Oct 3

“The NHS has many strong leaders. It needs more” – analysing the Darzi review

We’ve written quite a lot previously about the need to invest more in NHS managers. In fact, with excellent timing, our most recent blog focused on this very topic.

But it’s always reassuring when this is backed up by expert opinion.

Following on from the landmark Messenger Review in 2022, we recently saw the publication of the wide-ranging Darzi review, an independent investigation into the NHS commissioned by the new Labour government when they came to power.

Here, we do a deep dive into what the report said from an L&D perspective. At 163 pages, we’ve been through all the detail, so you don’t have to!  

What is the Darzi review? 

First, a very quick explainer about the Darzi review. Carried out by Prof Lord Ara Darzi, a world-renowned cancer surgeon, independent peer and former health minister, it was designed to be a ‘rapid investigation of the state of the NHS, assessing patient access, quality of care and the overall performance of the health system’.

You can check out the report in full here, if you fancy.

In short, Darzi’s review found that the NHS was in critical condition but still showing strong vital signs. Broken but not beaten. It found that the NHS workforce, ground down by Covid, targets and incessant pressures, need to be re-energised to increase productivity.  

What did it say about NHS managers? 

Admittedly, the space given over to NHS managers in the review was relatively limited. But you’ll be pleased to know that the importance of investing in managers to build a strong healthcare system in the future was made abundantly clear.

A popular criticism in the media and elsewhere is that the NHS has too many managers operating in a bloated, bureaucratic way. We know that not to be the case, and Darzi made the same point in his review.

He said the ‘problem is not too many managers but too few with the right skills and capabilities’. Hear, hear.

The underinvestment in training means too many managers are thrown in at the deep end without the necessary L&D support. Learning on the job has become commonplace. This isn’t always a bad thing, of course. Picking up skills and knowledge from those around you is an important part of any job, but it also needs to be underpinned by dedicated skills and knowledge training.

Promisingly, then, Darzi spoke of the ‘need to invest in developing managerial talent and creating the conditions for success’.

Facilitating the next generation 

Yes, the NHS has plenty of strong and capable leaders already, but – given the challenges faced – we all know it needs more.

It’s something Darzi made apparent in his report, the need to build on the strong leadership that exists presently. Fortunately, as he acknowledged, ‘leadership is not a quality that is simply endowed; it is a skill that can be learned.’

He added: “For the NHS to have more and better leaders, it needs to continue to invest in them.”

As we mentioned before, there is often the opinion, in media circles and elsewhere, that management in the NHS are a hindrance to progress rather than the instigator of it. No doubt you’ve heard those arguments a fair few times in the past!

But it’s not the reality. Far from it. The truth of the matter is that good management has a vital role in healthcare. It makes everything tick. It puts in place the structures, processes and operational knowhow that is vital to build strong, well-functioning teams.

“It exists to ensure that the maximum healthcare value is created with the resources that are available," Darzi says, putting the nail on the head. 

Will things change? 

We’ll have to wait and see what Kier Starmer, Wes Streeting and the government do in terms of bringing forward the recommendations of the Darzi review. It’ll be interesting to see how these tie in with the long-term workforce plan and the Messenger Review, too.

Starmer and his team have spoken of the importance of reform over more and more funding, which suggests that the NHS won’t necessarily be getting more money in the upcoming Budget at the end of October.


When it comes to allocating funding within NHS Trusts, leadership teams might feel like L&D is an area that is less important than others.


But it’s actually the exact opposite of that, for all the reasons mentioned above. To help your team to thrive, improving productivity and performance, they need the tools with which to do that. It’s all about sowing seeds for success, upskilling the leaders of the future.


Let’s look back on the words
Amanda Pritchard, CEO of NHS England, spoke as recently as November last year, where she said training and development of managers is ‘inadequate and patchy’ and argued that the NHS needed to ‘bake in’ an expectation of ongoing training and development in order to improve management and leadership, as well as attracting new talent.


The good news? You can get ahead of the game by investing in your team’s future. At evolve learning, we have the platform to facilitate just that!


Why not get in touch with us today to find out more.