NHS

maddyone

Well I have never worked for the NHS and consequently I don’t know whether there’s too much management, or poor use of funding. I’m finding it interesting though, reading just how many on here have worked for the NHS and who believe that money has been wasted.

Well if it helps I have a son and DIL who are working in the NHS, one a mental health nurse and one a Senior Registrar. They think the NHS needs more money and blaming poor use of funds is a cop out.

theworriedwell

Rosalyn69

I worked in the NHS as PA to a consultant surgeon.
I agree wholeheartedly about excess of management and misuse of funds.

You realise you were one of those useless pen pushers that people don't want to pay?

theworriedwell wins the internet today.

Casdon

I think managers in any organisation are the soft target, people always need somebody to blame rather than looking at the root causes for why organisations struggle. The reason there are so many managers in the NHS is because there are so many targets, standards and performance measures to meet, and the majority of them are from clinical backgrounds themselves. Staff frustrated by the system always blame ‘the management’, that’s how the world works.

You bring up another interesting point. The NHS gets criticised if managers don't have a clinical background as they don't know about what is involved and they get criticised for taking clinicians off the front line and into management.

A soft target indeed.

theworriedwell wins the internet today. I never win anything. do you think I should grasp the moment and buy a lottery ticket?

My dd has made a complaint about NHS management this week, after emails which had the potential to cause mental distress to young medics. She was the one brave enough to challenge management. First of all, they denied what had happened, moving the blame to someone else, and then they rescinded the orders they’d sent. ?‍♀️

Of course the NHS needs more money - to be spent on clinical staff and the nurses bursary to be reinstated in full. I would ask your sister for her evidence that managers distribute funds with an eye on their own jobs. She’s probably just repeating social media rubbish. I wouldn’t think it was something to fall out over though. My sister and I are at completely opposite ends of the political spectrum and I’m left gawping at some of the claptrap she comes out with. There’s more that unites us than divides us - well, sometimes.

Nobody wins anything on here, it isn’t a contest simply points of view from what posters have observed themselves within the NHS in their working lives.

Sorry theworriedwell, no lottery prize for you

Many years ago my husband said, if the NHS was given the whole of the national budget, it still wouldn't be enough. Think I agree with him now. I do believe many of us have the suspicion\knowledge that the admin numbers and salaries are out of keeping with those working at the coal face. Neither of the major political parties is prepared to put in a team of independent business people. We all know why. I've been on a couple of management boards in our county hospital as a volunteer after many years in the business private sector. Honestly, the incompetence and waste would make one weep. There's a built in state of institutionalism which is beyond belief. No rush....No urgency. Tomorrow will always do. When I queried this 'that's how it's done' Such complacency would result in private firms going burst. I do think there is some truth in current government trying to run NHS into the ground towards privatisation but I can't see much advantage in that for them or us. I do believe it is an open wound for them that it was Labour's magnificent baby originally. A masterpiece then, in fact. I've often wondered why, when our system is allegedly admired by the world, no one has copied it. Maybe some country has and I just don't know about it. Family members do tell me there is active competition between adjacent health boards rather than support. If true, I find this sad. Personally, I've been on the receiving end of excellent and tragic service from our NHS but have experienced only it so no practical comparison.

Alegrias1

Sorry theworriedwell, no lottery prize for you

See I was right never win anything. Well I tell a lie I did win a raffle, it was 47 years ago and I won the playgroup Christmas hamper I was so excited as we hadn't got much money and that hamper was brilliant. Some mums thought it was quite funny, someone offered to drop it off for me on their drive home, I couldn't risk it being out of my sight so I loaded it on the pram.

Maybe I will something on the golden anniversary of that win, only 3 years to go.

I worked for the NHS for almost 20 years before retirement. Your sister is right, I'm afraid. There has been a staggering increase in highly paid management whilst the grafters up the sharp end working 12 hour shifts, most of them, have their pay frozen or are drip fed a measly 1-2% in stages. It would be a colossal task but the NHS needs a thorough overhaul from top to bottom by unbiased experts (Boris's mates need not apply). The amount of money wasted would be a real eye-opener.

Crumbs, the incident I mentioned earlier has been escalated up to the head of the local health board. At least someone is taking it seriously.

Perception is not reality, I wish people would do their homework before posting wild statements based on hearsay or ‘experience’ because they or somebody they know happens to work in the NHS. Managers are soft targets, they are not the core of the problem. They make mistakes like everybody else, but they also have extremely difficult jobs, the service is under-managed, not over-managed. Here are some statistics, there is lots of information out there if people are interested.
There are around 31,000 managers employed in the English NHS. About a third of those are ‘hybrids’ – doctors or nurses with a frontline position and a management role – while the rest are dedicated managers, many off whom also came from clinical backgrounds originally but have moved into more generic roles. But in an organisation of 1.36 million employees that amounts to less than three per cent of the workforce. The average UK business has 9.5%.

In my local NHS Trust (by no means a large Trust) there are:

21 Clinical Leadership roles
45 under the Chief Operating Officer
9 non clinical Executive Directors
7 non Executive Directors
9 clinical Executive Directors
and associated staff, administrators, PA's, secretaries etc etc

If you'd like to know what your Trust spends on it's non clinical budget, you can apply on the foi. You'll be surprised.

Without context this means very little though. How many total staff in the Trust Chewbacca?
How many of the roles you have identified are full time, and how many are sessional? The non executive directors and clinical directors will be people with other roles and a small commitment to management, 2 or 3 sessions per week usually. I’m sure you know that some of the roles are prescribed roles, every Trust has to have a Board and designated Executive and non-Executive Directors to run the organisation. Non-executives are businessmen, university, professional bodies etc.

As an NHS clinician before I retired, I was very glad of the management and admin staff that took care of all the boring but necessary tasks that needed to be done and let me get on with my direct patient work.
As said by others, most of our managers had also been clinical staff.

Casdon All of the ones I listed were an actual "head count"; they either did their roles full time in that designated position or, as you say, sat on one or more boards within the Trust so that they're employed full time. I specifically checked for that. They have 55 vacancies across the Trust, 8 of which are non clinical and offering salaries up to £76,000 per annum. The highest salary being offered for clinical staff is £49,000, apart from one locum vacancy at £118,000 pro rata.

They would be full time in the organisation if they were part clinical/part managerial though, It would be very unusual for clinical directors to be full time managerial. Non-executives are never full time in a Trust, they are external people who sit on the Board and a few committees, but work one or two days a work to cover those functions, and in their substantive roles in their own organisations the rest of the time.
I’m really surprised that the best paid advertised roles in your area are non clinical, when I just looked at the vacancies in my local Health Board, nearly all the senior vacancies are for consultant medical staff, which is not a good position to be in for us.
How many total staff does the organisation employ, that gives an appreciation of the percentage of roles that are managerial?

Too many chiefs and not enough Indians, as the old saying goes.
Having worked in the NHS for 20 years I completely agree with her.

How strange that you say you're now finding it hard to talk to her.

She’s got a good point of view ?why wouldn’t you want to talk to her again because of a difference in opinion?

I had to attend hospital for a routine scan recently, I received 3 phone calls, numerous texts and best of all 36 pages ( in colour) of what to expect and the COVID precautions.

The hospital have my email address.

theworriedwell

People always seem to think management isn't needed. Would be chaos without it. The NHS actually spends less on admin/management than other big organisations as a percentage of their budget. It is an easy target.

I was a senior HR manager, I remember having meetings with staff where there would be moans and groans about how things were done. Eventually I suggested they nominated 2 people to come and represent them in HR for a month. Both dropped out within days, it is easy to moan but when you present them with the problem and they are expected to find a solution rather than moan about it they don't seem so keen to be involved.

I worked in NHS finance when a round of reporting on management costs came round, and I know exactly how the figures were massaged from the raw data I gave the senior management team (reaction: "We can't report that!") The whole organisation is vastly over-bureaucratised. As for spending on management consultants whose sole purpose is to carry the can for decisions already made - words fail me.

I have to agree with your sister. One very small incident I'll quote here. Because of Procurement rules a bottle of cleaning fluid that can be bought in any supermarket costs 3-4 times as much by the time you use it in the. NHS and unfortunately the same happens in schools especially with school meals and cleaning products. Many people don't know this happens because these organisations don't get too much scrutiny.

I worked as a nurse in the NHS for over thirty years and partially agree with your sister, the management is top heavy but it could also do with extra funding partly due to the growing population of the country

"How do you kinow? Do you have access to the accounts?"