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The Health Service Journal reports findings from Hay Group research suggesting one in four NHS managers believes underperformance is tolerated in their organisation, due to deficiencies in training and cultural acceptance,which prevented issues being effectively confronted.

The  multi-disciplinary working environment and the professional ethos of the majority ofthe workforce but the following results are interesting

• 51 per cent of managers find their ability to deliver results is hampered by a lack of organisation and planning,
• 40 per cent did not think they had enough autonomy to use their initiative,
• 38 per cent felt that the risk-taking required to innovate was not rewarded,
• 24 per cent felt they were not free to experiment.

While chief executives and trust boards often felt they were closely scrutinised by the Department of Health and strategic health authorities, the organisations’ internal performance management was considered weaker.

Does this research suggest a top-down, target driven NHS is mitigating against the innovation and experimentation needed to secure the changes and improvements required to deliver world class care?

Are the management culture and support arrangements for managing poor performance simply ineffective?

What are your experiences of dealing with poor performance within the NHS?