Talk Health and Care

The central role of line managers

I would like line managers to have the people management skills to be able to manage their staff well.  This includes, hearing what they have to say, giving them options in terms of ways in which they might want to go about achieving what they want to achieve and supporting their staff in a way that makes them feel safe and able to fulfill their potential.

Staff can endure high levels of work pressure if they know they have their managers support.  And also if they know that their manager will support them in a just way if things go wrong.

Similarly, if staff feel hemmed in, work intensity will adversely affect them.  If they know that they have the flexibility and the ability to 'decompress' should they need to, then they will thrive.

We should aim to have staff who are energised, positive and motivated and this is not achieved by having a workforce that are controlled, over managed and scapegoated should something go wrong.

Focusing on organisational culture is often thought of as the magic bullet.  However it is the immediate line manager who needs to be supported, guided and coached in best practice on how they manage their staff 

edited on Nov 2, 2018 by Isabel DHSC

Dr Helen McIlveen 10 months ago

I absolutely agree with your sentiments, but it takes me to another important aspect of leadership. There is concern at the aging workforce and the loss of highly experienced staff in great numbers over the next few years. We need to invest in a leadership culture which is drawing down those skills and experience before these people are lost from the system. Why do we not make it worth their while for these people to stay? Could we create a third wave vision for the NHS , the older person highly valued and encouraged to stay longer, creating worthwhile roles for them and a conduit for passing on their wisdom. Taking away their huge burdens of responsibility of managing services or teams, often the reason for retiring or leaving, and allowing them to be more creative with re-investment of their knowledge, skills and experience; coaching and supporting staff, contributing to management and board level decision-making and applying more objectivity and reason brought from experience working at coal-face services. The NHS and Social Services culture could only be enriched if it embedded such a change and grabbed hold of what it is rapidly losing and not able to replace.

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Morganth 10 months ago

The Third Wave vision is a good one and is being used at present through early retirement. Staff retire early, then come back, usually part time, on similar high wages, to almost the same role which is good for the services to have such experienced staff members available but not good for the younger staff. I have experienced this with other teams, where staff in their late 40's early 50's leave the NHS because there are no promotion prospects for them due to the prime roles being taken up with back to work retirees. Come back to work by all means, after retirement, it is good for the patients, the employee themselves and good for the employer, but not into the high flying roles, leave them for the younger workers to work towards.

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Matt Hancock 10 months ago

After only a couple of months in this job, it’s clear to me that effective leadership is vital in encouraging a culture where line managers are free to line manage well.

And it’s important to say that, when we talk about leadership, it doesn’t just mean the leaders at the very top. An effective health and care sector needs effective management and leadership at all levels. To develop an excellent workforce, we need to be supporting all management staff to support their teams. And that is about culture, but it’s also about finding leaders who can innovate, listen to their staff, and create an environment where people all the way down the chain can flourish.

I’m really interested in how and where people are getting this right and would love to hear more from you about it.

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RCEM SWPC Chair 9 months ago

Dear Matt,

Thank you so much for responding.

Just a bit of background, my name is Sunil and I chair the Sustainable Working Practices Committee at the Royal College of Emergency Medicine. At the moment the committee are fully focused on producing a set of guidance for Emergency Medicine (EM) which seeks to help challenged organisations to engage and retain their EM staff.

We have set out our stall in our first document EMPower. The twitter post is here

Our next document is EMPower Manager. This is going to be a practical guide for EM clinical and non clinical managers based on what we feel is the best approach for individuals managing their EM workforce. It will be part coaching guide, part resource library.

I hope this provides a bit of context. We hope to have the new guidance done by March next year in time for job planning and ahead of planning for the main August induction of junior doctors.

Anything you can do to instill a leadership and management culture which balances the needs of the service, of teams and of individuals in a positive, inclusive and supportive way would be amazing.

Thank you again


Dr Sunil Dasan

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Morganth 9 months ago

I think there needs to be a change in the general culture of the NHS. Staff who are brilliant at their work, are not necessarily the best managers. I work in IT and the management structure here depends on the competencies of the IT side, not the leadership qualities. But if you want to have the best IT staff, you have to pay them, and therefore to do that they have to be managers. And the best IT staff do not have the time or inclination to try to be a good manager. They want to work on the iT side of things, which I quite understand

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