Supporting the evolution of health services

The world is on the brink of a healthcare crisis. According to the World Health Organization, there will be a global shortage of 18 million healthcare workers by 2030. It also highlights the increasing threats of air pollution, climate change, non-communicable diseases, influenza pandemics, antimicrobial resistance, and illnesses such as dengue fever and HIV. The rising tide of mental ill-health and ageing populations place ever-greater pressures on already-stretched healthcare resources.

However, business schools are working to offer a solution. Nottingham University Business School’s Executive MBA in Healthcare is addressing management and leadership issues in the health service, in conjunction with its health service partners in the UK. We spoke to Stephen Timmons who is Professor of Health Services Management at Nottingham University Business School, Director of its sector leading Executive Healthcare MBA, and also of CHILL - the Centre for Health Innovation, Leadership and Learning. He worked as an NHS manager in London before beginning an academic career.

What role can a business school play in revolutionising healthcare management?

Healthcare organisations in which clinicians have a significant management role are more effective, safer and more efficient, meaning there is an opportunity for business schools – and in particular MBA programmes – to train clinicians, and other healthcare professionals, to lead and manage more effectively. Through applying business principles to healthcare settings, there might just be a way out of the crisis.

How did the Executive MBA Healthcare at Nottingham University Business School (NUBS) come into being?

An Executive MBA in Healthcare has been on offer at NUBS for the past decade. The programme grew out of the healthcare management expertise that already existed in the school, and the programme was co-designed with local partners from the NHS. NUBS continues to work closely with the NHS regionally and develop the MBA in response to feedback from participants who work in the healthcare sector.

There is an increasing acknowledgement that, given the complexity of the issues that the NHS and indeed, health services worldwide face, there is a pressing need for management and leadership development to address them. The creation of the NHS Leadership Academy (which offers tools, programmes and expertise to support and develop healthcare leadership that can have a positive impact on patient care) is evidence of how seriously the NHS takes this.

We drew on the best and most recent research in the field as the theoretical and conceptual foundations for the curriculum. The focus, in terms of issues, was developed in conjunction with our local NHS partners, many of whom we’ve worked with for a long time on research projects and consultancy, as well as the MBA.

The overall course structure is similar to a generalist executive MBA in terms of the pattern of delivery and the core modules. There are three healthcare-specific modules: ‘Ethics, Governance and Risk’; ‘Commissioning and Service Redesign’, and ‘Healthcare Finance and Economics’. All Executive MBA students also do a management project and so the healthcare EMBA students focus on projects relevant to their own work in healthcare.

What does an ideal programme cohort look like?

It works best when there’s a mixture of clinicians (from a variety of professions) and non-clinical managers from hospital and primary or community care. We have some students from outside the NHS, including private healthcare and the pharmaceutical industry, and it also works well when we have international students.

Why do you think it’s vital for clinicians to have management expertise?

Healthcare is complicated and expensive. Many of the main challenges facing healthcare services are as much managerial as they are clinical. Healthcare is unusual in that many clinicians are responsible for managing people and resources early in their careers. Many of our participants say they wish they had done something like an MBA when they were students or trainees. There is research evidence that shows that healthcare organisations in which clinicians have a significant management role are more effective, safer and more efficient. The course is designed to respond to the changing landscape by developing solutions to manage the competing demands of service users, commissioners and regulators.

What management issues do you see that need to be addressed in global healthcare?

The biggest one is ageing populations, and the increasing pressure that causes on resources. It’s a challenge in almost every country. Healthcare systems need to become more efficient and effective, and leadership and management play a part in achieving that. Healthcare systems need to become better employers, to recruit and retain professionals, and we need to innovate in terms of ‘who does what’ in healthcare; again, these are principally management challenges.

The programme is endorsed by the NHS Leadership Academy. How does it support the growth of the programme?

The NHS Leadership Academy saw that healthcare-focused MBAs had an important role to play in improving leadership in the NHS, and invited universities to put forward their MBA programmes for accreditation. I’m pleased to say that the NUBS Healthcare MBA was one of only seven accredited. The NHS Leadership Academy have given us some funding to enable eligible NHS staff to have a scholarship towards MBA course fees.

How is your research contributing to healthcare improvement?

The NHS is very good at innovation, but one of the main problems it faces, in common with other countries, is that it finds it difficult to spread new and effective services or treatments from where they were developed to the rest of the organisation. I’m working on several studies where we’re working out how to spread innovation more quickly, and on a large scale. A good example is a project we’ve recently finished, known by the acronym ‘PhISICAL’. It’s based on an exercise class for older people that has been shown to reduce falls. What we have learned in the study is how to persuade a wide range of organisations (both within and outside the NHS) to pay for and run this exercise class, and how to make it sustainable.

In addition to being MBA director of this programme you also head up CHILL. Could you explain a bit more about this?

The Centre for Health Innovation, Leadership and Learning (CHILL) is active in research, evaluation/consultancy and education (principally the healthcare EMBA). Our main areas of activity are improving quality and safety, sustaining innovation, integrating care organisations as well as implementation and evaluation. Our research is collaborative, with colleagues from medicine, nursing, pharmacy and public health.

What are the next steps for you?

In co-operation with our colleagues at the University of Nottingham in China and Malaysia, we’re working on developing an international MBA. We’ve got well-established research collaborations in Brazil, China, Japan, and the US, so we’re going to develop our international networks further.

A version of this article originally appeared in the November edition of 'AMBITION', the monthly magazine of the Association of MBAs (AMBA)