The Health Foundation podcast

23: From white coat to grey suit: should more clinicians manage the NHS? – with Dr Stephen Swensen and Dr Dominique Allwood


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In meeting the huge challenges facing the NHS, technology is often looked to as the great hope. Yet studies suggest good management is a more active ingredient for success. 

Over the years numerous reports have called for more clinicians to manage the NHS, highlighting their deep knowledge of clinical care, and insight and credibility to make effective change.  

Now, over a third of all NHS chief executives hold a clinical qualification and about a third of jobbing clinicians have part-time management roles too. But that’s still only a third, and getting trained in management is patchy and haphazard – a finding echoed in the recent Messenger Review of health and social care leadership. 

How can we support more clinicians to manage the NHS, and learn from those who already do it well? 

To discuss, our chief executive Dr Jennifer Dixon is joined by: 

  • Dr Stephen Swensen, Senior Fellow at the Institute for Healthcare Improvement. Stephen worked at the world-leading Mayo Clinic in Minnesota for three decades, overseeing the development of over 4,000 physicians and 200 leaders. 
  • Dr Dominique Allwood, Chief Medical Officer and Academic Health Science Network Deputy at UCLPartners, where her focus is on clinical engagement and management. Dominique is an experienced medical leader and an expert in quality improvement.
    Show notes
    • Management Lessons from Mayo Clinic Inside One of the World's Most Admired Service Organizations (2017) Leonard L. Berry, Kent D. Seltman
    • Mayo Clinic Strategies To Reduce Burnout: 12 Actions to Create the Ideal Workplace (2020) Stephen Swenson, Tait Shanafelt
    • Strengthening NHS management and leadership: Priorities for reform (2022) The Health Foundation
    • Leadership for a collaborative and inclusive future (2022) Sir Gordon Messenger
    • Five recommendations for strengthening NHS management and leadership (2022) The Health Foundation
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