The research found there are 33 members of staff for every one manager
The King’s Fund said that, contrary to popular belief, there is now a “near record low” number of NHS managers for every member of staff.
It analysed NHS hospital and community data and found there are 33 members of staff for every one manager, compared to 27 staff per manager 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.
“What we’re seeing is an absence of the right operational support structures that leaves clinicians plugging gaps in the system that should be filled by skilled administrative and managerial staff.
“Government must value NHS managers and the vital role they play in keeping frontline staff focused on patient care, not caught up in paperwork.”
Last year, Health Secretary Wes Streeting pledged to tackle “failing” NHS managers, adding they would be denied pay rises if they did not improve patient care or get their finances in order.
He is due to deliver a speech this week to NHS leaders at the annual NHS Providers’ conference in Manchester.
The analysis by the King’s Fund found that, in 2010, there were 975,298 NHS staff, rising to 1,334,011 in 2025 (37% rise).
Managers rose by 12% over the same period, from 35,696 to 40,021. This is the equivalent of one NHS manager per 33 workers, compared to one per 27 before.
Ms Bailey said: “Skilled clinical professionals across the NHS, whether doctors, nurses, allied health professionals or others, went into the NHS to make a real difference to people’s quality of life.
“They did not expect to be spending hours each week chasing paperwork, managing rotas or navigating broken administrative systems.
“It is no wonder burnout rates are so high and staff satisfaction is so low when clinical staff are being stretched beyond their roles, filling admin gaps on top of already excessive workloads.
“Rather than denigrating managers, we need a clear commitment to their professionalisation, underpinned by investment and support within a system of regulation to boost standards.”
She said the “growing scarcity” of managers means “it is ever more challenging to oversee the massive and complex organisations that hold our NHS together”.
She added: “Effective administration and high quality management is vital for patient experience and their feeling if the health service is working or not.”
It comes as a new report from the All-Party Parliamentary Group (APPG) on Emergency Care found almost one in five patients (19%) in England’s emergency departments this summer were being cared for on trolleys or chairs in corridors.
Research for the report was compiled by the Royal College of Emergency Medicine (RCEM).
RCEM president Dr Ian Higginson said corridor care is “a source of national shame”.
He added: “Every day, patients are counting the hours they have been in ED, on trolleys in corridors, on chairs in unsuitable spaces, or simply in any available spot.
“Emergency care never used to look like this. It’s incredibly disheartening for those working in our departments, who are doing everything they can to provide care under these conditions – and even more so for the patients through no fault of their own.
“It’s distressing, undignified and it’s putting lives at risk.”
A Department of Health spokesperson said effective management was about “having skilled managers in the right roles”.
They said: “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.”
Among the planned measures are the establishment of a College of Executive and Clinical Leadership and the introduction of professional standards for NHS managers.
