Policy paper

Letter from General Sir Gordon Messenger and Dame Linda Pollard on publication of the leadership review terms of reference, 23 November 2021

Updated 23 November 2021

This was published under the 2019 to 2022 Johnson Conservative government

Applies to England

The review of health and social care leadership: an open letter to all those who work in health and social care

With the leadership and management review now underway, we wanted to write to introduce ourselves, and to set out some thoughts on the approach we will be adopting as we take forward this important work. If we could start by seeking to reassure:

1. We fully recognise the complexity of the task ahead, and the need to engage comprehensively to get your views on how leadership and management, at every level, could be strengthened to ensure better outcomes – both for the public and for everyone who works in health and social care, regardless of your seniority or role. In the coming months, we will be conducting a comprehensive programme of engagement events, including site visits, webinar-style outreach, workshops and personal interviews, and aim to access as many viewpoints and diverse communities as we can.

2. Equally, we are mindful of the strain that you are working under, no more so than at present. Conscious of the potential for ‘review fatigue’, we will do all we can to avoid adding to that pressure during both the engagement and the implementation phases of our work.

3. We very much want the review to be regarded by you as an opportunity. Our starting premise is that the NHS and social care are staffed by a hugely impressive, dedicated, well-motivated workforce which deserves a system and a culture where its full talent and experience can flourish and where the right skills can be applied to where they are needed most. We acknowledge that the excellent leadership and management currently evident across many parts of the system can be built upon to the benefit of all.

The terms of reference explicitly ask us to focus on leadership and management, at all levels and across the breadth of primary care, secondary care and social care. This is a significant remit, and we will inevitably find ourselves narrowing in on priority areas where the potential for betterment is likely to have most impact. We have an open mind on where these areas might be, and are actively looking for proposals that could strengthen, broaden and deepen the leadership and management skills base across all components and all levels of our healthcare and social care. We will be shaped by the following factors:

• the importance of collaborative, systems leadership at every level, reinforced by the requirement to adapt the style and context of leadership as the integrated care system (ICS) and other local partnership models are introduced

• the impact of shared vision and ownership at all levels within a system, in order to empower decision-making and problem-solving appropriately, and to reinforce the sense of value across the workforce. Working together with NHS senior leadership, our collective goal is to create a culture where anyone can aspire to leadership roles, and which encourages personal development for all

• the need to address the variation in our national provision of health and social care; to build appropriate leadership and management incentives and structures to ensure that the right skills are targeted at our most pressing challenges

We will be focusing early on the challenges of successful implementation to ensure that our recommendations lead directly to better care and outcomes, for patients and staff alike.

Thank you in advance for your patience and support for this important piece of work, with its unifying objective of delivering better outcomes in population health for the nation and its NHS and social care services. We look forward to meeting as many of you as possible in the weeks ahead. If you would like to get in touch with us, please email us at leadershipreview@dhsc.gov.uk.

General Sir Gordon Messenger and Dame Linda Pollard

23 November 2021