recruitment specialist firm Russam GMS, undertook an assignment at the Department of Communities and Local Government to co-ordinate the agreement of its strategic priorities framework over the course of three years. Her role involved bringing together 11 government departments and nine regional government offices at two conferences, where representatives met to discuss their priorities and how they would be implemented across the UK.

In the past, each department held separate meetings with different processes and planning mechanisms and this meant it was difficult to get unanimous agreement on procedures. The goal was for the communities department to facilitate a more joined-up process with every department and government office understanding the bigger picture and working consistently towards the regional implementation of national policy.

"One of my strengths as an interim manager was my impartiality," Fiona explains. "I had a totally independent outlook that helped me gain the trust of representatives within different government departments and regions. I also have a great deal of experience managing large scale, participative events and I understand how groups work."

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