One in three managers working in health and social care (38%) are considered ineffective by their staff, according to a new report looking at the state of management and leadership in the sector from CMI (Chartered Management Institute). The research reveals particular problems at senior management levels, where the number of ineffective managers rises to almost half (43%).

Lower than average levels of investment in management and leadership development and the promotion of clinicians into management roles without adequate training and support are pointed to as contributing factors. Unlike other sectors, perceived management ability does not improve with job level – junior managers are most positive about their managers, with just a quarter saying their boss isn’t hitting the mark.

Investment in management skills and support – both in terms of finance and implementing best line management and HR practices – is shown to increase organisational performance in the health and social care sector by almost a third (29%) and people performance by almost a quarter (23%). However, the data reveals financial investment is almost a quarter lower than in other sectors – £1,075 per manager per annum, compared to a cross-sector average of £1,414. It also suggests a mismatch between the types of training provided and those that managers find work best. Managers and leaders said accredited learning and qualifications were most effective, but are more likely to receive training on-the-job or through internal development programmes, which were rated least effective.

Analysis of the top and bottom five  line management traits shows managers are perceived to be stronger in the skills that come from having a clinical background, like understanding the organisation, but are much weaker in  management areas  such as communicating objectives,  setting priorities, and seeking and responding to feedback on performance.

Ann Francke, Chief Executive of the CMI, comments: “Bad management has damaging consequences in any sector. But in the health sector more than anywhere else, strong management and leadership is critical. Yes, modern healthcare is about medicine and medics, but it’s also about management – something that is too often overlooked as an unfortunate cost to be minimised, or, worse still, a barrier to patient care. This report shows too many health and social care managers are ineffective, resulting in a lack of employee engagement, poor service and low patient satisfaction. The way we train and recruit health sector managers needs to change.”

While the report, ‘A Management and Leadership Health-Check’, highlights much room for improvement, it does not support the contention that management is significantly worse in the sector generally compared to other UK industries. Employee engagement levels were similar to the overall results – 54% of health and social care respondents are highly engaged compared to 57% across all sectors. There is also strong evidence that where managers and leaders are developed, rewards are reaped.

Francke continues: “These results show management and leadership development in the health sector works when done properly. Managers who can engage and motivate their teams, improve efficiency and deliver real improvements in care are worth their weight in gold in a health system continuing to adapt to significant challenges. A more strategic approach to investing in developing managers and leaders in the sector is the key to raising our game. The focus must be on professional qualifications, formal training and support for anyone transitioning to a management role.”

The report details the results of CMI’s management and leadership health check, with recommendations including:

  • Change need not cost the earth. Higher performing organisations do invest more in MLD, but positive change is not simply a case of throwing money at the problem. High performing organisations drive change through commitment, time, and matching what is offered to what is deemed most effective by the individuals involved.
  • Discretionary efforts drive patient satisfaction. Where management listens and is engaged, staff are more likely to feel a sense of wellbeing, patients’ satisfaction rates are higher and there are lower rates of sickness absence.
  • Supportive managers boost management and leadership development. A good line manager will encourage staff to take qualifications and set stretch goals that make work more interesting and challenging.