You’re fired and rehired: NHS managers are in demand

Payments can be up to £1,000 per day for experienced managers

When NHS managers are unable to fill their current roles for whatever reason, they can be offered one-year contracts with NHS Improvement and subsequently move on to interim work whereby the NHS pays them to fill gaps in the management structure. Payments can be up to £1,000 per day for experienced managers. This practice can be regarded as a huge waste of money and talent for the NHS.

NHS Improvement is the organisation set up in April 2016 to oversee trusts in the delivery of a quality service that is financially sustainable. NHS managers are being asked to oversee huge projects, which can involve merging groups into larger organisations, centralising specialist services, and reducing duplication of common services.

Timelines can be challenging and politically motivated rather than focussed on quality patient care or sound change management strategy. Often the resources and staff are not available to meet the deadlines. This pressure can lead to some managers resigning or being asked to move on so that fresh leaders can take their place.

One senior NHS manager in this position says he was offered a sideways move to work for NHS Improvement once it became clear he was unable to fulfil his assigned role. He noted that NHS managers have unique skills specifically for the NHS; therefore, they would never be offered the generous pay-off that would have been the norm in the private sector. One-year contracts were offered as standard practice for senior NHS managers; after this time, there were limited options available, including a move into interim work paying a lucrative salary.

An alternative option that could be offered to motivate these disillusioned staff could be a less senior permanent role in their current trust; however, very few managers are offered this option. These staff would be more motivated to carry out their role and subsequently satisfy the demand for experienced NHS staff. In the long term, this would reduce the interim work requirements, improving management continuity in trusts and ultimately reducing overall staff costs.

It is time for politicians and the Department of Health to reconsider the process of NHS manager redeployment. Experienced managers with useful skills should be valued and motivated to be productive within the NHS. The benefits of this debate would have positive implications for patients, taxpayers, policymakers and NHS managers themselves.

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