Policy paper

Review of health and social care leadership in England: terms of reference

Updated 23 November 2021

Applies to England

Review purpose

The strength of leadership across health and social care is an important driver of performance. It impacts on the quality of care people receive, the efficient use of public resources, the culture of the organisations they lead and the engagement and motivation of the diverse health and care workforce.

The move to integrated care boards in April 2022 and the need for ever closer working between NHS organisations and local authorities provides an opportune moment to look at what more needs to be done to foster and replicate the best leadership and management, including in the most challenged areas. It also provides a new focus on how leaders from both health and care work together to provide efficient and integrated care for the people they serve. It will look at how we can support leaders to drive up efficiency and give staff the space to focus on delivering care for patients.

The review will cover leadership and management in the NHS and social care and will include consideration of whether the findings of previous reports on leadership have been delivered and what their impact has been.

The review should report to the Secretary of State for Health and Social Care after 4 months and will be followed by a delivery plan with clear timelines on implementing agreed recommendations.

Review chair

The report will be led by General Sir Gordon Messenger, former Vice Chief of the Defence Staff, supported by Dame Linda Pollard, Chair of Leeds Teaching Hospital Trust.

Scope and content

The review will consider what is needed to improve how health and social care is led and managed in England, such as:

  • the drivers of performance and the standards expected of good leaders and leadership teams
  • what further powers may be needed to drive real and sustained change, including effective systems for intervention and recovery in both providers and integrated care systems
  • how to help health and care leaders collaborate for more integrated care for citizens
  • proposals for ensuring the right incentives for the best leaders and leadership teams to take on the most difficult leadership challenges
  • how to more rapidly foster and replicate the best of examples of leadership
  • how to support and improve the skills of all leaders and managers throughout their careers and encourage the best leaders within the system to rise
  • how to draw new expertise and talent into leadership roles in the health and care systems (including the NHS Management Graduate Trainee Scheme)
  • how to ensure the right training, opportunities and support for clinicians to take on management roles throughout their careers
  • whether the right pay and incentives are in place to foster good and excellent performance and recruit and retain the best leaders from start of career to retirement
  • driving up efficiency – to support leaders, managers, clinicians and wider staff, creating the space and time for them to focus as much time as possible on delivering for patients and care users

Secretariat

The chair will be supported by a joint Department of Health and Social Care and NHS England and NHS Improvement secretariat.