Code of practice for nurse managers in development
A formal set of standards for NHS managers, including nurses in leadership positions, is being created ahead of the potential future regulation of this senior staff group.
The NHS Management and Leadership Framework is currently in development, with the first stages set to be completed by the end of the year, Nursing Times understands.
“If we want a well-run NHS, we must support those who run it”
Amanda Pritchard
This framework will feature, among other components, a code of practice and set of competencies expected from clinical and non-clinical managers of all levels of seniority in the NHS and social care.
A tender document, published on the government website, appears to show the details of a contract for the project made between NHS England and the Chartered Management Institute (CMI), the former being the ‘contracting authority’ and the latter being the ‘supplier’, to create the NHS Management and Leadership Framework.
According to the document, a consortium led by the CMI and involving nursing charity the Florence Nightingale Foundation (FNF) has been, since May 2024, working on creating the framework’s key components.
The first is a code of practice for all NHS, as well as social care, managers at all levels. This will be a “clear and simple” document outlining how managers and leaders should behave.
Second is a set of competencies and standards for managers.
The standards will, as per recommendations of the 2022 Messenger Review of health and social care leadership, cover “operational, strategic management and… behavioural components and responsibilities”, and include “inclusive leadership”.
The NHS document stated that the competencies will “underpin” the standards.
Lastly, the framework will feature a “curricula”, linked to the code of practice, which will help standardise leadership and improve the quality of training and development.
The CMI-led consortium, according to the document, features FNF, the Faculty of Medical Leadership and Management, and consultancy firm KPMG.
Consortium members will identify and engage with key stakeholders, including nurse and medical managers and non-clinical leaders. From there, the components will be drafted and, eventually, signed off by NHS England.
The document suggested that the first part of the framework, the code of practice, is due by 31 October 2024.
The standards and competencies are then set to be completed by 20 December 2024, and the rest will be finished by the contract end date of 31 May 2025.
A timeline image on the document states that, by this point, the “final sign off of all deliverables” is expected, but that the “ultimate approval for launch” lies with NHS England executives.
The framework itself is not the long-awaited regulation of NHS managers that the government promised to introduce in its election manifesto in the wake of the Lucy Letby case.
However, it could lay the foundations and principles on which the health service creates a future professional register for managers.
The document stated: “Although it is unclear what regulation may look like, or who would hold responsibility for its enforcement, the development of the Management and Leadership framework must be developed with future regulation in mind.
“Irrespective of any future regulation, this work is expected to be a critical step in defining management and leadership standards and development curriculum for the NHS.”
The tender document for the framework was made public in August, around a month before the start of the Thirlwall Inquiry.
There, legal counsel to the Department of Health and Social Care (DHSC) suggested that different models regulation of managers were currently being explored.
Amanda Pritchard
Meanwhile, in June, NHS England chief executive Amanda Pritchard hinted at the creation of the framework.
Ms Pritchard said, in her keynote speech to the NHS Confed Expo 2024, that the health service needed “well-trained, well-supported” managers.
She said, currently, most of its leaders got to their position due to excellence in their field, not because they were trained and practiced managers.
To this end, Ms Pritchard said that, following the Messenger Review and also the 2019 Kark Review, which reviewed the effectiveness of the NHS ‘fit and proper person test’, a framework – featuring a code of practice and standards – would be created.
She said, in her speech: “If we want a well-run NHS, we must support those who run it.
“If we want leaders to be accountable – which we do – then we must give them the tools they need to do their jobs well.”
NHS England has been contacted for further information about the status of the framework.
