FMLM responds to new ‘carrot and the stick’ performance measures for NHS leadership

Responding to the Department of Health and Social Care’s new performance measures for NHS leaders, the Faculty of Medical Leadership and Management Chief Executive, Professor Rich Withnall, said: 

“Rewarding leaders financially is a well-intended, and potentially effective measure to incentivise performance improvements.   

“As the Secretary of State rightly recognises, there are lessons to be learned from industry and business, and it is fair to consider bonuses for those delivering exemplary outcomes. This action may also help broaden the attractiveness of senior roles in the NHS to a wider pool of talent. 

“However, financial penalties may not result in the desired outcomes, and we would encourage remediation and further training over punitive measures. Care must be taken to ensure the gap between good and less well performing areas does not widen and punishment rather than encouragement may result in the very thing we are trying to avoid; worsening patient care.

“The devil will be in the detail. Bonuses should also be considered in the context of wider workforce performance. Despite recent pay uplifts for NHS staff, performance-related bonuses may unintentionally causes wider disquiet, particularly when many ICBs are being told to cut costs. While one person may have responsibility for oversight for delivering change and improvement, it can only be achieved through a collective team effort.  It may become a matter of conscience for successful leaders: should they take performance-related bonuses when their team members may not be rewarded as handsomely, if at all? 

“A carrot and stick approach that balances incentivisation and accountability is welcome, but there are other ways in which to hold leaders responsible. Leaders and managers across the NHS must be better equipped with the skills, competence and confidence to do their jobs well – particularly within struggling Trusts – and there must be support for improvement as well as achievement.

“Work is ongoing to set new standards for NHS managers and leaders, but a new professional body must also be created to provide the developmental leadership support and training necessary to empower colleagues to meet these standards. Separate regulatory processes will also be required. Only then will we see the truly transformative change needed to level-up professionalised standards of leadership and management: FMLM is well placed to assist the Government’s good intention.”