UK

A retired general will lead a comprehensive review of the NHS in England.

A retired general has been drafted in to shake up the leadership of the NHS and social care in England as the government seeks to wring value for money from billions to be raised from a new health and social care levy.

General Sir Gordon Messenger, former vice-chief of the defence staff, will launch the most wide-ranging review for 40 years into how the NHS is led, with recommendations to be delivered to Sajid Javid, health and social care secretary, early next year.

Javid said the government was “committed to providing the resources health and social care needs but that must come with change for the better”.

The review would “shine a light on the outstanding leaders in health and social care to drive efficiency and innovation”. It would help make sure individuals and families got the care and treatment they needed wherever they were in the country, he added.

Under plans announced last month, national insurance will be raised by 1.25 percentage points of salary for both employers and employees from April 2022, delivering £36bn over three years for the NHS and social care. A total of £25bn will be allocated to NHS England, £5bn for healthcare elsewhere in the UK, and £5.4bn for social care.

However, the Treasury has long been concerned that the billions it pours into a cash-hungry health service does not deliver commensurate improvements.

The new levy will leave the UK with the highest tax burden since 1950, sharpening ministers’ determination to ensure the money is well spent.

About 5.6m people are waiting for treatment, including many whose care was postponed during the pandemic, threatening to undermine the government’s claim to successful stewardship of the service at the next general election.

The review will be followed by “a delivery plan with clear timelines on the implementation of agreed recommendations”, the government said.

Officials said Messenger would examine ways to replicate the best examples of leadership, “as well as looking at how to do more to support the training and development of existing leaders and support the pipeline of talented future leaders within the system”.

The review would also look at “how we can get fresh expertise and talent into management roles in the health and care systems”.

The NHS is sometimes criticised for failing to disseminate more widely innovations that have proved their worth in one part of the system.

Officials said strengthening leadership, including clinical leadership, and spreading the best examples of outstanding management was “vital in ensuring that every pound of investment is spent well”. These improvements would also “help to reduce regional disparities in efficiency and health outcomes”.

Messenger will have a team of officials from the health department and the NHS led by Dame Linda Pollard, chair of Leeds Teaching Hospital. They will also work closely with the NHS chief executive, Amanda Pritchard, and other health and care leaders.

The work of the review only applies to England, though other nations “will of course be free to consider its findings”, the government said.

Matthew Taylor, chief executive of the NHS Confederation, said it was right that new leadership skills and approaches were needed but “the operating environment is among the most fraught that NHS leaders have experienced and this review will need to support, not hinder, their progress”.

That meant the government “will need to do what it can to ensure we have the right regulatory environment in place that allows local leaders, including those across primary care, to lead effectively, with less bureaucracy and interference holding them back”, Taylor added.

Chris Hopson, chief executive of NHS Providers, said international evidence showed that the NHS “is one of the most efficient health services in the world”. The last 18 months of the pandemic had shown how NHS frontline leaders, working with staff, could deliver truly world class care.

“Those leaders are also deeply committed to improving care, reducing variation and cutting waste,” he added. “They will therefore want to work closely with this new review to identify ways to improve and deliver full value for the extra new taxpayer investment in the NHS.”

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