Now is Exactly the Time to Invest in Middle Managers

When budgets are tight and headlines are dominated by political and operational pressures, it’s tempting to see leadership development as something that can wait.

But let me offer a different view.

In the last few weeks alone, I’ve worked with NHS team leaders and middle managers who are carrying extraordinary responsibility. They’re the ones translating strategy into action, holding teams together, keeping morale afloat - and doing it all while navigating ambiguity, staff shortages, and relentless demands.

Yet they’re also the group most likely to miss out on meaningful development.

Let’s be honest: middle managers often fall through the cracks. They’re not seen as senior enough to justify investment, but they’re already leading people, shaping culture, and making decisions that directly impact patients and staff.

Many are new to management, expected to learn by osmosis, and under increasing scrutiny -all while being given little time or support to grow into the role.

And here’s the problem: without that support, we’re not just risking performance today, we’re starving our organisations of the senior leaders of tomorrow.

I don’t think we talk enough about this.

Because the truth is, middle managers are the backbone of the NHS and health systems. They’re the ones with the biggest span of influence when it comes to culture, staff experience, and day-to-day delivery. If we want better outcomes for patients and more resilient teams, we have to start by backing the people in these roles.

That doesn’t mean tick-box training or another corporate leadership framework. It means creating real space for reflection. Time to think through challenges. Tools that help them lead more humanely, communicate more clearly, and navigate the messiness of real-world leadership. And yes, it means trusting them enough to invest in their development.

Because when we do, something shifts. Confidence grows. Collaboration strengthens. Problems start getting solved lower down. And leaders start leading, not just managing.

It’s easy to cut development. It shows up as a quick win on the balance sheet.

But it’s also a slow leak - one that drains future capability, morale, and resilience.

So here’s my challenge to those of us working in and around the system:

Let’s stop viewing leadership development as a nice-to-have and start seeing it as what it really is - a critical enabler of performance, retention, and long-term change.

And let’s start with the people we too often overlook.