Health service manager

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, and your key responsibility will be to 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 varies 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:

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

Find out more about the roles in health service management.

Responsibilities

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.

Salary

• The starting salary for the NHS Graduate Management Training Scheme 2024 intake is £27,701 (plus the Higher Cost of Living Allowance, or HICA, where applicable), increasing to £29,832 after 12 months. Graduates also receive a fully financially supported study package and NHS pension entitlement.
• The average salary in a first NHS role on leaving the scheme is around £44,000, depending on your area of work.
• At the most senior levels of management (for example director or chief executive), your salary can be more than £100,000.

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

NHS employees may receive a range of additional benefits including interest-free season ticket loans and staff discounts on a range of products, services and leisure activities.

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 challenging situations. Because of the wide public interest in health matters, the management and effectiveness of health services will often come under public scrutiny.
• While implementing new budgets, systems and policies, you may occasionally encounter lobbying from representatives of the medical professions.

Qualifications

Graduates with a minimum 2:2 degree in any subject can apply to the NHS Graduate Management Training Scheme. This fast-track leadership development programme prepares you for a senior role in health service management.

The following subjects may be particularly suitable:

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

You can also apply if you have a postgraduate qualification (MBA, Masters, PhD) or a health or management-related degree-level equivalent qualification.

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

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

As you can only apply to one specialism per intake, research each area and think carefully about which specialism is right for you.

Competition for places is fierce and you'll need to complete an online application followed by a series of online assessments. If successful, you'll then be invited to take part in a half-day virtual assessment.

If you're particularly interested in health policy, the Department of Health and Social Care runs a three-year Health Policy Fast Track Scheme. You'll need a 2:1 degree minimum in any subject to apply to this scheme.

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

• NHS Scotland Management Training Scheme
• NHS Wales General Management Graduate Programme

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, equivalent vocational qualification or the Level 6 Chartered Manager Degree Apprenticeship (CMDA).

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 at various levels in areas such as management, business administration and HR, and IT.

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

Skills

You'll need to have:

• 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 the ability to identify with the common values and aims of the NHS (or private sector organisation)
• the ability to handle responsibility and to delegate effectively
• 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 you don't need any specific work experience to get 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. This experience will be particularly useful at the interview stage as you will be able to talk about and reflect on your experiences.

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.

For free mentoring resources and experiences designed to support aspiring healthcare and legal professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

Find out more about the different kinds of work experience and internships that are available.

Employers

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

Opportunities are also available in the private healthcare sector.

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

Look for job vacancies at:

• HSJ Jobs
• NHS Jobs
• NHSScotland Jobs
• websites of private healthcare providers.

Many NHS Authorities and Trusts also have their own vacancy bulletins.

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 placements 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 across a particular region.

The NHS Leadership Academy provides a range of management programmes and resources for those who are interested in leadership or are already in a leadership role and want to further develop their management skills.

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 Health and Social Care Management (IHSCM) is also useful as this provides you with access to a range of benefits, including:

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

To become a full member of the IHSCM and use the initials MIHSCM after your name, you will need two years demonstrable management experience within health or social care.

Leadership and management qualifications are offered by a range of organisations such as the ILM and the CMI.

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 improve 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.

Flexibility and geographical mobility can help you progress your career as you can move to where the opportunities are.