‘Fuzzy’ NHS management standards to be revised

The NHS’s first proposed skills framework for managers has too much “fuzzy language” and needs to be simplified, the NHS England board has decided.

It is meant to give clinical and non-clinical NHS management its first “code of practice, defined set of standards and competencies [and] a national development curriculum” and to “elevate NHS management and leadership as a recognised professional discipline”.

It should “work alongside” the government’s proposed management regulation and “any potential future accreditation [system]”, a board paper said.

It responds to recommendations from a 2019 review of the “fit and proper person test” by Tom Kark KC, and the 2022 Messenger review of NHS leadership, as well as renewed support for management standards and accountability after Lucy Letby’s conviction for murdering babies in Chester.

But NHSE chair Penny Dash told the NHSE board meeting that officials needed to “tighten up” the current document and its language, and include clearer methods for measuring leaders’ performance.

She said: “I have to say I had a bit of a personal problem with some of the language in here. This one on self-effectiveness [says], ‘keep safe’.

“What does that mean? Does that mean I walk slowly down the corridor? We keep using that word, I wouldn’t know what that meant.

“We’ve also got things in here like ‘patient-centred care’, I don’t know what that means. We’ve got a whole lot of really good patient experience metrics, which we could be aspiring to, so we’ve got a bit too much fuzzy language in here.

“I think we need to be much clearer on the sorts of things we have been talking about [at the board] today, like ‘do we have a group of managers who can really think about resource allocation?’

“We do refer to that but I’m not sure it’s quite tight enough.”

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Source: HSJ, 24 September 2025