NHS managers ‘not bureaucratic burden’ but adding value to health system

By Claire Hayhurst18th February 2019News EnglandCare Standards, Management, News England, NHS, Workforce

Having more NHS managers improves efficiency and the quality of healthcare provided in hospitals, researchers have said.

A study by the Universities of Bristol, Warwick and Leeds involved data on managers and the performance of 160 hospital trusts in England from 2007 to 2012.

The proportion of managers, hospital efficiency, patient experience and hospital infection rates had been consistently reported by all trusts involved.

Results of the study, published in the Journal of Public Administration Research and Theory, showed that having a higher proportion of managers had a significant impact on performance.

Even a small increase in managers – from 2% of the workforce to 3% – was associated with a 15% reduction in infection rates.

There was also a 1% increase in patient satisfaction scores and a 5% improvement in hospital efficiency.

Researchers say raising the proportion of managers by 1% could cost less than £500 million – a relatively small proportion of the annual NHS budget.

Professor Gianluca Veronesi, of the University of Bristol, said: “Our research shows that infection rates decreased and patient experience improved with a higher proportion of managers to staff.

“This suggests that policies aimed at downsizing managers are potentially misguided as they undermine the productive potential of managers and should therefore be reversed.

“Managers are often blamed for the extra paperwork doctors need to deal with, however much of this is generated by national policies and regulatory demands.

“Equally, managers in the NHS are not well paid relative to the private sector, while the intensity of work and stress is probably higher.”

There are 31,000 managers in the NHS, accounting for 3% of its workforce of 1.36 million.

Across the UK economy as a whole, managers make up 9.5% of the workforce, researchers said.

Their findings will be sent to senior decision makers in a policy briefing.

This states: “NHS managers are far from being a bureaucratic burden and a waste of public money; rather, they add value to the healthcare system.”

The document advises that policies to downsize the amount of managers are “potentially misguided” and should be “reversed”.

Professor Ian Kirkpatrick, from Warwick Business School, said: “Our findings are not intended to overlook the fact that managers can sometimes make mistakes.

“Instead, it suggests that as a complex organisation – now the fifth biggest in the world – the NHS needs more managers.

“Strengthening management is not about wasting money and nor does it mean privatising the NHS, it is about making the NHS work better as a public service in the public interest.”