NHS managers believe that the potential for concerns about, quality, safety and standards will increase in the next 12 months. Responding to a Managers in Partnership (MiP) survey, 86% of managers shared this view, driven by political pressure to pursue short-temrist interventions, staffing shortages and poor organisational culture.

Over half of managers do not think that professional regulation will positively impact concern raising, with an additional 1 in 5 believing that it would actually make the process worse.

Rather than solely focussing on statutory regulation, members suggested that improving organisational culture, establishing clear processes for raising concerns and dealing with them, and ensuring safe staffing levels would be more effective than regulation. As one respondent put it:

“Safe staffing levels. You can have all the regulation you like, but no amount of regulation helps if you have 30% too few staff and increasing demand.”

The survey also showed that standardised training around dealing with concerns should be introduced as just under a third of managers felt their organisation does not currently have a clear process for dealing with concerns raised, while around a quarter of managers do not feel confident in managing concerns raised by their staff.

Respondents stated that organisational culture plays a significant role in staff feeling confident in speaking up. But 42% of managers polled rated their organisation’s culture as ‘poor’ compared to 30% who said it was ‘good’. Team cohesion between medical, nursing and management leaders was only rated ‘okay’ by just under half of the respondents (46%), with ‘seniority’ and ‘fear of reprisal’ mentioned as the most prominent cultural barriers for staff wishing to raise concerns.

Responding to the results, Jon Restell, Chief Executive of Managers in Partnership said:

“Regulating NHS managers will not be the silver-bullet many politicians are hoping it to be.

“From our survey, it’s clear that managers feel improving existing processes around concern raising, creating an organisational culture were speaking up is encouraged and valued, and making sure teams have the capacity, resources and staff needed to safeguard the quality of day-to-day care, are all more urgent than setting up a regulatory body which will likely take years to get off the ground.

“Managers should be held accountable for the decisions they make, but must have agency in making them. Pressure from government to pursue short term political priorities undermines managers’ ability to deliver the local interventions needed to get the NHS back to where it should be, delivering high quality, timely care to those who need it.

“MiP encourage policymakers to engage with us and our members to develop the processes needed to maintain quality, safety and standards across the NHS.”