The document discusses the challenges facing medical managers in the NHS. It identifies the key challenges as clinical engagement, quality, and innovation. Regarding clinical engagement, it notes that strong clinical leadership is important for success but that some perceive management roles negatively. It also stresses that engaged clinical staff can improve patient experience, safety, and staff well-being. Overall, the document argues that meeting financial, quality, and innovation challenges will depend on effectively engaging senior medical clinicians in leadership roles.

1. +
Challenges for Medical
Managers in the NHS
Dr Imran Waheed
22 May 2014

2. +
Introduction
 The familiar challenges faced by mental health trusts have
intensified in the face of considerable financial constraints.
 The need for innovation and increased levels of productivity
has probably never been greater.
 All healthcare staff will need to contribute significantly to this
effort.

3. +
Clinical Engagement
 The challenge is to nurture a positively
committed and engaged medical
workforce
 The recent Francis and Keogh reports,
both identified a lack of strong clinical
leadership as a fundamental contributor
to the failures of some NHS Trusts
 The need to challenge the perception
that doctors who become managers go
to the “dark side”
 The crucial question is whether the
organisational culture and structure
facilitate or inhibit this.
“Good management is the art of
making problems so interesting and
their solutions so constructive that
everyone wants to get to work and
deal with them.” - Paul Hawken

4. +
Clinical Engagement
Organisations with engaged staff deliver:
 Better patient experience
 Fewer errors
 Stronger financial management
 Higher staff morale and motivation and
less absenteeism and stress.

5. “An unduly casual
attitude towards
sudden death [and]
inadequate systems
for reporting
incidents”
“Incident
reporting
systems were
criticised by
many staff”

6. +
The Quality Challenge:
lessons from Mid Staffs
 Setting up proper systems of supervision
 Understanding what pressures staff are
experiencing
 Taking action when things go a bit wrong
rather than waiting until they are very
wrong
 Patient feedback to be a key indicator of
performance
 Taking seriously the ‘gold dust’ of
complaints
 Prioritising patient care over
organisational needs
“We must put patients at the heart of
everything we do”
[Prof Sue Bailey, RCPsych]

7. +
The Innovation
Challenge
 Harnessing transformational
technologies
 Exploiting the potential of data
 Moving away from the ‘one size fits all’
model of healthcare
 A health service, not an illness service –
the NHS has helped many quit smoking
but what else can we do...?
“Insanity: doing the same thing over
and over again and expecting different
results.” [Albert Einstein]

8. +
Conclusion
 Financial constraints will persist for at
least a decade but cannot be allowed to
dominate management
 Challenge of ensuring quality – putting
patients first and prioritising patient
safety and well-being
 Innovation challenge – trying to increase
productivity through innovation
 Meeting these challenges is dependent
on the clinical engagement challenge –
ensuring that senior medical staff are
playing leadership roles in their clinical
teams