Partha Kar: Streeting’s NHS should apply the Jürgen Klopp test
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q1538 (Published 12 July 2024) Cite this as: BMJ 2024;386:q1538
- Partha Kar, consultant, diabetes and endocrinology
- drparthakar{at}gmail.com
Follow Partha on X @parthaskar
Looking at the NHS from outside, you’d think that it placed a strong emphasis on leadership: events, conference sessions, and organisations such as the NHS Leadership Academy and the Faculty of Medical Leadership and Management. But there’s a dichotomy between what’s defined as leadership in the NHS and the failures in leadership we see around us—whether that be patient outcomes, access to care, or cancer targets—and it doesn’t paint the system in a flattering light.
I appreciate that many reasons underpin these failures. But amid all the debate about funding, productivity, and efficiency, NHS leadership itself is rarely discussed. It’s not just about renewing the leaders: it may be time to rethink how we look at leadership and at what point we acknowledge that it’s failed. We shouldn’t let the personal hubris of a few leaders bring down this institution we’re all so proud of. It’s common to hear reasons for failure but rarely, if ever, acknowledgment of failures from the leaders concerned.
So, what can we learn from examples of good leadership elsewhere? Recently, Jürgen Klopp retired from being the coach of Liverpool Football Club. Don’t worry, this isn’t a love letter to him or a eulogy of what he achieved—my question is whether we could apply the “Klopp test” to our NHS leaders. There are two quotes of his that all relevant leaders in the system could ask themselves and that the wider community they serve could also think about.
The first is simple: “You have to change those you lead from doubters to believers.” Klopp pinned the success or failure of his leadership on making people believe. Nine years on, when he decided to retire, the affection, adoration, and respect of the fans told its own story. The story wasn’t just about victories: it was about dedication to the cause against all odds, leading communities, and being open about failures. This was something the fans understood and valued him for. Our NHS leaders should ask themselves whether they have a similar approach. Can they look at the healthcare community and say that they’ve turned these people into believers during their tenure? Healthcare staff and patients need to believe that their leaders will improve the NHS.
The second quote is even more powerful, something I believe every leader should aspire to: “It’s not so important what people think when you come in—it’s much more important what people think when you leave.” Ask yourself, as a leader, whether you’ll leave with people’s love, admiration, and respect—or none of those. And I’m not talking about a few people in an echo chamber but about a wider cohort. Detractors will always be present (such is the bane of leadership in challenging environments), yet leaders must listen to those they serve and the communities they help. If you lead a workforce, what do those workers think about you? And how will they view you when you leave?
New era
Asking those two questions as part of the “Klopp test” should encourage NHS leaders to self-reflect, but this also applies to members of the wider medical community, who want to see effort and a commitment to better outcomes from their leaders. They don’t want complicity, collusion, and an inability to answer questions. I’m afraid that this is now a problem across our NHS leadership, as well as institutions such as the royal colleges. Something simple like a Klopp test would help focus the minds of all involved in improving the NHS.
Nine years ago a man from Germany with a boisterous laugh came to Liverpool, to a football club that had struggled through decades of mediocrity after a glorious past. He left with love and affection from a city that believed again in its ability to compete with the best. As a new leadership takes charge of the UK and as a new health secretary, Wes Streeting, tries to usher in a new era, it’s worth considering whether further plans, reviews, and commitments are the sole way forward—or whether that should include reviewing the leadership itself and what it’s achieved. If we take the example of workforce—still the biggest challenge—will the same NHS leadership improve things by using the same approach or style? Or are we confining ourselves to the doldrums of the recent past?
The NHS, once upon a time, was the pride of this country. With the right leadership we could make people believers again. We could have a similar redemption story to Liverpool Football Club—the question is whether we have the right leaders to achieve it. The club’s motto is, “You’ll never walk alone.” If we as leaders can show our willingness to stand by the people we serve, and to walk together, we may be able to make some much needed progress.
Footnotes
Competing interests: see www.bmj.com/about-bmj/freelance-contributors. Partha Kar is national specialty adviser, diabetes, and former lead of the Medical Workforce Race Equality Standard.
Provenance and peer review: Commissioned; not externally peer reviewed.