An MiP member survey has shown there is growing support for manager regulation in principle, but not everyone is convinced it will improve standards, culture or lead to better patient safety in the NHS. It begs the question: what problem is the government actually trying to solve?

To support MiP’s evidence to the now closed Department for Health and Social Care’s consultation on regulating NHS managers, MiP surveyed 790 members for their views on regulation and management behaviours.

70% of MiP members support the ‘principle’ of regulation, a marked increase of around 20% compared to our last poll on the subject in November 2023.

A similarly high number of members (82%) felt there is a need to improve management behaviours, culture and standards, however less than half believed that regulation would actually raise these standards.

The government said ‘the overarching aim’ of regulating NHS managers is ‘ensuring patient safety’, however two-thirds of MiP members are not satisfied that regulation in and of itself would lead to a safer NHS.

While the survey results show a growing acceptance that some form of regulation is coming for managers, many managers are still raising concerns on whether it will be fair, proportionate and independent. Less than one in five managers have confidence that an existing organisation would be duly independent enough to regulate fairly.

MiP members have warned about the ‘chilling effect’ a poorly implemented form of regulation could bring, with around a quarter of respondents stating regulation would make them more likely to leave the NHS. Over a third also said it would make them less likely to seek promotion to more senior roles, potentially making already difficult positions to recruit for even more challenging.

As such, MiP still treats regulation with caution and asks the government to consider what problem they are hoping to solve with it. MiP supports efforts to professionalise managers through training, support and ongoing professional development. This would not only raise the standards of NHS management, it would recognise it as a skilled profession and help improve prevailing attitudes to non-clinical leaders.

But if the government believes that regulating NHS managers is a silver bullet to improve patient safety, change culture and a quick-fix to raise standards – we urge it to tread carefully.

For regulation to be successful, the government must first articulate what it seeks to achieve by regulating NHS managers. Only then can meaningful engagement begin on the regulatory framework and process, ensuring it works for the NHS, its staff and patients.