Our bloated NHS - it’s beyond ridiculous now.

You mean like the ones people didn't even know they had?

And you are as entitled to your opinion as I am to mine, Glorianny.

Deliberate mis reading volver and making assumptions based on your prejudices.

Perhaps you can explain what my prejudices are kittylester? Given that I have never worked in the NHS but I have worked in organisations where all the people on the factory floor thought the organisation had far too many managers and they all needed to be got rid of?

And then those who were invited to join the board as reps for the organisation lasted a couple of weeks before they realised it wasn't quite as straightforward as they thought?

MissAdventure

You mean like the ones people didn't even know they had?

It would take some research to know if that was a common problem or only one experienced by a few

Yes MaizieD, missed appointments is a huge problem creating waste.
Perhaps no shows should be billed unless they can show that they weren’t informed. In my neck of the woods we are reminded via mobile phone about hospital, dental and even specsaver appointments a week before, the day before and on the day if an afternoon appt. I’m sure GP surgeries could set up such a system quite easily.

Ilovecheese

Didn't it have an overhaul when the coalition Government came in. The "top down" overhaul that David Cameron said was not going to happen.
Before the coalition the country was very positive about the NHS, about 75% wasn't it.
So let's think what has possibly happened since then.

The NHS has had two major restructures since 2010. The first was the overhaul Cameron said would never happen. It's in the process of the second. Google "Integrated Care System", which will mean many people will lose their local facilities and adds another layer.

How does anybody who thinks changes are needed think they will happen without managers?

kittylester

^Not so much shortage of funding as mismanaged funding^

Precisely this Laura. Including an oversupply of 'managers'.

So how come private companies have, on average, three times as many managers for the number of employees?

LauraNorderr

Not all departments are managed well. Take procurement as an example. Shortage of PPE at the outbreak of a major pandemic was a disgrace not all down to government.

Procurement had been outsourced to a quango, operating outside the NHS.

I don’t get the impression that anyone on here thinks that change can happen without managers. There seems to be a feeling from some that there are two many tiers of management.

Too many

Perhaps two too many ?

Toodly toot toot!

icanhandthemback
Re IT connectivity. We can do all these wonderful procedures but I can have an ecg reading done at my surgery where my Dr isn’t happy with the results so sends me to A&E to see someone whereby I’m given another ecg because the hospital can’t connect with my surgery to get the reading that was taken 30 minutes before.
You couldn’t make it up, could you ?

So people are having to go to food banks, having to choose between eating and heating, and now the right wingers want them to conjure up money to pay for health insurance. What next, pay insurance to send their children to school? Just how much has to be taken away before the right wing are satisfied?

growstuff

kittylester

Not so much shortage of funding as mismanaged funding

Precisely this Laura. Including an oversupply of 'managers'.

So how come private companies have, on average, three times as many managers for the number of employees?

Oh, FGS, growstuff. Stop trying to blind people with facts...

Who said all managers needed to be got rid of?

All organisations are different so your experience has no relevance to the NHS.

DH didn't need managing at all in reality. In the early days, there was one manager overseeing all roles similar to his - heaven knows how many there are now. But at least she knew what his job was.

Being overmanaged was one of the reasons dh stopped working, aged 71, and now no one in the county carries out his fairly vital role.

IMO, experience is either a small part of the picture or a small example of how things are wrong.

NO hairdressers, aunts, cousins, neighbours were consulted to acquire this knowledge.

ref OakDryad 11.32.38

Interestingly, one of the criticisms which has been coming out of the Messenger report (and others) is that the NHS is highly regulated from the centre (ie government). Local managers aren't given much freedom to innovate, so essentially become mere administrators, responsible for ensuring their local areas run smoothly. They are so overwhelmed by regulations from government that they have almost no leeway to do anything else, even if they can see that something isn't working for them. Being an EDI Manager is a huge job, with serious repercussions if equality isn't heeded. The standard pay is about £45-50,000, not £90,000, which is at the bottom end for similar jobs in large private companies

kittylester

Who said all managers needed to be got rid of?

All organisations are different so your experience has no relevance to the NHS.

DH didn't need managing at all in reality. In the early days, there was one manager overseeing all roles similar to his - heaven knows how many there are now. But at least she knew what his job was.

Being overmanaged was one of the reasons dh stopped working, aged 71, and now no one in the county carries out his fairly vital role.

IMO, experience is either a small part of the picture or a small example of how things are wrong.

NO hairdressers, aunts, cousins, neighbours were consulted to acquire this knowledge.

Are you serious that he didn't need managing? Should he not have been accountable to someone?

MerylStreep

icanhandthemback
Re IT connectivity. We can do all these wonderful procedures but I can have an ecg reading done at my surgery where my Dr isn’t happy with the results so sends me to A&E to see someone whereby I’m given another ecg because the hospital can’t connect with my surgery to get the reading that was taken 30 minutes before.
You couldn’t make it up, could you ?

That's partly because there isn't the funding to put integrated systems in place.

There isn't even the funding to upgrade the IT in the system. Do you remember when the NHS was hit by a ransom virus a few years ago and it was discovered that a huge number of computers were running on obsolete Windows XP? I wonder if they've ever been upgraded?

MerylStreep

icanhandthemback
Re IT connectivity. We can do all these wonderful procedures but I can have an ecg reading done at my surgery where my Dr isn’t happy with the results so sends me to A&E to see someone whereby I’m given another ecg because the hospital can’t connect with my surgery to get the reading that was taken 30 minutes before.
You couldn’t make it up, could you ?

So who do you think will put the systems in place to ensure that this is possible? Managers? Who do you think will sign off the funding to employ the people and buy the software to make sure it happens? Where will this investment come from? Who will decide whether the changes are good value for money and will result in better outcomes for patients? Managers?

LauraNorderr

I don’t get the impression that anyone on here thinks that change can happen without managers. There seems to be a feeling from some that there are two many tiers of management.

Well, the OP certainly implied there are too many managers by using the word "bloated".

I know many bloated folk, not many are managers. ?

varian

I wonder how much of NHS funding goes to outsourced services, private health care providers and staff agencies?

I don't know, although I've tried to find out a figure in the past. Whatever it is, it's billions. Not only does this mean that cash is siphoned off to shareholders, but it means that change is even more difficult to achieve because the whole service is so fragmented. Once a service has been outsourced, delivery is delegated and it's difficult to change the terms of the contract. The focus changes to delivering at the lowest cost, not whether patients are satisfied with the service provided.

growstuff accountable, yes of course, but managed, no.

The worry is that to bring about change will require yet more managers - heaven help us.