In a healthcare system often defined by immediate “firefighting”, how do we create the space to actually improve? On November 11th, over 600 people attended a Health Foundation webinar to confront this challenge. The event marked the third stakeholder session of an ongoing, two-year research project, “Management Capacity and Capability in NHS Trusts and System-level Partnerships.” Led by Professor Ian Kirkpatrick at the University of York, this study seeks to move beyond the “bureaucracy” debate to understand how management can be strengthened to drive the sustainable innovation that the NHS desperately needs.
Dr. Nnenna Osuji, the session chair, opened with a provocative reminder: while often portrayed negatively in the media, managers are actually the “lifeblood of the NHS”. The “hunger” for this conversation—proven by the high attendance—shows a service eager to move from surviving to thriving.
The “Extreme Job” of the Modern Managers
Undoubtedly, NHS management is an “extreme job”, with a workforce representing only 3% of the total staff—significantly lower than the 9% seen across the wider UK economy. When managers are stuck in cycles of quick fixes, there is little “discretionary capacity” left for the creative work of improvement.
However, the session highlighted that innovation isn’t just about “new toys”; it’s about the dynamic capabilities that allow an organisation to develop.
Lessons from the Frontline: Turning Ideas into Impact
The heart of the webinar featured three NHS managers who proved that management capacity is the bridge between a good idea and a better patient outcome:
- Demystifying the Process: At Midlands Partnership NHS Foundation Trust, Mark Hayward’s “Blue Sky Training” has empowered over 600 staff with project management skills. By “unravelling and demystifying” these tools, they’ve turned a perceived bureaucratic burden into a practical way for every ward to lead change.
- The Power of Engagement: Sarah Wellings, from Mid and South Essex NHS Foundation Trust, showcased the “My Staff” app, which slashed document retrieval time for 17,000 staff from 20 minutes to under 30 seconds. The project lead attributed the success of this completely grassroot innovation to a combination of “heart” (values), “team” (engagement), and “competencies” (skills).
- Transforming Mindsets: Julia Nixon discussed a monumental shift at Yorkshire Ambulance Service, moving from a “dispatch” model to a clinical triage system. This required “tenacity with a capital T” to support staff through the emotional upheaval of changing long-held ways of working.
The Path Forward: Purpose, Precision, and Persistence
The session concluded with a call to move away from “heroic” lone leadership toward a culture of collective capability. Ian Abbs, Strategic Advisor and former CEO of Guy’s and St Thomas’ NHS Foundation Trust, summarized the mission ahead with three words: Purpose, Precision, and Persistence.
The message was clear: innovation is not an optional extra; it is the only way to ensure the NHS remains sustainable. As Dr. Osuji noted, “inaction and indecision is a risk in and of itself”. This is our moment to broaden the work of innovation, ensuring every manager is supported to be a steward of change.
As a past culture change bod ( oil,chemicals ,construction ,nuclear etc) have taken a strong interest.
It’s clear to me that there’s a dearth of well intentioned interest in making positive change , and leadership ( rather than management in the strict sense ):imho remains tha absolute key.
Disappointing n that nhs not yet grasped this fully due to lack of clarity about great leadership really means .
I’d be glad to assist in the definition of this vip aspect of ‘ getting it right’.
Thank you Robin,
We appreciate your reply and interest in the blog. We also agree that leadership is key, although our research also suggests that – without solid management capabilities in support – even the most dynamic leaders will struggle to achieve much. I suspect that these capabilities are a given in the corporate sector, but that is not the case in today’s NHS (where management functions are being stripped to the bone). Leadership therefore is a necessary but not sufficient condition for innovation.
You also refer to ‘a dearth of well intentioned interest in making positive change’. I think we will need to agree to disagree on that statement. Again, our research, suggests the opposite. There is significant enthusiasm for innovation in the NHS and a great deal of energy. Often lacking however, is the headroom and (management) capabilities to make it happen.