Lack of parity of esteem ‘remains a blight’ on effective collaboration

Health and social care secretary of state Sajid Javid

The cultural environment across health and social care tends to be ‘unfriendly’ to collaborative leadership that is needed to deliver services across the sectors.

An independent review of health and adult social care leadership, led by General Sir Gordon Messenger and Dame Linda Pollard, heard ‘too frequently’ that poor inter-personal behaviours and attitudes were experienced in the workplace.

Acceptance of discrimination, bullying, blame cultures and responsibility avoidance had become normalised in certain parts of the system.

‘This exists at the micro-level, in individual workplaces, and across sectors, where the enduring lack of parity of esteem, conditions and status between healthcare and social care remains a blight on effective collaborative working,’ said the report, Leadership for a collaborative and inclusive future.

The review team identified a strong appetite among both local government and independent providers for collective, pan-sector leadership and management development, and strongly supported the need for greater parity of investment.

It found social care needed mechanisms to build and reinforce horizontal, collaborative decision-making within and between individual organisations. It also encouraged teams and organisations in to set year-on-year goals for improvement, such as increasing the representation of under-represented groups in training, in development opportunities, and in senior roles.

It found a positive cultural legacy of the pandemic was that it had encouraged innovation, magnified the value of teamwork across health and social care, and strengthened a workforce sense of community through common experience and shared hardship.

This changing dynamic needed to be capitalised upon, according to review, which engaged with more than 1,000 stakeholders including patients and users of social care services, GPs, allied health professionals, clinicians, managers, care workers, researchers, clinical fellows, chief executives, chairs and MPs.

‘The findings in this report are stark, it shows examples of great leadership but also where we need to urgently improve. We must only accept the highest standards in health and care – culture and leadership can be the difference between life and death,’ said health and social care secretary Sajid Javid.

Recommendations included an induction for new joiners to instil core values across health and social care; a mid-career programme for managers; stronger action on equality and diversity to ensure inclusive leadership at all levels; and greater incentives for talent to move into leadership roles in areas facing the greatest challenges.

General Messenger said: ‘The best organisations are those which invest in their people to unlock their potential, foster leadership and accountability at every level, with good leadership running through the entire workforce. This must be the goal and I believe our recommendations have the potential to transform health and social care leadership and management to that end.’

Independent Care Group chair Mike Padgham said: ‘Whilst leadership is vital, what we need to see is investment targeted at the workforce, which is going through its worst recruitment crisis in more than 30 years. We need to better recognise, respect and reward the workforce first by properly funding a minimum wage and a career structure for staff.’