Does the NHS have too many managers?

Politicians and the media regularly accuse the NHS of spending money on managers rather than front-line patient care. Over many years such accusations have resulted in many people thinking that the NHS is top heavy with thousands of overpaid managers.  

Lansley’s reforms of 2012 targeted management and led to a big reduction in managers. When General Gordon Messenger was appointed in 2021 to lead a review into management in the NHS, the media hoped this would lead to a cut in the number of fat-cat NHS managers and bureaucrats so more money is spent directly on patient care.  

And again, in late 2022, when Steve Barclay appointed Patricia Hewitt to review NHS organisation, it was reported gleefully that this would ‘slash the number of bureaucrats’ and reduce ‘pen-pushers’. 


In reality, the NHS has far fewer managers than other industries. Many of the figures for the number of managers that have been suggested, such as that managers makeup almost half of the NHS workforce, have been due to (wilful) misinterpretation in the media of the figures provided by the NHS.  

Workforce data shows that the percentage of NHS employees that are doctors or nurses, is around half, but this does not mean that the rest of the NHS is composed of managers, the other half of the NHS workforce includes cleaners, porters, canteen staff, healthcare assistants, scientists, data analysts, IT staff, administration staff, and managers.  

Full story in The Lowdown, 5 July 2023