More than a manager

 Interim managers have been working in the public sector for at least 15 years and current estimates suggest there are between 1,500 and 2,000 currently employed. Our first national survey of the industry shows public services now account for one third of all interim assignments. Of these, local government accounts for 37 per cent, health 27 per cent, and central government 14 per cent. The Department of Health alone has around 200 interim managers currently in place working on a variety of change programmes and new projects.

The health service was slower than other public sector organisations to pick up on using interims. Initially, the experience brought in from the private sector was introduced through permanent placements. As these outside influencers proved their capability, it paved the way for the NHS to take on interims.

There are two major factors driving the uptake of interims in the NHS. One is the extent of the change being implemented and the other is the speed at which the change is needed. Together these make for shortfalls in capacity and capability. The first full wave of interims in the NHS came on stream about four years ago and we are now seeing a significant body of interim managers with three or four successful health service assignments under their belt. More recently, take-up has been boosted by the serious financial deficits facing health service departments over the last nine months and the serious problems surrounding the national computer programme, Connecting for Health. It’s widely acknowledged that this major project is significantly behind schedule and the way organisations are catching up is to bring in expert external resources. Huge numbers of IT interims are working on Connecting for Health.

But we often find that while executives initially set out to bring in private sector experience, they often default to take a public sector candidate. I think it’s a comfort factor. However, where I see this significantly changing is in the health service, particularly around the areas of commissioning where the skills do not exist and never have existed. The best way to deliver these projects is to bring additional resources from outside.

Consultancy vs Interim
Historically, the public sector may have turned to consultants to provide the solution. But there has been significant exposure on cost and lack of delivery from consultants and we are seeing a general dampening of enthusiasm towards consulting firms. It’s worth looking at the distinctions between the two professional groups. Interims managers are experienced executives who become part of the senior management team and take hands-on ownership of the assignment. Consultants give advice on strategy, process and action, but the client implements the change. We sum it up as interims work from the inside out, consultants work from the outside in.

Managing changes
There are large numbers of extremely talented people working in the health service. But some of them are suffering from change fatigue. They are punch drunk with the extent and speed of the changes that are being demanded. It will be particularly interesting to watch how the NHS manages the most recent change programmes - the Strategic Health Authorities reduced this summer from 28 to 10 and the autumn reorganisation of Primary Care Trusts down from 303 to 152.

Health service departments considering hiring an interim manager can get help and advice from our website There you will also find a list of our members. All have been vetted to ensure they comply with a clear set of standards and professionalism and have signed up to our professional code of practice. The code covers issues including client confidentiality, professional values, introduction fees, equal opportunities, fair trading policy and competition. Not all our members operate in the public sector and organisations need to be comfortable that the provider they choose understands their department, their environment and the current issues and climate that they will be operating in.

Introducing external influence through an interim can bring clarity to the department and the impact is palpable and immediate. Interims can guide, direct and draw out the capabilities that already exist, enabling the organisation to make the change happen. Given the seniority of the many of these interim appointments in the NHS, it’s not about the individual contributor as the interim, it’s about mustering the resources that already exist in the organisation and helping them achieve the change that they haven’t been able to realise themselves.

Further information:
The Interim Management Association,
15 Welbeck Street, London W1G 9XT
Tel: 020 7009 2194

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