NHS managers need to be appointed on merit of their managerial aptitude not clinical skills in order to do the job effectively, according to a new report written by University of Central Lancashire researchers.
Commissioned by the Healthcare People Management Association (HPMA) and Conflict Management Specialists (CMP), the report, written by researchers from the University’s School of Business, covers the findings of an NHS-wide study on the state of employee relations in the NHS.
The report draws on 211 survey responses and 33 in-depth interviews with human resource (HR) leaders, senior practitioners and trade union representatives from NHS Trusts* in England, Scotland, Wales and Northern Ireland.
It found that the pressures on line managers, often managing their operational and management roles, mean they regularly doesn’t have the capability, capacity or confidence to undertake people management tasks, which created challenges in the service in terms of effective employment relations.
"Clinicians transitioning into line management roles frequently struggle to transact their management role partially, due to a lack of preparedness and relevant training."
— Director of iROWE and Associate Dean of the School of Business Dr Adrian Wright
A key caveat to this finding was the view that clinicians were habitually promoted to line manager for their operational skills, rather than their leadership and management skills and their potential to manage effectively.
“Clinicians transitioning into line management roles frequently struggle to transact their management role partially, due to a lack of preparedness and relevant training,” said Director of the Institute for Research on Organisations Work and Employment (iROWE) and Associate Dean of the School of Business Dr Adrian Wright.
“This issue is prevalent in the NHS, where promotion is frequently based on clinical performance rather than managerial competencies. Therefore, senior leaders need ensure that their aspiring managers and practicing managers are accessing development opportunities regularly, making sure managers have the time and space to access training.”
The researchers also found evidence of a significant culture shift in the NHS around how conflict is managed, where blame is attributed less to individuals but, rather, systemic issues of service delivery are scrutinised and addressed.
"This issue is prevalent in the NHS, where promotion is frequently based on clinical performance rather than managerial competencies. "
— Dr Tony Bennett, Senior Research Fellow in iROWE
Dr Tony Bennett, Senior Research Fellow in iROWE, said: “This is a positive change. The focuses move away from the individual and instead emphasises reflection and learning. However, it requires continued culture change to ensure this approach is consistent.”
Interpersonal and relationship issues were seen as a key source of workplace conflict, and line managers’ style and competence were highlighted as the top reasons for conflict in the workplace.
Informal approaches, in particular workplace mediation, were reported as the best solutions for resolving conflict, however, this requires managers to understand when and where informal methods of resolution are appropriate.
The report recommends giving employees a greater voice, particularly as a collective, as a way to improve people management.
"It reflects the importance of our partnerships with Trades Union colleagues in supporting positive employee experience across the employment life cycle."
— Sarah Morley, Executive Director of WOD Velindre and Joint President of the Healthcare People Management Association
“To maintain and enhance employee relations, we would recommend that all NHS organisations fully involve their trade union partners in the reassessment and implementation of management training” added Dr Bennett.
Sarah Morley, Executive Director of WOD Velindre and Joint President of the Healthcare People Management Association, said: “This report shines a light on a key competence for line managers in the NHS. It also reflects the importance of our partnerships with Trades Union colleagues in supporting positive employee experience across the employment life cycle.”
The report, A critical reappraisal of the effectiveness of employee relations in the NHS, is available to download via the HPMA.
* 32 NHS Trusts across England, Scotland, Wales and Northern Ireland took part in the study.