MANAGEMENT techniques were up for scrutiny in the health press this week.

Nursing Standard (Feb 6) reports on Peter Carter’s shock over the high attrition rates among directors of nursing services because their “face did not fit”. Carter, general secretary of the Royal College of Nursing (RCN), says that the situation is not widely known because the majority of those concerned had signed confidentiality clauses. “The individual concerned often says it is an injustice,” he says. “It feels like there is cheque-book management going on: ‘Your face does not fit so here is the deal’.” The RCN has secured severance payments of £150,000 to £200,000 for senior nurses, but, Carter says: “That may sound like a lot of money, but it is not if you are in your mid-forties and your career hits the buffers.”

In GP-land, primary care trusts (PCTs) are taking a tougher stance during annual visits to assess performance on the quality and outcomes framework, after pressure from the Government to scrutinise practices more closely, reports Pulse(Feb 6). Dr John Grenville, the secretary of Derbyshire Local Medical Committee, says that visits are becoming “increasingly vehement”. “PCTS are being performance managed by the strategic health authorities (SHAs), and they don’t trust GPs,” he says. Dr Richard Vautrey, deputy chair of the British Medical Association’s GP Committee, says: “We are aware that SHAs are encouraging PCTs to [show] that they are getting full value for money. As always some PCTs act in a less than helpful way than others when putting this into action.”

But managers are being managed too. Sir Bruce Keogh, medical director of the NHS, tells Health Service Journal (Feb 7) that managers of the national clinical audit programme “must deliver” or they could lose their contract.

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