Responding to a Policy Exchange report into NHS management and leadership, NHS Confederation chief executive Matthew Taylor said:

“This is a detailed and considered report with some useful recommendations, but the last thing the NHS needs right now is the kind of top-down reorganisation that it recommends.

“As Lord Darzi concluded in his investigation into the NHS last week, the structural reforms to the NHS led by the Coalition Government in 2012 were a ‘calamity’ and took years to unravel.

“We agree that more work is needed to clarify roles and accountabilities and to ensure we get the right balance of management resources in different parts of the NHS. But that needs to stop short of major structural changes – this would only serve to distract NHS leaders from the most pressing challenges that need to be prioritised.

“Policy Exchange acknowledge that the NHS is under-managed, albeit by less than the 2% figure that independent academics have reported. As Lord Darzi’s report concluded, the NHS’ managerial capacity was ‘degraded’ following the 2012 reforms and there continue to be ongoing reductions in management spend and headcount numbers. NHS leaders are clear that effective management, including in operational managerial roles in front-line organisations, is critical to the NHS’ efforts to reduce waiting lists, improve outcomes for patients and deliver more efficient services.

“Some of the report’s recommendations around how we improve managerial capability and enhance the operating environment in which managers are working are welcome and are already being implemented. NHS leaders will continue to work closely with the government and its national bodies to make progress in this area.”