Sajid Javid has promised urgent action to reform health and social care management after a review found evidence of bullying, discrimination and blame culture.

The health secretary is promising “the biggest shake-up of leadership in decades” in response to a “stark” conclusion that there is “instructional inadequacy” in how leaders and management are trained, valued and developed.

Former military officer Sir Gordon Messenger – who led the Royal Marines in Iraq – was in charge of the review, which will be published in full later.

The Department of Health said the report showed examples of inspirational leadership but that overall there was “a lack of consistency and coordination”.

It highlighted “evidence of poor behaviours and attitudes such as discrimination, bullying and blame cultures in certain parts of the health and social care system, with some staff in the NHS in particular not feeling comfortable to speak up”.

There was also a “lack of equal opportunity” for managers to access training, “with those who have existing networks or contacts more likely to access these opportunities”, the department added.

The review recommends measures such as improving diversity, equality and inclusion; developing consistent management standards through accredited training; and clear pathways to promotion and progression.

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‘The difference between life and death’

Mr Javid said he fully backed the review’s conclusions.

“The findings in this report are stark, it shows examples of great leadership but also where we need to urgently improve,” he said.

“We must only accept the highest standards in health and care – culture and leadership can be the difference between life and death.

“I fully support these recommendations for the biggest shake-up of leadership in decades. We must now urgently take them forward, to ensure we have the kind of leadership patients and staff deserve, right across the country.”

Sir Gordon said leadership in the health sector could be transformed if his recommendations are actioned.

“A well-led, motivated, valued, collaborative, inclusive, resilient workforce is the key to better patient and public health outcomes, and must be a priority,” he said.

“This must be the goal and I believe our recommendations have the potential to transform health and social care leadership and management to that end.”

Interim chief executive of NHS Providers, Saffron Cordery, said it showed there was a “window of opportunity” for change, while the head of the NHS Confederation Matthew Taylor said the review showed more diverse leadership was needed.

“We can’t hide from the fact that all too often staff from ethnic minority backgrounds are still not being provided with the support they need to progress to leadership roles,” he said.

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