The ‘arbitrary target’ to cut management staff by 45% should be re-visited as there is no persuasive evidence the NHS is over-managed, MPs have been told.
In written evidence supplied to the Health Committee, the King’s Fund argues high-quality leadership and management are “essential” to delivering the Nicholson Challenge.
“Senior members of the government should stop denigrating NHS managers as ‘bureaucrats’,” writes the King’s Fund.
“While there is evidence the NHS is over-administered, there is no persuasive evidence it is over-managed.”
John Appleby, chief economist for health policy at the King’s Fund, warned the Health Committee during its session on public expenditure on Tuesday (13 September), that the very people being asked to deliver efficiency savings are either demoralised or been made redundant.
He claims the Nicholson Challenge is difficult enough on its own but it has been made worse by the “huge” upheaval for management staff.
“The people who are working in PCTs should be congratulated for still doing their jobs,” he said.
“It is very difficult to work in an organisation that you know will be disappearing.
“Not only do they have to carry on working and prepare the ground for the next wave of commissioning services, they have got to grapple with savings on top of that.”
Appleby warned the government should be mindful that the QUIPP challenge is not as simple as just saving money.
Instead, staff have to be motivated and enthused to search out new ways of working and new ways of delivering healthcare to patients.
Dr Judith Smith, head of policy at the Nuffield Trust, also told the Health Committee that a richer sill set is required among an organisation striving to improve productivity.
She said the NHS needs to be cautious when considering ‘watering down’ its skill mix because there is “fairly convincing evidence” this may have an impact on care and quality.
“Health service managers are critical to savings. The King’s Fund research underlines the importance of management to the challenge we face,” said Smith.
