The King’s Fund, in collaboration with the HSJ Future of NHS Leadership Inquiry, undertook a freedom of information (FOI) request to obtain an accurate picture of board-level vacancies, supplementing the data gathered with in-depth interviews and a literature review. This report details the level of vacancies and their impact and suggests reasons for this.
- A third of NHS providers have at least one board-level position not permanently filled. This is especially true for NHS trusts with poor performance/quality care, like those in special measures. This loss of leadership could be creating strategic instability, wasting financial resources, reducing staff morale and affecting quality of care.
- Factors contributing to this are a perceived blame culture in the NHS where executives feel exposed if anything goes wrong (even for things outside their control), excessive regulation and unrealistic expectations of what can be achieved in short timeframes.
- Every NHS organisation should have a leadership strategy and leadership development plan. National organisations have a key role in removing excessive regulation and modelling the kinds of leadership behaviours needed for the future.
- National bodies such as Monitor, the NHS Trust Development Authority and the Care Quality Commission have a key role to play in creating a culture that removes the barriers to recruiting and retaining board-level leaders. This means reducing the regulatory burden on NHS organisations and offering support and time to organisations facing challenges.
- There is a need to develop individuals who have the requisite skills and experience to lead organisations in difficulty and potentially to lead multiple organisations.
- Reforming the NHS needs to rely more on change from within organisations and systems and less on performance management and regulation.
More on leadership vacancies in the NHS
- Read Ayesha Janjua's blog: What impact are senior leadership vacancies having on the already financially troubled NHS?
- See our leadership vacancies in the NHS infographics
- Read the press release for this report: Worryingly high numbers of vacancies on NHS boards may affect the quality of patient care, report finds
- Find our more about our leadership development work