NHS leaders in England will expected to show how they are driving service improvement, delivering transformation, promoting equality and developing a just culture as part of new “competency framework” for directors introduced by NHS England at the start of April.
The framework, which applies to trusts, ICBs and NHS England itself, sets out six “domains” within which board-level managers must assess themselves. Each domain contains a series of “competency statements” against which directors must mark themselves on a sliding scale from “almost always” to “no chance to demonstrate”. These assessments will then be discussed with chairs or chief executives as part of the annual appraisal process.
The six domains, which NHS organisations have been instructed to include in all board-level job descriptions from April, are:
The competencies strongly emphasise equality and inclusion, with requirements to “speak up” against racism, bullying and sexual harassment, challenge unsafe or unfair practices and ensure a “safe culture” for staff who want speak up.
“Competency frameworks underpin good management practice, but they don’t make management good by themselves,” commented MiP chief executive Jon Restell. “Good culture and do-able jobs are just as important, if not more so. The present drive to make the executive management overhead go further, coupled with micro-management and too much regulation, will eat the framework for breakfast.”
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MiP says regulation alone will not improve the NHS culture around raising and acting on concerns, following the findings of the Thirlwall Inquiry into the Lucy Letby case.
TUC Congress has backed a motion calling for an evidence-based and fully resourced plan for NHS management, with unions warning that cutting management capacity risks shifting essential work onto clinical teams.
The Scottish Government has announced plans to radically restructure the NHS, replacing Scotland’s 14 territorial health boards with two new ‘Strategic Health Boards’ covering the west and east of the country.
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