NHS

Casdon

Matrons do run wards and manage beds here still Shropshirelass, but they are called Senior Nurses now. I’ve never known a ward be managed by anybody other than nurses. I’m in Wales though, are wards in England now managed through outside contracts?

A rose by any other name?

Casdon

Calistemon there were still bed managers when I retired last year, so I expect there still are. The bed managers are a mixture of nursing and admin staff, managed by a senior nurse, who identify where beds are coming up in a hospitals and help the A&E team and emergency admissions unit get new patients into a suitable bed as quickly as possible. Some of the wards don’t like them because they are on the case constantly making sure that there are plans to discharge patients and they are followed through quickly, and beds are never left unfilled (which would make the life of ward staff easier]. If the bed management teams didn’t exist then the queues for beds at the front door would be far worse than they are now. I don’t know what the answer is, the only way they could be dispensed with would be more beds made available, which would cost a lot more.

A very clear explanation.

Calistemon there were still bed managers when I retired last year, so I expect there still are. The bed managers are a mixture of nursing and admin staff, managed by a senior nurse, who identify where beds are coming up in a hospitals and help the A&E team and emergency admissions unit get new patients into a suitable bed as quickly as possible. Some of the wards don’t like them because they are on the case constantly making sure that there are plans to discharge patients and they are followed through quickly, and beds are never left unfilled (which would make the life of ward staff easier]. If the bed management teams didn’t exist then the queues for beds at the front door would be far worse than they are now. I don’t know what the answer is, the only way they could be dispensed with would be more beds made available, which would cost a lot more.

Casdon

Matrons do run wards and manage beds here still Shropshirelass, but they are called Senior Nurses now. I’ve never known a ward be managed by anybody other than nurses. I’m in Wales though, are wards in England now managed through outside contracts?

In our local Welsh hospital there were "bed managers" - remote beings who presumably co-ordinated number of beds on wards with planned procedures, operations, surgeons available adding in the emergency factor too.

Annoyed the sister in charge of the ward I was on as a patient no end! She said she had managed to sort that out herself perfectly well for years without the help of a bed manager.

That was a few years ago, perhaps that layer of junior management is now redundant.

The food in the large hospital where I volunteer is noticeably good. The patients all comment on how nice it is.
That is good, but much food is bought in or transferred distances between hospitals, just like school meals are now.

And yes, inefficiency is costing the NHS money. Appointments sent out after the date of the appointments as was happening here? Consultants wondering why so many people with appointments are not turning up for clinics?

The food in the large hospital where I volunteer is noticeably good. The patients all comment on how nice it is.
Dozens of wards each to be run by dozens of nurses? Little empires to be built? Potential shambles. So easy to rubbish what's happening. Read the whole thread to find out and stop knee jerk comments.

Matrons do run wards and manage beds here still Shropshirelass, but they are called Senior Nurses now. I’ve never known a ward be managed by anybody other than nurses. I’m in Wales though, are wards in England now managed through outside contracts?

I agree, go back to Matrons running wards and managing beds. There is a huge amount of money wasted within the NHS on administration. This puts pressure on the real treasures of the NGS, the nurses and doctors, plus the ancillary ward staff who play such a vital part. Too much of running wards is farmed out to outside contracts. Bring it all back into the hospitals where it can be managed properly. Bring back meal preparation and cooking in hospital so that food for staff and patients is freshly cooked and nourishing instead of the garbage currently offered. I could go on but think I should stop here!!!

I think it might have been the local population reflected in the hospital. The ward was literally half women of Asian descent so I suppose in the days when you were in hospital for a week after the birth of your first child they needed to be catered for. As there was a mixture of Sikh, Hindu and Muslims the curry was always vegetable so there was no problem with pig/cow or whatever.

Actually I think a big pot of curry is probably more suitable for mass catering than alot of standard English meals. I always wondered if many of the kitchen staff were Asian as the curry was as good as a decent restaurant.

The English menu was poor, one day we had a horrible brown soup and then the poor nurse serving us realised she'd served up the gravy. So we had no gravy on the meal, not sure what happened to the actual soup. It was definitely a bonus if you managed to get a curry.

Oh, interesting, no it was in fact later than that and Hobson's choice!

Calistemon

theworriedwell
I don't think choice of menu had been invented when my DC were born!

Well this was 50 years ago. You didn't actually get to choose anything other than English or Asian.

theworriedwell
I don't think choice of menu had been invented when my DC were born!

Calistemon

^I was in hospital a couple of months ago, and the food was great!^

Many years ago, DC1 was born in hospital - have you ever eaten a fried egg with thin greasy gravy on it, complete with globules of fat?
Me neither, I had to leave it!

When I was in a maternity home a couple of years later, the food was wonderful! Freshly cooked on site, however, that maternity home closed along with all the others.

What was that about nutrition aiding healing?
The nurses said they were embarrassed by the poor standard of nutrition offered to patients in our new hospital.

When I had my first baby in a busy inner city hospital you had to book for English or Asian menu. We quickly discovered that the Asian menu was great and we'd be waiting every evening for the Asian ladies to be served so that we could get a curry if there was any left, obviously as they'd booked Asian they got priority.

We were happy with English for a bacon and egg breakfast though.

Calistemon

^How are people supposed to recover from illness or surgery without proper nutrition?^
Just what we said recently.

When I was in hospital years ago, most of the food was inedible.
Nothing has changed, it seems.

I was in our local general hospital a couple of years ago. The ward had it's own kitchen. For breakfast we had a choice including cereal, toast, yogurts, eggs. For lunch we could choose sandwiches, freshly made, or jacket potatoes. The evening meal came from the main kitchen and suffered from mass catering as all mass catering does but we quickly learned that if you asked our lady in the kitchen you could get her to make you a nice sandwich and salad before she left and have a yogurt for afters and miss the mass catering if you wanted to although it wasn't that bad.

Casdon

14% is NOT spent on management in the NHS, 14% covers all administrative and managerial grades - ward clerks, medical records teams, salaries, procurement, departmental admin staff. 4.8% is spent on managers, of whom one third are clinical departmental managers. The cost of non clinical management is 3.2% of the NHS budget.
Shall we get rid of all administrative support for clinical teams and expect clinicians to do their own admin? Shall we get rid of all the non clinical managers and expect the clinicians to do that as well on top of their day jobs?
Or maybe the NHS, which is the biggest employer in Europe doesn’t need managing at all - or maybe Gransnetters would like to take on what has to be the most thankless job in the UK themselves. It’s time to get real.

Exactly, 14% for management and admin is actually low.

bobbydog24

I doubt only 14% is spent on management when you see the salaries some of them are on and as has been stated, assistants to assistants. It wouldn’t be a consideration in the private sector. Also it’s not the canteen staff that source the supplies for the hospital food, it is management.

Oh well you obviously know more than The Kings Fund, they obviously wasted their money doing a study.

I've worked in public sector, senior managers do not source food for the canteens. There will be lists of approved suppliers, that is because although someone will say they could nip down the road and buy 5lb of potatoes cheaper that is totally useless if you need 100lbs of potatoes.

Fully agree Casdon. Another layer of trouble has been created by the need to cover all possibilities in order to avoid litigation. So many risk assessments and clinical governance measures to complete. All for the ultimate benefit of patients.

There is inefficiency, I’d agree Calistemon. Any huge and complex organisation with vested professional and staff side interests is going to be inefficient to some degree.
Clinical managers are run off their feet trying to keep their departments and services running, due to short staffing and the number of targets that have to be hit, they have so many balls in the air that it’s impossible to do their jobs as efficiently as they would like to. That doesn’t mean they aren’t hugely committed to doing the best they can. Being castigated by everybody for doing your best is a thankless position to be in, particularly when your own staff don’t want to know what you have to do. Staff themselves often won’t apply for managerial jobs because they don’t want the hassle, it’s easier to complain than it is to do the job yourself. That includes Consultants and GPs, those I’ve worked with who have made the leap into managing themselves all say how much more complex and political it is than they ever realised (and end up being cold-shouldered by their own teams when they have to make tough decisions).
At executive level there is a lot of political pressure, both from within the organisation and from above, which forces managers to work in ways which I’m sure none of them want to to achieve the targets- and balls do get dropped because the effort has to be put into issues that of choice would be less important.
There are no easy answers, but it’s the system that’s the problem, not the managers themselves. It’s got much worse in the last few years due to financial cuts, and many high quality managers have left, or been off sick due to the insurmountable pressure they are put under.
Pile ons like on this thread are demoralising, not least because most Gransnetters and many NHS staff themselves haven’t walked a mile in an NHS manager’s shoes so actually have no idea what they are talking about, and take the unthinking ‘this happened to somebody I know and it’s all management’s fault’ approach.

Casdon

I don’t know why we bother Alegrias1. People have to have somebody to blame to deflect from the real issues facing the NHS. Scapegoating is what people do when faced with the ‘too hard’ box.

There is so much inefficiency, though, Casdon which is costing the NHS possibly billions.
Consultants we have spoken to recently are concerned at what is happening.

Alegrias1

Here's this again.

Watch yourself, you might end up in Casualty!

Off topic...

People on the factory floor in the place I used to work didn't understand why we had HR as all they did was organise picnics and put up the Christmas decorations.

I was a Project Manager. God knows what they thought I did.

I don’t know why we bother Alegrias1. People have to have somebody to blame to deflect from the real issues facing the NHS. Scapegoating is what people do when faced with the ‘too hard’ box.

Here's this again.

Oh... and I don't understand why you would find it difficult to talk to your sister. My sister spouts all sorts of rubbish but we still get together and have a laugh.

Same in Education - too many chiefs and not enough indians.
My daughter works in the NHS and she says that some management have little or nothing to do. She had 3 top dogs observing her to see if she washed her hands properly.
It's criminal.

14% is NOT spent on management in the NHS, 14% covers all administrative and managerial grades - ward clerks, medical records teams, salaries, procurement, departmental admin staff. 4.8% is spent on managers, of whom one third are clinical departmental managers. The cost of non clinical management is 3.2% of the NHS budget.
Shall we get rid of all administrative support for clinical teams and expect clinicians to do their own admin? Shall we get rid of all the non clinical managers and expect the clinicians to do that as well on top of their day jobs?
Or maybe the NHS, which is the biggest employer in Europe doesn’t need managing at all - or maybe Gransnetters would like to take on what has to be the most thankless job in the UK themselves. It’s time to get real.