The NHS is expected to deliver large-scale transformation with limited resources, all while improving in year financial performance and saving cash against long-term commitments.
Bringing about these kind of results requires impeccable management at the highest level, but often management procedures are ad-hoc, based on tradition and personal preference rather than strategic aims and objectives.
With increasing pressure to bring about challenging results, NHS decision makers must face up to the fact that some programmes fail and opportunities are missed because of failings at the managerial level.
NHS leaders need to face the management problem head on and answer the question: “Are our management practices preventing us from moving forwards?”
What does good management look like?
The UK Government’s former Office for Government Commerce developed the P3M3 reference guide for best practice in portfolio, programme and project management. The P3M3 model identifies the following as characteristics of bad and good programme management, respectively:
Bad: “Programme management is likely to be a vague idea, perhaps limited to one department undertaking a lot of projects and trying to co-ordinate them”
Good: “Mature programme management processes that are proven and have been optimised to maximise the likelihood of delivery success”
Management practices need to be deliberate to allow the realisation of strategic aims while accomplishing short-term objectives. Programmes and projects should be initiated with clear goals in mind and continually assessed against such.
Financial and clinical practices are already subject to constant scrutiny and assurance processes, as it is expected that established procedure will be followed. Not only does this instil confidence in an organisation, it allows for improvement as practices can be critically assessed and procedures refined.
The same kind of scrutiny should be applied to management. Any success at the highest level stems from the base systems up, so it is vital to ensure that those systems are functioning effectively.
Undertaking a management review can provide assurance that management is effective and capable of producing the kind of ambitious results that are expected of the NHS. Reviews will also identify areas of weakness to kick-start improvement and allow organisations to move forward effectively.
We at USL are experienced in carrying out management reviews.
If you would like to explore this kind of opportunity further please contact either Ian Chadwick or James Donnison on 0800 019 8980 or email us at
This article is also available as a pdf: USL Newsletter November 2016