Increasing management spend does not improve hospital performance, research concludes

There is no significant relationship between the number of managers or the amount spent on management and the quality of NHS hospital services, research has concluded.

Researchers at the London School of Economics studied the performance of all 129 non-specialist acute trusts between 2012-13 and 2018-19.

They measured hospital performance on five indicators covering financial position, elective and emergency waiting times, level of admissions and mortality. This was then compared to the number of managers each trust employed and the amount spent on management staff.

The researchers also attempted to measure the quality of management based on answers given to relevant questions in the annual NHS staff survey.

Reviewing the evidence they analysed, the LSE team state: “We find no evidence of an association between our measures of quantity of managerial input and quality of management… Furthermore, we find no associations between our measures of quantity of management input and five measures of hospital performance.”

They add: “This holds, irrespective of how we define managerial input, whether by number of managers or expenditure on management. These results are generally robust to how we account for variation between hospitals and within hospitals over time.”

This leads the researchers to conclude: “Hospitals hiring more managers do not see an improvement in the quality of management leading to better performance, and increasing the numbers of managers does not appear to improve hospital performance through any other direct or indirect mechanism.”

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Source: HSJ, 17 January 2022