NHS problems from the horses mouth

What a lot of out of date rubbish.
Hospital Secretaries vanished in the 70's.
As a ex Clinical manager I know it needs mix of people with proven skills. I'm still working so, I am aware of the current situation.

Look at a hospital management board, it has a mix of professionals, including Doctors, Nurses Accountants,, Health professionals, as well as experienced Managers, Solicitors, Estates professional to name just a few. They keep the Hospital running, it's a big set up.

I have a old girlfriend who is the Chair of her local Heath Board, she is a ex - journalist/TV producer, that brings interesting results.

Total disaster if left to Doctors.

LadyGracie

The letter did not say they don’t need managers, it said they don’t need the numbers they have, a number which is ever increasing.

It literally says, they do not need managers

Literally. In writing.

especially as the government imposed more initiatives and targets

That's a pertinent point growstuff

Should the NHS be subjected to evermore initiatives and targets imposed by politicians?
Is it too politicised?

I have heard medical staff say that decisions which they had undertaken for years were taken out of their hands, the system slowed down because the medical staff had to await decisions from middle managers.
Rooms which were formerly used for patients were being converted into more offices. The Sister who told me that was in despair as she said those rooms were desperately needed for patients.

I have just picked up a thread headed 'Bonkers new rule at our GP's surgery. Says it all really.

The letter did not say they don’t need managers, it said they don’t need the numbers they have, a number which is ever increasing.

When the NHS started in 1948, my aunt was the head of the nursing school in a big London hospital. She said the first thing that happened was that a second storekeeper was employed. The one they had did not consider himself over worked. Then as there were now 2 stock keepers, they appointed a third person to manage them.

Similarly, I was phoned last week to be told I had an appointment in January. The nurse gave me the details verbally, but when I asked her to wait while I got my online calendar up, she said not to bother as everything she had told me was also being sent to me in a letter. The letter has now arrived. It tells me everythig about the appointment - that it will be a telephone appointment, that I need several tests beforehand. The one thing it doesn't contain is the date and time ofthe appointment. My DD and DH, who have both been seriously ill in the last couple of years could recite whole lists of times they were double informed - or not informed at all - about all sorts of matters.

If managers are cut, it doesn't need to mean that those remaining are then overworked. What is needed is for hospitals to look at their systems and organisations to get them running smoothly and efficiently and reduce the plethora of systems, constantly doing the same thing twice. I am beginning to suspect that a lot of the problem with the NHS, is lots of managers scurrying round all doing the same thing, but in different ways for different reasons.

The letter writer literally wrote, they don't need managers. They do need managers, because however good their training is as a surgeon (for instance), they probably don't know much about GDPR implementation (for instance).

volver

Luckygirl3

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

Managers are not administrators.

signed, a former manager

(Who generally knew what she was talking about. Not NHS)

I know managers are not administrators! - that was my point!

Someone needs to take the policy decisions (managers) and administrators need to administer these.

The person writing to the paper was querying the nature of the decision-makers. As do I.

Consultants and medical staff should be autonomous and managers who are not clinically trained should not be in charge of anything involving medical decisions... In my experience the MH service was hugely overloaded with managers...

I posted on another thread that a close relative who works in the NHS said that there are an unbelievable amount of managers thinking up 'initiatives' which cost a fortune. Someone called it manager bashing.

the letter writer seems to ignore the input of nursing staff in the efficient running of a hospital.

Luckygirl3

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

Luckygirl3
A good summing up of the situation.👏🏻👏🏻👏🏻

growstuff
Just because your sister was a manager in a hospital trust doesn’t mean that you are an expert.
Just as having a sister who was a teacher in a particular school doesn’t make a poster an expert on what happens in all schools.
There have been many articles written by hospital doctors and consultants over the past 25 years bemoaning the rise of the hospital managers.

Luckygirl3

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

Managers are not administrators.

signed, a former manager

(Who generally knew what she was talking about. Not NHS)

Luckygirl3

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

The government actually makes most decisions. The managers just enforce them.

King's Fund (2012):

"The NHS in England is a £100 billion-a-year-plus business. It sees 1 million patients every 36 hours, spending nearly £2 billion a week. Aside from the banks, the only companies with a larger turnover in the FTSE 100 are the two global oil giants Shell and BP. If the NHS were a country it would be around the thirtieth largest in the world.

If anything, our analysis seems to suggest that the NHS, particularly given the complexity of health care, is under- rather than over-managed."

www.kingsfund.org.uk/projects/health-and-social-care-bill/mythbusters/nhs-managers

growstuff

kittylester

Exactly what LadyGracie said.

The people on the front line consider they are over managed by people who have no experience.

I wonder if they actually know what "management" does.

Not an anecdote about the NHS, but about knowing what managers do...

The manufacturing company I worked in decided to have 2 people from the "factory floor" on the senior management team. In part, because there were lots of complaints that the managers didn't have any idea what was right for the company.

When they finally managed to get a couple of people to take on the responsibility, they lasted two meetings then decided it was too hard.

I think the letter-writer is complaining abut the fact that managers are taking decisions that need to be taken by those with on-the-ground experience.

Clearly you need administrators to put decisions into practice - recruitment, buildings etc. but those who take the decisions need to be people who know what they are talking about.

LadyGracie

They obviously need managers but not to the detriment of medical staff. There are layer upon layer of managers, a total waste of money.

Maybe the government should stop issuing more and more targets.

kittylester

Exactly what LadyGracie said.

The people on the front line consider they are over managed by people who have no experience.

I wonder if they actually know what "management" does.

Oreo

There were always some managers but the proliferation over the years has resulted in the mess now in place.
That Telegraph letter is not wrong.

Do you have direct experience at a senior level?

Exactly what LadyGracie said.

The people on the front line consider they are over managed by people who have no experience.

volver

growstuff

So if hospitals don't need managers, who is going to be responsible for recruitment, maintenance, the appointments and record keeping systems, cleaning, catering, ordering equipment, prioritising patients, making sure that budgets aren't overspent (and all the other tasks I've forgotten)?

The magical "hospital secretary", presumably, Growstuff.

Who can apparently implement things without anybody allocating any funds to them.

Oh! You mean the ones who know so much about running a hospital that they should be in charge?

Management by the staff was tried at Hinchingbroke Hospital, but was a disaster. It was judged to be the second most inefficient hospital in England before the contract was handed back to the NHS

LadyGracie

They obviously need managers but not to the detriment of medical staff. There are layer upon layer of managers, a total waste of money.

This, totally.

There were always some managers but the proliferation over the years has resulted in the mess now in place.
That Telegraph letter is not wrong.