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Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, responded to the Secretary of State for Health and Social Care's speech at the King's Fund Annual Conference

“Leading a front line healthcare organisation is one of the most challenging roles in any sector – it can be incredibly rewarding but these are highly complex operations, where life and death decisions are made every day often in a highly political environment.

“These are not careers for the faint hearted. But the Secretary of State is right – we need the best people to take on these roles and that means casting our net widely. Experience and perspective from other industries can be incredibly valuable and good leadership is not sector specific. He is also right to say we have a huge resource in our clinicians, many of whom have exceptional leadership skills which can be nurtured and developed.

“We do have a crisis at the top. Not enough talented and committed individuals are willing to take on these roles and we need to acknowledge that and question why.

“At least part of the answer is the culture of the service which is too quick to blame, too slow to support. And some of that comes from the top. Of course leaders of this public service need to be held to account for performance but more than ever today we need a different approach, in which the centre issues fewer commands, interferes less, bombards less with requests for information and instead provides encouragement and support beyond the favoured few. And setting that new tone is a task for the Secretary of State and the national bodies, as well as what NHS organisations themselves need to do.

“We also welcome the recognition of the need for greater diversity among NHS leaders especially in the middle and senior ranks. This is not just about being fair, it is about not wasting a precious resource – in our workforce and beyond there are many from all sorts of background who should be encouraged and supported to become the NHS leaders of tomorrow.

“And to be blunt there is also the willingness of the system to invest in staff. There have been cuts in continuing professional development and workforce development funding. That has undoubtedly had an impact on the breadth and volume of training and development for staff."

Related information:

• Good NHS leadership starts with culture change
• Matt Hancock: NHS needs to widen search for best leaders