NHS frontline staff forced to cover gaps as managers remain scarce

Published: 10 November 2025. The English Chronicle Desk. The English Chronicle Online.

Frontline NHS staff are increasingly being forced to fill gaps in services that should be managed by skilled administrators and managers, a new report warns. Despite widespread perceptions of the health service being overrun by managers, research from the King’s Fund suggests that the number of NHS managers per staff member is now near a record low.

Analysis of hospital and community NHS data shows there are currently 33 staff members for every manager, up from 27 in 2010. Suzie Bailey, director of leadership and organisational development at the King’s Fund, said, “The narrative that there are too many managers does not survive contact with reality.”

She added that clinical professionals spend hours each week dealing with paperwork, rota management, and navigating broken administrative systems. “It is no wonder burnout rates are so high and staff satisfaction so low when clinical staff are being stretched beyond their roles, filling admin gaps on top of already excessive workloads,” Bailey said.

The research highlighted that NHS staff numbers have grown by 37 per cent from 975,298 in 2010 to 1,334,011 in 2025, while the number of managers increased by only 12 per cent during the same period, from 35,696 to 40,021.

High-quality management and effective administration, Bailey said, are “vital for patient experience,” yet the scarcity of managers forces clinicians to take on administrative tasks that prevent them from focusing on care. “Government must value NHS managers and the vital role they play in keeping frontline staff focused on patient care, not caught up in paperwork,” she added.

Health Secretary Wes Streeting is set to deliver a speech to NHS leaders this week at the NHS Providers’ conference in Manchester. The address follows his pledge to tackle “failing” managers, including denying pay rises last year.

The pressure on the system is evident in recent findings from the All-Party Parliamentary Group on Emergency Care, which revealed that 19 per cent of hospital patients are being cared for in corridors. Dr Ian Higginson, president of the Royal College of Emergency Medicine, which compiled research for the report, described corridor care as “a source of national shame,” adding that it is “distressing, undignified, and putting lives at risk.”

A spokesperson for the Department of Health stressed the importance of having “skilled managers in the right roles.” They added, “We are reforming the NHS to make it fit for the future – attracting, supporting and developing the best talent to boost productivity and divert resources back to the front line. Our introduction of NHS league tables will also drive up standards, with top-performing trusts rewarded with greater freedoms and investment, and underperforming trusts receiving targeted support.”