Health Service Manager

The Job and What's Involved

Health service managers help run hospitals, GP surgeries and other health services effectively and efficiently. Most work in the National Health Service (NHS), managing staff, measuring and reporting on performance, controlling finances and overseeing resources, buildings and services.

Just as in managing a business, the work might focus on areas such as staffing, budgets and spending, monitoring quality, overseeing special projects or buying equipment. The main jobs tend to fall into these categories:

Clinical Managers - managing the delivery of clinical care and treatment. They may be heads of departments, leading teams of other professionals.

Estates and Facilities Managers - managing buildings and support services anywhere that healthcare is delivered.

Financial Managers - controlling budgets and allocating resources to ensure that money is spent wisely. This includes payroll and pensions and paying for goods and services.

General Managers - organising the provision of healthcare to everyone who needs it. This includes strategic management (setting goals and then planning to meet these goals), service management (running a team within a hospital or in the community) and project management.

Human Resources (HR) or Personnel Managers - responsible for staff recruitment, selection, development and training.

Information Managers - using information and communication technology (ICT) to improve patient care, monitor performance and set priorities.

Practice Managers - running GP surgeries and health centres.

Most managers in the NHS are contracted to work 37.5 hours a week, Monday to Friday, but hours may be longer. In certain roles and specialist areas, shift cover may be required. Managers may be on an on-call rota to cover evenings and weekends. Part-time work and job sharing is possible.

Managers tend to be based in offices, but those offices can be in a variety of environments, including hospitals and in the community. Traveling may be required between sites, so a driving licence can be useful.

The starting salary for those on the NHS graduate management training scheme is around £22,000 a year.

A project manager or catering manager in the NHS might earn between £24,831 and £33,436 and senior managers in the NHS could earn between £37,996 and £79,031 depending on their role.

Salaries outside the NHS are broadly in line, but tend to vary more, depending on the size of organisation and the experience of the manager.

Getting Started with this Career Choice

There are around 440 NHS organisations in England and all employ managers. Each organisation provides a particular area of healthcare including:

Primary Care Trusts (PCT's) - the initial point of contact with the NHS for most patients. This includes GP surgeries, pharmacists, dentists, NHS walk-in centres and ambulance trusts.

Secondary Care - where patients are referred for treatment, including NHS hospital trusts and mental health trusts.

Strategic Health Authorities - responsible for day-to-day performance management.

There are also opportunities in the Department of Health, which provides health and social care policy and guidance nationally.

Health service managers are also employed in the independent sector with organisations such as BUPA and BMI, in the armed forces and in the prison service.

Vacancies are advertised in local and national newspapers and in the Health Service Journal. They are also advertised on website's, such as Some specialist healthcare recruitment agencies also advertise jobs.

Education and Training

It is possible to join the NHS at an administrative level and progress into management. Entry at this level is usually with at least four or five GCSE's (A*-C) or equivalent. In practice, most entrants have either two or three A levels or a double award A level in an applied subject.

The Diploma in society, health and development may be useful for entry.

The Association of Medical Secretaries, Practice Managers, Administrators and Receptionists (AMSPAR), in partnership with City & Guilds, offers a Certificate and Diploma in Primary Care Management and other qualifications for administration and managerial staff, ranging from level 2 to 5. Study options range from full-time college courses to distance learning.

Some NHS trusts may offer the chance to train through an apprenticeship in administration, leading to supervisory and junior management roles.

Graduates - from outside and inside the NHS - can apply to join the graduate management training scheme. Entry is with a degree in any subject (2:2 or higher) or postgraduate qualifications. Health or management-related higher education professional qualifications, including diplomas in nursing and other allied health professions, the diploma or CQSW in social work or the NVQ level 5 in management are also accepted. See for a list of acceptable qualifications.

There is a lot of competition for the scheme and the application process involves online screening tests, an interview and attending a National Leadership Challenge.

Applications for the NHS graduate management training scheme need to be in before the end of December, with places usually offered by mid-March the following year.

Some private-sector healthcare providers, such as BUPA and BMI healthcare, also run graduate management schemes. Entrants usually need a minimum 2.1 degree or equivalent.

The NHS welcomes applications from people who have experience in administration, or business or who have relevant qualifications. This includes experienced NHS employees who want to move into management, as well as external applicants with backgrounds in areas such as accountancy, property management, purchasing and supply, human resources, IT and information management.

For senior managers with at least five years' managerial experience, the NHS offers the Gateway to Leadership programme. Entry is with a minimum of a 2.2 degree, or equivalent. Applicants need to demonstrate strong project management skills, as well as experience of managing a team and large budgets.

A Few More Exams You Might Need

Training usually combines on-the-job training with study either at college or in-house. Managers may study for professional qualifications relevant to their job.

Managers can take many other in-service management qualifications. The Institute of Healthcare Management (IHM) and Institute of Leadership and Management (ILM) offer general supervisory level courses. These include NVQ's and the IHM/ILM Introductory Award and Award for First Line Managers. Middle managers in a clinical role may study the IHM's Certificate in Managing Health and Social Care (CertMHSC).

AMSPAR offers a short, in-house course, leading to the Certificate in Health Service Administration.

The NHS graduate scheme lasts for two years (two and a half years for finance managers), starting every September. Training is a combination of work placements, and study towards relevant professional qualifications.

General management trainees and HR trainees can choose to top up their qualification to a masters degree in years three and four.

The NHS encourages continuing professional development (CPD) to keep skills up-to-date.

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Skills and Personal Qualities Needed

A health service manager should:

  • Have strong leadership skills.
  • Be able to make difficult decisions.
  • Be able to prioritise work and handle a range of tasks simultaneously.
  • Have excellent communication skills.
  • Be persuasive and a good motivator.
  • Have excellent negotiation skills.
  • Be able to balance the needs of different groups, for example, staff, patients and health service organisations.
  • Be able to cope with change.
  • Be comfortable dealing with numbers and statistics.
  • Be able to produce written reports and give presentations.

Your Long Term Prospects

There is a clear career structure in the NHS. Chances of promotion can be enhanced by moving between different areas of health service management. NHS graduate management scheme trainees are expected to gain rapid promotion.

The NHS Gateway to Leadership programme is a fast-track scheme for experienced managers. Within five years candidates are expected to become a chief executive or director of an NHS trust.

In private healthcare, large organisations may offer good prospects for promotion, but it may be necessary to move location or employer.

Qualifications such as a masters in business administration (MBA) or a diploma in management studies (DMS) can be useful to enhance promotion prospects.

Experienced managers may work on a self-employed basis as consultants. It is also possible to work abroad.

Get Further Information

Association of Medical Secretaries, Practice Managers, Administrators
and Receptionists (AMSPAR), Tavistock House North,
Tavistock Square, London WC1H 9LN
Tel: 020 7387 6005

Institute of Healthcare Management (IHM),
18-21 Morley Street, London SE1 7QZ
Tel: 020 7620 1030

Institute of Leadership and Management (ILM),
1 Giltspur Street, London EC1A 9DD
Tel: 020 72942470

NHS Careers
Tel: 0845 60 60 655
Website: and

NHS Graduate Management Training Scheme
and Gateway to Leadership programme
Tel: 0845 300 1426

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