Good leadership

As the NHS recovers from the pandemic, there is a dire need for sound health and social care leadership. The alliances responsible for developing sustainability and transformation plans (STPs) have been replaced by legal entities in the form of integrated care systems. The executive teams of these systems are responsible for making difficult decisions pertaining to resource allocation against compelling and competing demands within a constrained system (Brown, 2022). Integrated care systems are expected to make collaboration and system-level working the norm, and drive interorganisational working to deliver the desired service and client outcomes across the local health and social care economy. Delivery upon this ambition will require good communication across all contributing organisations if staff and clients are to feel fully engaged in the integrated care endeavour.

Over the years, various failures in communication and NHS leadership have emerged. The Francis Report (House of Commons, 2013) was highly critical of the leadership and resulting culture at Mid Staffordshire NHS Foundation Trust. Sir Bill Kirkup (2015) described the dysfunctional maternity provision at Furness General Hospital, part of the University Hospitals of Morecambe Bay NHS Foundation Trust, where he found ‘failures at almost every level’. More recently, the Ockenden (House of Commons, 2022) inquiry has laid bare the inadequacy of maternity services at the Shrewsbury and Telford Hospital NHS Trust, which failed parents and their infants. Donna Ockenden is now undertaking a review of maternity services at Nottingham University Hospital NHS Trust in light of concerns raised by the Care Quality Commission regarding 19 serious incidents reported between March 2021 and February 2022, in addition to five Healthcare Safety Investigation Branch investigations. However, leadership failings are not unique to maternity services, nor individual NHS Trusts, which is why Sajid Javid, the former Secretary of State for Health and Social Care, asked General Sir Gordon Messenger in October 2021 to examine leadership and management in health and social care.