Health service managers are responsible for the financial, strategic and daily operations of running a hospital, GP practice or community health service

As a health service manager, you'll work in either an NHS setting or the private healthcare sector. In this role, you'll manage the cost, delivery and quality of healthcare services. You'll work with both clinical and non-clinical staff, as well as other partner organisations, while considering the demands of political policy and local circumstances.

The work you do can vary widely depending on the area you specialise in. For example, you could manage an ambulance service, GP practice or community health service team, be responsible for a division of staff and a multi-million pound budget in a hospital trust, or manage mental health services across many sites.

Types of health service manager work

A range of managerial roles exists within health services across many areas, including:

  • patient consultation
  • people management
  • performance and quality management
  • project management
  • purchasing and contract management
  • resource and budget management
  • strategic management
  • clinical practice, working alongside clinician colleagues.


As a health service manager, you'll need to:

  • oversee the day-to-day operations of a healthcare organisation, a specific unit or a service area
  • gather and analyse data, using it to plan and manage both projects and systems
  • manage clinical, professional, clerical and administrative staff
  • implement new policies and directives
  • manage the recruitment, selection, appraisal and development of staff
  • liaise and negotiate with medical and non-medical staff (often at the most senior levels) and with people in external organisations, e.g. social services, voluntary groups or the private sector
  • work towards ensuring quality and value for money for patients
  • implement policies and ensure government guidelines are followed
  • extrapolate data for quality assurance and monitoring purposes
  • set budgets and maintain finances within tight constraints
  • manage contracts and service delivery agreements
  • plan and implement strategic changes to improve service delivery
  • attend meetings, write reports and deliver presentations
  • organise clinical governance and audit
  • sit on committees and represent the views of departments and teams
  • handle communications and corporate affairs
  • manage premises, catering, cleaning, portering and security (often via sub-contractors)
  • buy equipment and supplies and organise stores
  • use computers to manage information and financial data and to analyse and measure performance
  • support IT systems and plan new provision and development, sometimes for major projects.


  • The starting salary for the NHS Graduate Management Training Scheme 2020 intake is £24,628 (plus the Higher Cost of Living Allowance, or HICA, where applicable). Graduates also receive study leave and NHS pension entitlement.
  • The average salary on leaving the scheme varies between £27,000 and £37,000, depending on your area of work.
  • At the most senior levels of management (for example director or chief executive), your salary can range from £90,000 to in excess of £100,000.

For details of salary scales within the NHS, see Agenda for change (AfC) pay rates.

NHS employees receive a range of additional benefits including interest-free season ticket loans, discounts on sports club membership and other products and services.

Salaries for private-sector management schemes and health service manager roles may vary. Income figures are intended as a guide only.

Working hours

You'll typically work 9am to 5pm, although in certain roles and specialist areas you may need to work shifts. As a manager you may be on-call during evenings or weekends and you should expect to work extra hours during certain periods.

There are often opportunities to work part time or to job share.

What to expect

  • Work is usually office-based, although you may need to spend time in different parts of the site (or on a different site).
  • Vacancies are available across the UK. Larger hospital trusts tend to be located in cities or large towns, while smaller, community-based practices can be found across most locations.
  • The role can be challenging as managers are expected to implement new policies, often in adverse situations. 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, you may occasionally encounter lobbying from representatives of the medical professions.


As a graduate with a minimum 2:2 degree (or equivalent) you can apply to the fast-track NHS Graduate Management Training Scheme.

Any subject is acceptable, though the following may be particularly suitable:

  • accountancy
  • business
  • human resource management
  • information technology
  • maths
  • psychology
  • purchasing and supply chain management
  • social studies
  • sociology.

In England, there are six specialist areas on the graduate scheme:

  • general management
  • finance
  • health analysis
  • health informatics
  • human resources
  • policy and strategy.

The application process typically takes place between mid-October and mid-December. As you can only apply to one specialism per intake, think carefully about which specialism is right for you. Use the NHS's match-me tool to check whether the scheme is right for you.

Competition for places is fierce and you'll need to complete an online application followed by a series of online tests. If successful, you'll then have interviews and an assessment centre.

Separate graduate management schemes are run in Scotland, Wales and Northern Ireland. See individual websites for specific information and key dates:

Some private-sector providers have their own graduate management training schemes. Check individual websites for more information.

You can also apply directly for junior health service management roles with a relevant degree or equivalent vocational qualifications and background. Although not essential, it may be useful to take a postgraduate degree in management.

It's possible to join at administrator level with GCSEs, or equivalent qualifications, and work your way up, gaining promotion through junior management roles. NHS apprenticeships are also available in areas such as management, IT and business administration and HR.

Experienced staff from other backgrounds, such as nurses, doctors and therapists, can move into general management roles. You can also move into healthcare services management if you've got management experience from other sectors.


You'll need to have:

  • good verbal and written communication skills - for working effectively with a variety of individuals and professional groups
  • listening skills and the ability to both cooperate and negotiate with others
  • motivation and an interest in the sector and be able to identify with the common values and aims of the NHS (or private sector organisation)
  • the ability to delegate effectively
  • the capacity to handle responsibility
  • the ability to manage resources effectively
  • 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 and ongoing change in the form of new medical technology and treatments, policies, practices and reorganisation.

Work experience

Although it's not essential to have work experience to land a place on the NHS Graduate Management Training Scheme, you'll need knowledge of the current issues and challenges facing the NHS. Work experience, a work placement or voluntary work in a health service environment will help you gain an insight into the sector.

To work as a health service manager in the NHS or private sector, you'll usually need experience in the area you want to work in as well as an understanding of the health sector.


Health service managers are employed by the NHS in hospitals, general practitioner (GP) surgeries and community health services.

There are also opportunities in the private healthcare sector. BMI Healthcare, for example, is the UK's largest private hospital group with 59 private hospitals throughout the UK.

There are also health service manager opportunities in the armed forces.

Look for job vacancies at:

Professional development

If you're on the NHS Graduate Management Training Scheme, you'll be employed on a fixed-term contract and receive a salary. The scheme lasts for two years (30 months for the finance specialism) and includes a combination of structured work experience and formal management training, projects and attachments.

As part of the training, you'll complete a professional or postgraduate qualification, depending on your specialism. Throughout your training you'll receive mentoring and support from experienced managers and will work in diverse areas of the NHS and in different parts of the country.

If you're not on a graduate management scheme, you may still have access to other in-service management training programmes. Continuing professional development (CPD) is important, and as you progress you're likely to need a professional qualification (if you don't already one) from a relevant body, for example the Chartered Institute of Personnel and Development if you're working in HR. You may also need an MBA (Master of Business Administration).

Membership of the Institute of Healthcare Management (IHM) is also useful as this provides you with access to a range of benefits, including:

  • events, surveys and toolkits
  • news and research
  • online training and development modules across a range of topics
  • mentors and coaching from industry experts.

With experience and a recognised professional or managerial qualification, you can become a full member of the IHM and use the initials MIHM after your name.

Career prospects

Although you're not guaranteed a job after completing the NHS Graduate Management Training Scheme, you are helped to secure your first management post. The opportunities available will depend on your specialism and you can work in a community or hospital setting, and in policy development and operational or strategic planning.

Leadership responsibility starts early and your career should advance quickly. It's possible to move into director or chief executive roles within ten years of completing your training.

If you've entered directly into a junior management role, or have moved up from an administrative role into junior management, you can enhance your career prospects by taking professional qualifications in management and/or relevant specialist areas such as facilities management, human resources (HR) or finance. These are particularly important for jobs at the most senior level.

In general, flexibility and geographical mobility can help you progress your career as you can move to where the opportunities are.

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