A health service manager is responsible for the strategic, financial and day-to-day running of hospital, general practitioner (GP) or community health services.
Managers liaise with clinical and non-clinical staff and other partner organisations, while considering the demands of political policy and local circumstances.
There is a huge range of managerial roles within health services, including those in:
- human resources (HR);
- clinical management;
- staff management;
- project management and procurement;
- information management;
- facilities management;
- operational management.
Most jobs are in National Health Service (NHS) settings, with opportunities also increasing in the private healthcare sector.
Managers in both the NHS and the private sector are required to manage the cost, delivery and quality of healthcare services.
Depending on the department and the specific nature of the role, tasks may involve:
- managing clinical, professional, clerical and administrative staff;
- managing the recruitment, selection, appraisal and development of staff;
- overseeing the day-to-day management of an organisation, a specific unit or a service area;
- implementing new policies and directives;
- liaising and negotiating with medical and non-medical staff internally (often at the most senior levels) and with people in external organisations, e.g. social services, voluntary groups or the private sector;
- gathering and analysing data and using it to plan and manage both projects and systems;
- working towards ensuring quality and value for money for patients;
- extrapolating data for quality assurance and monitoring purposes;
- setting budgets and maintaining finances within tight constraints;
- planning and implementing strategic changes to improve service delivery;
- attending meetings, writing reports and delivering presentations to a variety of audiences; clinical governance and audit;
- sitting on committees and representing the views of departments and teams;
- handling communications and corporate affairs;
- managing premises, catering, cleaning, portering and security (often via sub-contractors);
- purchasing equipment and supplies and organising stores;
- using computers to manage information and financial data and to analyse and measure performance;
- supporting ICT systems and planning new provision and development, sometimes for major projects.
- The current starting salary for the NHS Graduate Management Training Scheme is approximately £23,000, excluding London allowance. Current NHS employees have the opportunity of capped-salary protection (conditions apply). Graduates also receive study leave and NHS pension entitlement. Private sector management training schemes tend to pay slightly more.
- First-post salary varies according to the position, but the average within the NHS is between £27,000 and £37,000. Typical NHS salaries start at Band 6 or 7 (£26,041 to £31,072) according top; Agenda for Change (AfC) Pay Rates.
- The most senior roles within the NHS rise to band 9 (£77,850 to £98,453). Salaries in the private sector may be slightly higher.
For details of NHS pay structures, performance review, etc, see the Agenda for Change.
Income figures are intended as a guide only.
Working hours are often 9am to 5pm but, in certain roles and specialist areas, shifts may be required. A flexible attitude is needed and extra hours should be expected during certain periods. Managers may sometimes be on-call during evenings or weekends.
The NHS believes strongly in a good work-life balance for their managers and encourages flexible approaches to working. There are often opportunities for managers to work part time or to job-share. Some trusts provide career break options.
What to expect
- Work is usually office-based, but in large organisations managers may spend time in different parts of the site.
- NHS organisations often have well-developed equal opportunities policies. Women make up nearly 80% of the total NHS workforce, although there are more men than women in senior positions.
- NHS vacancies are available across the UK. Larger hospital trusts tend to be located in more densely populated areas, while smaller, community-based practices can be found across most locations.
- Dress code varies, but most managers are expected to dress smartly.
- Managers are expected to implement new policies, often in adverse situations. The rapid rate of change and demands of new government or local initiatives can lead to stressful periods in some roles. Because of the wide public interest in health matters, the management and effectiveness of health services will often come under public scrutiny.
- In the course of implementing new budgets, systems and policies, managers may also occasionally encounter lobbying from representatives of the medical professions.
- Travel may be required in some roles.
The NHS Graduate Management Training Scheme is open to internal and external graduates of all disciplines. In England, there are four specialist areas:
- general management;
- human resource management;
- health informatics management;
- finance management.
Each requires a minimum 2:2 degree in any subject or an alternative equivalent health or management-related qualification. A full list of accepted qualifications is available on the same website.
In England, applications open in October of the year before the scheme begins and candidates need to apply by early December of that year. Following online testing, an interview and a leadership challenge assessment, offers of employment are made in April or May. The graduate scheme starts in September.
Candidates for schemes in Scotland, Wales and Northern Ireland should check recruitment schedules and procedures by contacting the:
- NHS Scotland Management Training Scheme
- NHS Wales Graduate Management Scheme
- Health and Social Care in Northern Ireland: General Management Training Scheme
Entry is very competitive. England has the largest NHS graduate programme and recruiting figures vary depending on requirements.
Some private sector providers also have their own graduate management training schemes. For more information, check individual websites.
Entry and progression are also possible (with an appropriate degree and background) into specialist areas, such as property management, human resources (HR), IT and information management.
Some staff with backgrounds in areas other than management can progress into management by gaining qualifications and experience. It is also fairly common for medical professionals, such as nurses, doctors and therapists, to move into general management roles, particularly those involving clinical services. Unlike the Graduate Management Training Scheme, this is not a formalised process, but works on an individual basis. Others with management experience who are working outside the NHS may also apply for management positions.
People with an HND qualification can enter management roles within the NHS, although they are not normally eligible to enter any of the graduate training schemes. Entrants can also join the NHS at administrator level with GCSEs or equivalent qualifications and work their way up, gaining promotion through junior management roles.
You will need to show evidence of the following:
- communication skills, both oral and written, as you will need to communicate effectively with a variety of individuals and professional groups;
- listening skills and the ability to negotiate with and persuade others;
- motivation, interest in the sector and identification with the common values and aims of the NHS;
- patient/customer focus;
- an emphasis on achievement of results and both the energy and enthusiasm to ensure that objectives are met;
- initiative and leadership skills and the ability to gain the trust, commitment and cooperation of others;
- teamworking skills and the ability to collaborate effectively with others;
- the ability to grasp clinical issues, including the understanding of treatments and evolving medical technologies;
- organisational skills to deal with a diverse range of challenges;
- flexible and creative problem-solving ability;
- decision-making ability, particularly in sensitive areas such as the allocation of funds or organising staff levels for a unit;
- numeracy and the ability to analyse complex issues, absorb information, understand data and identify underlying trends;
- adaptability and readiness to challenge existing practices and find alternatives;
- the ability to cope with pressure, stress and ongoing change in the form of new medical technology and treatments, policies, practices and reorganisation.
The National Health Service (NHS) is the largest employer in Europe, with over 1.3 million staff. In the short term, the number of administration and managerial staff may be reduced slightly due to efficiency savings and planned structural changes across the sector.
Managers may work in one of the approximately 500 NHS organisations in England alone, in one of many NHS authorities or trusts. For more information, see:
The private healthcare sector is continuing to expand. To reflect this, some providers have now developed their own graduate management training schemes. Check individual websites for details.
To illustrate the relative size of the private sector, BMI Healthcare (part of the General Healthcare Group (GHG), the largest provider of independent healthcare in the UK) now operates 60 private hospitals. Recruitment is open to both new entrants to the sector and to those with NHS experience. Some providers, such as BMI, actively encourage speculative applications from those interested in a career with them.
Look for job vacancies at:
- NHS Jobs
- NHS Authorities and Trusts - links to all UK trusts, which have their own vacancy bulletins (useful for junior posts).
- Guardian Jobs
- Health Service Journal
General, health informatics and human resources (HR) management trainees have two years of intensive training. Financial management trainees are allowed up to two and a half years in order to complete professional qualifications.
National Health Service (NHS) training for all schemes combines work experience with formal management training, projects and attachments. All include an orientation programme introducing trainees to the NHS. The training scheme is followed by a further two years of support. Individual learning accounts are provided to enable new managers to top up their qualifications or to carry out other developmental opportunities.
All management trainees work towards a postgraduate certificate in healthcare leadership. General management trainees then work towards a diploma in healthcare leadership. Graduates studying the HR management thread work towards a postgraduate diploma in human resources and graduate Chartered Institute of Personnel and Development (CIPD) status. Health informatics management trainees work towards a postgraduate diploma in health informatics.
Training in the financial scheme lasts slightly longer and combines work-based placements with studying for a professional accounting qualification with the Chartered Institute of Public Finance & Accountancy (CIPFA).
Managers not on graduate schemes can take advantage of many other in-service management training programmes. Within most areas of the NHS, there is a culture of continuing professional development (CPD). More information is available from the Institute of Healthcare Management (IHM).
See the websites of private healthcare providers for details of their training expectations and provision.
Trainees on the graduate training schemes aren't guaranteed employment after completion of training but are supported into a first post. A range of opportunities are available within NHS management upon completion of training, including roles in community or hospital settings, and in policy development and operational or strategic planning.
Managers coming through the graduate trainee schemes will usually be expected to gain rapid promotion, largely subject to achievement and performance in initial roles. A degree of mobility and flexibility is helpful to enhance development prospects. Many trainees get their initial job through their final placement.
It is possible for highly successful managers to move into director or chief executive roles within ten years of completing their training.
For those entering management from internal administrative or other roles, qualifications in management and/or relevant specialist areas, such as facilities management, human resources (HR) or finance, would assist promotion. Management training is also offered by the IHM. Specific higher level management qualifications, such as a Masters in Business Administration (MBA), a Diploma in Management Studies (DMS) or S/NVQ Levels 4 and 5, would also greatly assist progression.
A good understanding of health policy and trends in government thinking can assist career development. In recent years, the NHS has had to deal with changes of government and many new policies and initiatives in funding, organisation, approaches to management, and patient care, along with a demand for increasing accountability, efficiency and measurement of performance. These require managers to adapt successfully and implement changes quickly.