NHS managers will be sacked if they fail to improve patient care and struggling hospitals will be named and shamed as part of plans to ensure there are “no rewards for failure” in the health service, Wes Streeting will pledge.
The Health Secretary will on Wednesday announce a package of measures aimed at tackling poor performance in a speech at the NHS Providers conference in Liverpool.
It will include proposals to incentivise better performance by rewarding high-performing trusts with greater freedom over funding and flexibility.
Persistently failing managers will be replaced and “turn around teams of expert leaders” will be deployed to help providers which are running big deficits or poor services for patients, according to the Department for Health and Social Care (DHSC).
Senior managers who fail to make progress will also be ineligible for pay increases, while there will be “financial implications” for very senior managers such as chief executives who fail to improve their trust’s performance.
However, senior leaders who improve performance at their trust will be rewarded.
The policies will form part of a new pay framework for senior management in the NHS, which will be published before April 2025.
NHS England will also carry out a “no holds barred” review of NHS performance across England, with the results made public in league tables which are regularly updated.
Experts welcomed Mr Streeting’s ambition to retain and reward top talent but said that “naming and shaming” NHS trusts could make it more difficult for them to recruit staff.
Nuffield Trust Chief Executive Thea Stein said: “It’s unclear what new league tables will measure – a table based on general waiting times doesn’t add much if you need to know how good heart surgery is.
“Many of the drivers of poor productivity are systemic – from the dire state of social care stranding people in hospital, to crumbling roofs and worsening population health.
“They happen across England – which trust is worst affected is often a matter of luck and history as much as leadership. We need a system that encourages leaders to go to the most difficult and challenged trusts to improve patient care – not one that rewards them for choosing easier places to work.”
The proposals mirror attempts by former Conservative Health Secretary Steve Barclay to name and shame GP practices offering the lowest number of appointments.
The policy sparked criticism from the Royal College of GPs (RCGP), who argued that comparisons between surgeries were not useful as levels of funding and patient population differ in each practice.
The deputy chief executive of NHS Providers, Saffron Cordery, said: “It’s vital we take decisive action to tackle the deep-rooted causes of pressures on the health services including the lack of resources for public health, prevention and social care, chronic workforce shortages, financial shortfalls and historic under-investment in the bricks and mortar of the NHS which underpin so many of the challenges we face today.
“Taking steps to resolve these root causes is critical before any plans to introduce league tables and threats to ‘sack failing managers’ are even put on the table.
“Trust leaders are highly accountable, subject to rigorous standards and stand ready to tackle the challenges ahead, as they have always been. League tables bring with them significant risk of unintended consequences.”
Mr Streeting will say: “The Budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service. Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.
“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.
“Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.
“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”
