HSMC at 50: a retrospective

Professor Judith Smith, current Director of HSMC, reflects on the key contributions made by HSMC to health policy and management


My first encounter with the Health Services Management Centre (HSMC) was in 1987 when, as a final year undergraduate, I walked down the drive to Park House on the advice of the University Careers Service, to find out about the NHS General Management Training Scheme (GMTS). 

I am eternally grateful to Professor Peter Spurgeon for agreeing to see me there and then. A few months later I was a GMTS trainee, based at HSMC for my academic management training with Peter as my tutor.  The Centre has threaded itself through my career - after several years of NHS management, I joined the academic staff in 1995 when Professor Chris Ham was Director, at a time of major growth in HSMC’s teaching, executive education, research and evaluation activity.  In 2015, after almost a decade working overseas and in London, I was privileged to be invited to return as Director of HSMC.

There is something about anniversaries that makes one turn to personal experience, and I have done so deliberately to highlight what I consider to be the key contributions made by HSMC to health policy and management since 1972. 

First, a profound and enduring commitment to evidence-based and excellent management of health (and latterly also social) care services.  This has been expressed through countless postgraduate education and development programmes for health services managers and clinicians, an almost continuous role across 50 years in delivering the NHS Management Training Scheme academic programme, and in a sustained body of research focused on what defines effective health management.

Second, a relentless focus on undertaking research that matters directly to health care managers and the multiple and knotty challenges they face. Themes that have endured across our 50 years have included: priority setting; health purchasing and commissioning; organisational governance, ethics and culture; the management of primary care, community health and integration; clinical leadership; health policy; and user and patient involvement. Major funding awards from the Department of Health, National Institute for Health Research (NIHR), Economic and Social Research Council (ESRC) and others have enabled the establishment and growth of these research programmes.  Examples include: the University of Birmingham Health Economics Unit (now based in the College of Medical and Dental Sciences); the NIHR-funded BRACE Rapid Evaluation Centre; the NIHR School for Social Care Research; and the ESRC Centre for Care.   

Third, a commitment to deep engagement with NHS organisations and policy, at a local, national and international level. This can take the form of advice, evidence reviews, facilitation, service evaluation, action learning networks, responses to consultations, and secondment of staff into and out of HSMC. Examples of influential work in this area include: the Inter-Authority Comparisons Centre led by Professor John Yates, trailblazing the use of routine data to track and analyse organisational performance; evaluations of major service improvement programmes initiated by the Blair Government; secondment of Professor Chris Ham to lead the NHS Strategy Unit; studies of whistle-blowing and speaking up within the NHS; a sustained body of analysis of how to make a reality of integrated care; support for emerging and established health care leaders; and evaluating and developing the expanding role of primary care within health systems in the UK and internationally.  

Fourth, HSMC has been forging ever stronger collaborations across the University of Birmingham, in the spirit of interdisciplinarity which increasingly defines academic life and endeavour.  Examples include our work with the College of Medical and Dental Sciences in launching a highly successful undergraduate intercalated BMedSci programme in health management and leadership, and in being a key contributor to the work of Birmingham Health Partners.   In similar vein, we work in close collaboration with Birmingham Business School, as evidenced by the newly designed Clinical MBA programme and a body of research into purchasing and procurement in health. With our sister department of Social Work and Social Care, we have worked closely in designing programmes to support integrated health and care management and leadership, including the delivery of an MSc Degree Apprenticeship in health and care leadership, and teaching social and health policy evaluation.  With the Institute of Local Government Studies, we have played a central role in developing the 21st Century Public Servant programme of research.

Fifth, our alumni community is vast, including over 1800 MSc graduates from the renowned Elizabeth Garrett Anderson Programme, most of whom are senior NHS managers and clinicians.  As HSMC staff, we are always encountering people who were taught at HSMC, involved in our research, were ‘our’ MTS trainees, or in other ways feel part of the HSMC community.  This community includes all present and past academic and professional services staff, and our partners across the University of Birmingham and the local and wider NHS. 

We hope that in this anniversary year, as many as possible of our extensive HSMC community will engage with the exciting programme of seminars and other activities, come along to the celebration event in October, and share your memories, as well as ideas for our next phase.

As well as taking time to reflect and celebrate, we are of course intensely focused on supporting the NHS and wider health services as they emerge from the COVID-19 pandemic, address profound workforce pressures, tackle major inequalities in health status and provision, and adapt to fast-moving technological and societal changes. 

HSMC will continue to evolve to meet these challenges, and this will include a change of its leadership.  I am standing down as HSMC Director on 31 January 2022 after almost seven years, handing over to Dr Ross Millar for the interim as we seek to recruit a new substantive Director. After a period of sabbatical, I look forward to being part of HSMC’s next decade of research, teaching and development in support of high-quality health and care management, policy and leadership.

HSMC has sought always to be rigorous and relevant, and this will stand us in excellent stead for many years to come.  And if we can continue to welcome the inquisitive student who knocks on the door pondering a career in health management, and offer lifelong opportunities in research, development and education, then we have much to celebrate and anticipate.  

Professor Judith Smith, Director of HSMC